Health insurance costs surge in Brazoria County cities

From 2022 to 2026, the average monthly cost for an individual enrolled in a standard mid-tier ACA marketplace plan—known as a silver plan—increased by 63% in Brazoria County and by more than 76% in Galveston County, according to PlainHealthPlan data, which provides an ACA premiums database on county levels.

Officials with the Texas Department of Insurance, or TDI, said multiple factors drive up premium health insurance costs.

“When premiums increase, it’s primarily driven by underlying health care costs and insurer experience, not by the state setting rates,” TDI spokesperson Mistie Hinote said. “Insurers most commonly cite rising medical costs, increased use of health care services and higher prescription drug spending as key drivers of premium increases.”

From 2005 to 2025, inpatient facility care costs have risen by over 166%, according to data from the Milliman Medical Index, a global consulting firm that analyzes health care costs for families in the U.S. covered by employer-sponsored health plans. Other common needs, such as prescriptions, have risen by over 233%, data from Milliman shows.

As health care costs increase, employee contribution rates have risen faster than contribution rates for employers.

For employers such as Friendswood ISD, one of the largest employers in Friendswood, offcials have seen “double-digit percentage increases” in health insurance premiums over the past two years, FISD’s Benefits and Leave Coordinator Callie Rhodes said in an email May 19.

Both FISD and Pearland ISD use the Teacher Retirement System, or TRS, of Texas.

For FISD, officials have “limited flexibility” in controlling employee health insurance costs, Rhodes said.

“Because plan options and base premiums are established through TRS, districts cannot negotiate directly with insurers, and available funding resources must also be carefully considered,” Rhodes said.

Last school year, FISD explored alternatives by going out for bid to evaluate whether opting out of TRS ActiveCare would be more suitable for employees. However, the proposals had “higher costs and less competitive coverage,” Rhodes said.

On a national level, with family coverage, the national average annual health insurance premium cost has risen by over 21%, data from the Kaiser Family Foundation shows.

While a few recent policies were enacted to lower health insurance costs, legislators are seeking additional national measures.

The following bills have recently been enacted:

No Surprises Act

• Protects patients from surprise out-of-network billing
• Status: enacted in 2022; patients should watch for unexpected out-of-network charges after emergency treatment or hospital visits and verify disputed bills with insurers or providers.

• Lets Medicare negotiate prices for select high-cost prescription drugs (starting 2026)
• Status: enacted in 2022; Medicare patients should review prescription bills and pharmacy charges to ensure insulin and annual out-of-pocket costs comply with federal caps.

ACA Premium Tax Credit Extension

• Extends expanded ACA subsidies that lower marketplace premiums
• Status: House has passed extension version, competing bills stalled in Senate

• Extends enhanced ACA premium tax credits temporarily (typically 1-2 years) to prevent sudden premium increases
• Adds income limits or adjustments to target subsidies toward lower- and middle-income enrollees
• Status: stalled in Congress

• Aims to regulate pharmacy benefit managers that negotiate drug prices between insurers, pharmacies and manufacturers
• Status: actively debated in Congress with bipartisan interest