The Marketplace is a service through the federal government that provides health insurance for those who do not have insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP) or other qualifying insurance plans.
Foundation Communities hosted an event with U.S. Rep. Lloyd Doggett, D-Austin, on Oct. 30 at Foundation Communities Prosper Center to discuss enrolling for ACA health insurance. Austin City Council member José “Chito” Vela, Travis County Judge Andy Brown and representatives from Health Alliance for Austin Musicians (HAAM) were also in attendance.
The details
Health insurance plans through the marketplace are required to hold specific benefits. These include 10 essential health benefits, like prescription drugs, emergency services, hospitalization, mental health, laboratory services and substance misuse services. Marketplace plans also include coverage for preexisting health conditions and free preventative health services, like shots and screening tests.
To receive coverage starting Jan. 1, members must be enrolled by Dec. 15. Coverage for those who enroll by Jan. 15 will receive coverage starting Feb. 1.
Why it matters
Over 4.7 million Texans do not have health insurance, according to the United States Census Bureau. The state also has the highest rate of uninsured people among the rest of the United States, with about 18% of Texans not having insurance coverage. In Travis County, over 148,000 people are uninsured, according to 2022 Census data.
This is the first year recipients of Deferred Action for Childhood Arrivals, or DACA, will be able to enroll in the ACA health insurance marketplace. The change comes after the Biden administration changed ACA regulations in May 2024 to consider DACA recipients as “lawfully present,” making them eligible for federal health care coverage. Prior to the new regulations, DACA recipients were ineligible to apply for federally funded coverage.
There are around 89,000 DACA recipients in Texas as of June 30, according to U.S. Citizenship and Immigration Services.
The ACA open enrollment period will also be important for Austin residents living in lower-income areas, Austin City Council Member José “Chito” Vela said at the Foundation Communities event.
Vela, who represents District 4, said many residents in his district have gone without health insurance and face “significant obstacles” to obtaining coverage. District 4 is also one of the lowest-income areas in the city, he said, making it difficult to get affordable insurance.
“Not only are many people working multiple jobs while taking care of families, but many of them have limited English proficiency or lack reliable internet access,” he said.
Expansion of Medicaid in Texas is also necessary to address the issue of high uninsurance rates, Vela said.
“We're turning down billions in federal dollars every year and forcing over a million Texans to scramble for health insurance coverage that they should have if we would just expand Medicaid,” he said. “It is far past time to do that.”
Getting insurance is also important to the Austin music scene, HAAM member Raul Adrian Ochoa said.
Ochoa, a solo artist and band member, said musicians often face certain occupational hazards. Loading band equipment and exposure to loud noise can lead to health issues, like injured limbs or tinnitus.
“I've thrown my ribs out more times than I can say, because of loading gear in and out of the car,” he said.
Ochoa said it’s important for musicians to be insured to sustain Austin’s love of music.
“We have to keep the music alive,” he said. “Sometimes that involves us being alive.”
Learn more
To enroll in an ACA marketplace plan in Texas, visit www.HealthCare.gov.
Foundation Communities offers bilingual services for those looking for free health insurance consultation.
To learn more about HAAM health care, visit www.myhaam.org.
