Health insurance in Jefferson County, Texas
6 insurers sell 91 marketplace plans here, and 20.3% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
Who sells here, and how much choice that gives
6 insurers compete in Jefferson County with 91 plans between them, about 15 plans each. The number has not changed since the previous plan year.
One in six has no coverage
20.3% of Jefferson County's 194,962 under-65 residents have no health coverage — 39,578 people. That is close to the Texas rate of 19.1%, and puts Jefferson County in the top 10% of the 1,817 counties on this site (116th).
Some of those 39,578 are in the Texas coverage gap: under $15,960 a year, too little for a subsidy and no expanded Medicaid to fall back on.
The marketplace is used heavily here
29,547 Jefferson County residents selected a marketplace plan for 2026: 152 per thousand under-65 residents, 334th of 1,817. That is 1.9× the 78 per thousand typical here. 3,826 of them — 13% — were new rather than renewing.
Jefferson County against Texas
Jefferson County is the 25th largest of the 43 Texas counties we publish. Its uninsured rate runs 1.2 points higher than Texas overall and its 6 insurers sit between the state's 1 and 10. Marketplace use is close to the Texas rate.
| Jefferson County | Texas | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 20.3% | 19.1% | 9.9% |
| Insurers selling | 6 | 1–10 | 4 |
| Plans offered | 91 | — | 57 |
| Selections per 1,000 | 152 | 159 | 78 |
| New rather than renewing | 13% | 18% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Smith County | 198,975 | 21.0% | 4 | 61 |
| Ellis County | 199,216 | 16.1% | 8 | 119 |
| Brazos County | 200,739 | 17.3% | 4 | 55 |
| Johnson County | 178,018 | 19.6% | 6 | 86 |
Ellis County has 8 insurers against this county's 6 — a reminder that the county line, not the state line, is what decides your options.
Other Texas counties · Where the subsidy stops · Enrollment dates