After retiring as a receptionist for Friendswood ISD four years ago, Pearland resident Violet Solano and her husband began receiving health insurance through the Affordable Care Act, or ACA, marketplace.
Since making the switch from employer-based insurance, Solano and her husband’s insurance premiums have risen by around $75-$100 each year, she said.
“This past year ... everything has just gotten so much more expensive—gas, groceries, everything,” Solano said. “Going from a $500-something premium each month to now [over] $600, that’s a lot of money after a year, so that definitely made a difference.”
With more than 90% of Pearland, Friendswood and Manvel residents insured, many residents still face the impact of rising premiums, deductibles and out-of-pocket costs. While Solano said her and her husband are stable enough for the increase in costs, she acknowledged many families in the area who are not.
The cause
Health insurance premium costs have risen nationwide—and Pearland, Friendswood and Manvel have been no exception. Residents and employers alike are seeing higher costs each year.
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.
Milliman attributes a large bulk of the increase to higher prescription drug spending, expanded outpatient facility care and the growing use of new medical treatments.
As health care costs increase, employee contribution rates have risen faster than contribution rates for employers.
“[Health insurance] needs to be totally revamped. The difference between not having insurance and having insurance is the bills that you get are different," Pearland resident Shannon Simececk said. "When they realize you get insurance, you get charged more.”
Another viewpoint
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.
Zooming out
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.
Going forward
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.
Inflation Reduction Act
- 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.
The following bills are pending legislation:
ACA Premium Tax Credit Extension
- Extends expanded ACA subsidies that lower marketplace premiums
- Status: House has passed extension version, competing bills stalled in Senate
Fix It Act
- 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
Pharmacy Benefit Manager Reform Bills
- Aims to regulate pharmacy benefit managers that negotiate drug prices between insurers, pharmacies and manufacturers
- Status: actively debated in Congress with bipartisan interest
