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  "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx.jsonld",
  "@type": "schema:Dataset",
  "name": "Atlas Commons research objects — ACA marketplace coverage for Texas (2026)",
  "description": "Texas's ACA marketplace coverage from the CMS ACA Plan Attributes PUF, with each figure's epistemic status labeled: every plan count — medical plans, standalone dental plans, and breakdowns by metal level, plan type, HSA-eligibility, and referral requirement — is a measured census of plans offered (counts of rows in the CMS file, all labeled RECORDED); the sticker premium landscape by metal tier (40yo, pre-subsidy) is a recorded set of published CMS Rate PUF rates, with the subsidy note labeled CONTEXT; the boundary note is context (labeled CONTEXT) — these count plans offered and their sticker price, not enrollment, the insured rate, or net cost after subsidies. Sources: CMS ACA Plan Attributes PUF, CMS Marketplace Rate PUF. CC0.",
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  "about": {
    "@type": "schema:Place",
    "name": "Texas",
    "identifier": "TX"
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  "claims": [
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/medical-plan-count",
      "@type": "schema:Claim",
      "name": "4,183 ACA medical marketplace plans are offered in Texas for plan year 2026",
      "text": "The CMS ACA Plan Attributes PUF records 4,183 on-marketplace medical plans from 18 issuers offered in Texas for the 2026 plan year. A census of offered plans.",
      "claimType": "official_fact",
      "reviewStatus": "current",
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      "epistemicStatus": {
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        "value": "4,183 plans / 18 issuers",
        "adjudicator": {
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      "falsifier": "A RECORD of measured/reported events (occurred=true) from CMS ACA Plan Attributes PUF (2026 plan year); superseded when CMS ACA Plan Attributes PUF (2026 plan year) publishes its next release."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/metal-distribution",
      "@type": "schema:Claim",
      "name": "Medical plan counts by CMS metal level in Texas (2026): Silver 2,119, Gold 1,106, Expanded Bronze 728, Bronze 172",
      "text": "Counts of the 4,183 medical plans by CMS-defined metal level: Silver 2,119, Gold 1,106, Expanded Bronze 728, Bronze 172, Catastrophic 58. The metal levels are CMS categories; this is a count of PUF rows per category.",
      "claimType": "official_fact",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": true,
        "supported": true,
        "adjudged": true,
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      },
      "grounding": {
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        "source": "CMS ACA Plan Attributes PUF (2026 plan year)",
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        "value": "Silver 2,119, Gold 1,106, Expanded Bronze 728, Bronze 172, Catastrophic 58",
        "adjudicator": {
          "name": "CMS ACA Plan Attributes PUF (2026 plan year)",
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      },
      "falsifier": "A RECORD of measured/reported events (occurred=true) from CMS ACA Plan Attributes PUF (2026 plan year); superseded when CMS ACA Plan Attributes PUF (2026 plan year) publishes its next release."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/plan-type-distribution",
      "@type": "schema:Claim",
      "name": "Medical plan counts by CMS plan type in Texas (2026): HMO 2,755, POS 1,260, EPO 168",
      "text": "Counts of the 4,183 medical plans by CMS-defined plan type (HMO/PPO/EPO/POS): HMO 2,755, POS 1,260, EPO 168. A count of PUF rows per CMS category.",
      "claimType": "official_fact",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": true,
        "supported": true,
        "adjudged": true,
        "operative": true
      },
      "grounding": {
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        "source": "CMS ACA Plan Attributes PUF (2026 plan year)",
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        "value": "HMO 2,755, POS 1,260, EPO 168",
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      "falsifier": "A RECORD of measured/reported events (occurred=true) from CMS ACA Plan Attributes PUF (2026 plan year); superseded when CMS ACA Plan Attributes PUF (2026 plan year) publishes its next release."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/hsa-eligible",
      "@type": "schema:Claim",
      "name": "958 of 4,183 medical plans in Texas are HSA-eligible (2026)",
      "text": "The PUF flags 958 of the 4,183 medical plans as HSA-eligible — a count of plans carrying the CMS HSA-eligibility attribute.",
      "claimType": "official_fact",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
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        "supported": true,
        "adjudged": true,
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        "value": "958 HSA-eligible",
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          "name": "CMS ACA Plan Attributes PUF (2026 plan year)",
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      "falsifier": "A RECORD of measured/reported events (occurred=true) from CMS ACA Plan Attributes PUF (2026 plan year); superseded when CMS ACA Plan Attributes PUF (2026 plan year) publishes its next release."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/no-referral",
      "@type": "schema:Claim",
      "name": "678 of 4,183 medical plans in Texas require no specialist referral (2026)",
      "text": "The PUF flags 678 of the 4,183 medical plans as not requiring a referral to see a specialist — a count of plans carrying the CMS no-referral attribute.",
      "claimType": "official_fact",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
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        "supported": true,
        "adjudged": true,
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      },
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        "value": "678 no-referral",
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    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/dental-plan-count",
      "@type": "schema:Claim",
      "name": "94 standalone dental plans are offered in Texas for plan year 2026",
      "text": "The PUF records 94 standalone dental plans from 15 issuers offered in Texas for the 2026 plan year.",
      "claimType": "official_fact",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": true,
        "supported": true,
        "adjudged": true,
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      },
      "grounding": {
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        "source": "CMS ACA Plan Attributes PUF (2026 plan year)",
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        "value": "94 dental plans / 15 issuers",
        "adjudicator": {
          "name": "CMS ACA Plan Attributes PUF (2026 plan year)",
          "url": "https://www.cms.gov/marketplace/resources/data/public-use-files"
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      },
      "falsifier": "A RECORD of measured/reported events (occurred=true) from CMS ACA Plan Attributes PUF (2026 plan year); superseded when CMS ACA Plan Attributes PUF (2026 plan year) publishes its next release."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/premium-landscape",
      "@type": "schema:Claim",
      "name": "STICKER ACA premiums in Texas for a 40-year-old (before tax credits): Silver median $762/mo",
      "text": "Per-metal-tier MEDIAN and range of full (pre-subsidy) monthly premiums for a 40-year-old, individual, non-tobacco, across Texas's 27 rating area(s): Catastrophic $452 ($320–$630), Bronze $496 ($352–$973), Silver $762 ($540–$1,409), Gold $663 ($467–$1,231). The per-plan rates are RECORDED in the CMS Marketplace Rate PUF; these per-tier median/min/max figures are DERIVED — the atlas's own aggregation over 834 Rate-PUF rate rows (CMS does not publish a state×tier median). The FULL sticker price — most marketplace enrollees pay less after income-based premium tax credits; this is not net cost.",
      "claimType": "derived_measure",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": false,
        "supported": true,
        "adjudged": false,
        "operative": true
      },
      "grounding": {
        "groundingType": "DerivedMeasure",
        "source": "CMS Marketplace Rate Public Use File (atlas-aggregated per tier)",
        "sourceUrl": "https://www.cms.gov/marketplace/resources/data/public-use-files",
        "value": "Silver median $762/mo (40yo, sticker)",
        "adjudicator": null
      },
      "falsifier": "occurred=FALSE (a computed summary, not a single published figure) and adjudged=FALSE (the atlas's aggregation, not a CMS-published statistic). Reproduce it: take the median/min/max of the 834 CMS Rate-PUF rows for a 40yo non-tobacco enrollee per metal tier across the rating areas. Falsified if the per-row rates or the aggregation are wrong; it is sticker (pre-subsidy), so it overstates what a subsidized enrollee pays."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/premium-subsidy-boundary",
      "@type": "schema:Claim",
      "name": "What the Texas premiums mean — sticker, not your price",
      "text": "The premiums above are FULL pre-subsidy stickers. The Affordable Care Act caps a household's benchmark-Silver premium at a share of income via an advance premium tax credit, which can be applied to any tier — so a subsidized lower-income enrollee can pay far less, sometimes near $0. The sticker tells you how plans compare and the unsubsidized cost, NOT what you will pay. Net cost depends on your income and the prevailing tax-credit rules; we do not compute it. Get your actual price at HealthCare.gov.",
      "claimType": "interpretation",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": false,
        "supported": true,
        "adjudged": false,
        "operative": true
      },
      "grounding": {
        "groundingType": "Interpretation",
        "source": "Coverage Atlas framing (over the CMS Rate PUF figures above)",
        "sourceUrl": "https://coverage-atlas.ryanjhunter.workers.dev/",
        "value": "sticker premiums; net cost depends on income-based tax credits — use HealthCare.gov",
        "adjudicator": null
      },
      "falsifier": "occurred=FALSE (a framing, not an event) and adjudged=FALSE (the atlas's reading, not a CMS verdict). The sticker premiums above are CMS Rate PUF records (recorded); this subsidy note is interpretation."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/states/tx/boundary",
      "@type": "schema:Claim",
      "name": "What these coverage figures are — and are NOT — for Texas (the epistemic boundary)",
      "text": "The plan counts above are a COUNT OF PLANS OFFERED on the ACA marketplace for plan year 2026 (a CMS PUF census); the premiums are FULL sticker rates for a 40-year-old. They are NOT enrollment counts, the insured/uninsured rate, NET cost after subsidies, or who actually has coverage. For your net premium use HealthCare.gov / your state marketplace; for the insured rate use the Census ACS / KFF. This object describes what is OFFERED and its sticker price, not who is COVERED or what they pay.",
      "claimType": "interpretation",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": false,
        "supported": true,
        "adjudged": false,
        "operative": true
      },
      "grounding": {
        "groundingType": "Interpretation",
        "source": "Coverage Atlas framing (over the CMS facts above)",
        "sourceUrl": "https://coverage-atlas.ryanjhunter.workers.dev/",
        "value": "counts of plans offered + sticker premiums; not enrollment, insured-rate, or net cost",
        "adjudicator": null
      },
      "falsifier": "occurred=FALSE (a framing, not an event) and adjudged=FALSE (the atlas's reading, not a CMS verdict) — the LOWEST-warrant claim here. The plan counts and sticker premiums above are direct CMS records; this is interpretation, and the four-status says so."
    }
  ],
  "hasPart": [
    {
      "@type": "schema:ItemList",
      "name": "Texas — every coverage indicator (typed)",
      "numberOfItems": 11,
      "itemListElement": [
        {
          "@type": "schema:ListItem",
          "position": 1,
          "item": {
            "indicator": "Medical plans offered",
            "value": 4183,
            "warrant": "RECORDED",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 2,
          "item": {
            "indicator": "Medical issuers",
            "value": 18,
            "warrant": "RECORDED",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 3,
          "item": {
            "indicator": "HSA-eligible medical plans",
            "value": 958,
            "warrant": "RECORDED",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 4,
          "item": {
            "indicator": "Medical plans requiring no specialist referral",
            "value": 678,
            "warrant": "RECORDED",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 5,
          "item": {
            "indicator": "Standalone dental plans offered",
            "value": 94,
            "warrant": "RECORDED",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 6,
          "item": {
            "indicator": "Standalone dental issuers",
            "value": 15,
            "warrant": "RECORDED",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 7,
          "item": {
            "indicator": "Distinct issuers (medical + dental)",
            "value": 32,
            "warrant": "RECORDED",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 8,
          "item": {
            "indicator": "Plan year",
            "value": 2026,
            "warrant": "—",
            "source": "CMS ACA Plan Attributes PUF (2026)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 9,
          "item": {
            "indicator": "Silver median sticker premium (USD/mo)",
            "value": 762,
            "warrant": "DERIVED",
            "source": "CMS Marketplace Rate Public Use File (40-year-old, individual, non-tobacco)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 10,
          "item": {
            "indicator": "Rating areas (premium aggregate)",
            "value": 27,
            "warrant": "RECORDED",
            "source": "CMS Marketplace Rate Public Use File (40-year-old, individual, non-tobacco)"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 11,
          "item": {
            "indicator": "Rate-PUF rate rows summarized",
            "value": 834,
            "warrant": "RECORDED",
            "source": "CMS Marketplace Rate Public Use File (40-year-old, individual, non-tobacco)"
          }
        }
      ]
    },
    {
      "@type": "schema:ItemList",
      "name": "Texas — medical plans by CMS metal level (RECORDED)",
      "numberOfItems": 5,
      "itemListElement": [
        {
          "@type": "schema:ListItem",
          "position": 1,
          "item": {
            "metal_level": "Silver",
            "plan_count": 2119
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 2,
          "item": {
            "metal_level": "Gold",
            "plan_count": 1106
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 3,
          "item": {
            "metal_level": "Expanded Bronze",
            "plan_count": 728
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 4,
          "item": {
            "metal_level": "Bronze",
            "plan_count": 172
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 5,
          "item": {
            "metal_level": "Catastrophic",
            "plan_count": 58
          }
        }
      ]
    },
    {
      "@type": "schema:ItemList",
      "name": "Texas — medical plans by CMS plan type (RECORDED)",
      "numberOfItems": 3,
      "itemListElement": [
        {
          "@type": "schema:ListItem",
          "position": 1,
          "item": {
            "plan_type": "HMO",
            "plan_count": 2755
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 2,
          "item": {
            "plan_type": "POS",
            "plan_count": 1260
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 3,
          "item": {
            "plan_type": "EPO",
            "plan_count": 168
          }
        }
      ]
    },
    {
      "@type": "schema:ItemList",
      "name": "Texas — medical plans by market coverage (RECORDED)",
      "numberOfItems": 2,
      "itemListElement": [
        {
          "@type": "schema:ListItem",
          "position": 1,
          "item": {
            "market_coverage": "Individual",
            "plan_count": 4272
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 2,
          "item": {
            "market_coverage": "SHOP (Small Group)",
            "plan_count": 5
          }
        }
      ]
    },
    {
      "@type": "schema:ItemList",
      "name": "Texas — sticker ACA premiums by metal tier (40yo, pre-subsidy, DERIVED)",
      "numberOfItems": 4,
      "itemListElement": [
        {
          "@type": "schema:ListItem",
          "position": 1,
          "item": {
            "tier": "Catastrophic",
            "plans": 49,
            "median_usd": 452,
            "p25_usd": 426,
            "p75_usd": 533,
            "min_usd": 320,
            "max_usd": 630
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 2,
          "item": {
            "tier": "Bronze",
            "plans": 599,
            "median_usd": 496,
            "p25_usd": 462,
            "p75_usd": 554,
            "min_usd": 352,
            "max_usd": 973
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 3,
          "item": {
            "tier": "Silver",
            "plans": 818,
            "median_usd": 762,
            "p25_usd": 709,
            "p75_usd": 844,
            "min_usd": 540,
            "max_usd": 1409
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 4,
          "item": {
            "tier": "Gold",
            "plans": 797,
            "median_usd": 663,
            "p25_usd": 620,
            "p75_usd": 739,
            "min_usd": 467,
            "max_usd": 1231
          }
        }
      ]
    },
    {
      "@type": "schema:ItemList",
      "name": "Texas — issuers present on the marketplace (RECORDED)",
      "numberOfItems": 27,
      "itemListElement": [
        {
          "@type": "schema:ListItem",
          "position": 1,
          "item": {
            "issuer": "Ambetter from Superior HealthPlan"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 2,
          "item": {
            "issuer": "BEST Life"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 3,
          "item": {
            "issuer": "Baylor Scott and White Health Plan"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 4,
          "item": {
            "issuer": "Blue Cross and Blue Shield of Texas"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 5,
          "item": {
            "issuer": "CHRISTUS Health Plan"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 6,
          "item": {
            "issuer": "Cigna Healthcare"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 7,
          "item": {
            "issuer": "Community First"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 8,
          "item": {
            "issuer": "Community Health Choice"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 9,
          "item": {
            "issuer": "Delta Dental PPO"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 10,
          "item": {
            "issuer": "DeltaCare USA"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 11,
          "item": {
            "issuer": "DentaQuest USA Insurance Company, Inc."
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 12,
          "item": {
            "issuer": "Dominion National"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 13,
          "item": {
            "issuer": "EMI Health"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 14,
          "item": {
            "issuer": "Guardian"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 15,
          "item": {
            "issuer": "Harbor Health"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 16,
          "item": {
            "issuer": "Humana"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 17,
          "item": {
            "issuer": "Imperial Insurance Companies, Inc."
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 18,
          "item": {
            "issuer": "MetLife"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 19,
          "item": {
            "issuer": "Moda Health Plan, Inc."
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 20,
          "item": {
            "issuer": "Molina Healthcare"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 21,
          "item": {
            "issuer": "Oscar Insurance Company"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 22,
          "item": {
            "issuer": "Renaissance Dental"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 23,
          "item": {
            "issuer": "Sendero Health Plans, Local Nonprofit"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 24,
          "item": {
            "issuer": "Solstice Healthplans of Texas, Inc."
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 25,
          "item": {
            "issuer": "TRUASSURE INSURANCE COMPANY"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 26,
          "item": {
            "issuer": "UnitedHealthcare"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 27,
          "item": {
            "issuer": "WellPoint"
          }
        }
      ]
    }
  ]
}