Ken Paxton led the 2018 lawsuit that sought to strike down the Affordable Care Act, including the tax credits that lower monthly premiums on the marketplace; the Supreme Court dismissed it in 2021. In July 2025 he praised the One Big Beautiful Bill Act, which removes the caps on what enrollees repay when their income rises, ends automatic re-enrollment with financial help from 2028, and cuts off tax credits for many lawfully present immigrants. In 2024 Texas, under Paxton, was one of 19 states that won a court order blocking DACA recipients from buying marketplace coverage in those states.
On May 26, 2026, Paxton told supporters he was running so Texans would not have to stay up at night worrying about their monthly premium.
Ken Paxton's Lawsuit and Statements on What Texans Pay for Health Insurance
- Paxton Sued in 2018 to End the Affordable Care Act and Its Premium Tax Credits. On February 26, 2018, Ken Paxton filed a 20-state lawsuit to free states "from the stranglehold of Obamacare." Had the suit succeeded, it would have ended the law's marketplace tax credits along with the rest of the law; the Supreme Court dismissed the case in 2021 because the states "lack Article III standing as a matter of law."
- Paxton Joined a 2024 Suit That Cut Texas DACA Recipients Off From Marketplace Coverage. Texas, represented by Attorney General Ken Paxton, was one of the 19 plaintiff states in Kansas v. United States, a suit against the federal rule that let Deferred Action for Childhood Arrivals (DACA) recipients buy Affordable Care Act marketplace coverage. On December 9, 2024, the federal court in North Dakota granted the states' motion, ruling that "Defendants are preliminary enjoined from enforcing the Final Rule against the 19 Plaintiff States." To comply, HealthCare.gov says, "the Marketplace canceled enrollments for 2025 Marketplace coverage selected by DACA recipients" in Texas and the other plaintiff states it serves; Kiplinger reported on December 11, 2024, that the order could affect as many as 87,620 Dreamers in Texas. A separate federal rule then terminated DACA recipients' marketplace eligibility nationwide, effective August 25, 2025, and the court adopted the plaintiff states' voluntary dismissal of the case on December 11, 2025.
- Paxton Praised a Law That Makes Marketplace Enrollees Repay Their Full Excess Tax Credits. Ken Paxton posted on July 1, 2025 that the Senate-passed bill was "One step closer to massive tax cuts," and on July 3, 2025 that "President Trump's Big Beautiful Bill is HISTORIC legislation." Section 71305 of the law he praised removes the caps on repaying excess advance premium tax credits, starting with tax year 2026. Before the law, repayment limits ranged from $375 for a single person with an income that is 100% FPL up to 200% FPL to $3,250 for families with incomes between 300% and 400% of the poverty level, KFF explains; now all premium tax credit recipients repay the full amount of any excess, no matter their income, and the Congressional Budget Office expects the change to increase the number of people who are uninsured by 100,000 in 2034.
- The Law Paxton Praised Ends Automatic Re-Enrollment With Financial Help From 2028. The law Ken Paxton praised requires the marketplace to verify income and other information before paying tax credits, and KFF says this provision effectively ends auto-renewals, starting with tax years after December 31, 2027. Nearly half of Marketplace enrollees in 2025 auto-renewed, and the Congressional Budget Office estimates the change will increase the number of people who are uninsured by 700,000 in 2034.
- The Law Paxton Praised Cuts Off Marketplace Tax Credits for Refugees, Asylees and Other Lawfully Present Immigrants. The law Ken Paxton praised ends premium tax credits for many lawfully present immigrants, including refugees, asylees, and people with Temporary Protected Status, from 2027, and for lawfully present immigrants below the poverty line from 2026. The Congressional Budget Office estimates the first change will increase the number of people who are uninsured by 900,000 in 2034, and the second by another 300,000.
- Paxton Promised Texans Relief From Worrying About Their Monthly Premium After Praising a Law That Raises What Many Will Pay. In his runoff victory speech on May 26, 2026, Ken Paxton said: "I'm running to lower your cost of living, because you deserve to be able to buy a home, afford groceries, and have a high quality of healthcare without being forced to stay up at night, worrying about how you're going to pay your monthly premium." The law he praised in July 2025 makes marketplace enrollees repay their full excess credits, ends automatic re-enrollment with financial help, and leaves 480,000 more Texans uninsured in 2034, by KFF's estimate.
What the Marketplace Changes Ken Paxton Praised Mean for Texas
- Marketplace enrollees. Texas had 3,277,198 people with effectuated marketplace coverage in 2026, down 4% from 2025, all of them subject to the law's full-repayment rule and, from 2028, its end of automatic re-enrollment with financial help.
- Uninsured Texans. KFF projects 1.4 million more uninsured Texans in 2034 from the law together with the expired enhanced credits, 480,000 of them from the law alone.
Frequently Asked Questions About Ken Paxton on Insurance costs
What is Ken Paxton's record on health insurance costs under Trump?
Ken Paxton praised the One Big Beautiful Bill Act in July 2025, a law that makes marketplace enrollees repay their full excess tax credits, ends automatic re-enrollment with financial help from 2028, and cuts off credits for many lawfully present immigrants. Earlier, as Texas attorney general, he led the 2018 suit to strike down the Affordable Care Act and its subsidies. In May 2026 he promised Texans they would not have to worry about their monthly premium.
Will Texans have to pay back health insurance tax credits under the law Ken Paxton praised?
Yes, some will: under the law Ken Paxton praised, starting with tax year 2026 an enrollee whose income ends up higher than estimated must repay the full amount of any excess credit, no matter their income, so the first repayments come with 2027 tax filings. Before the law, KFF notes, most enrollees had a repayment cap that varied based on household income.
Will refugees and asylees in Texas lose help paying for marketplace insurance under the law Ken Paxton praised?
Yes. The law Ken Paxton praised ends premium tax credits for many lawfully present immigrants, including refugees, asylees and people with Temporary Protected Status, for taxable years beginning after December 31, 2026. The Congressional Budget Office expects 900,000 more people to be uninsured in 2034 because of the change.
Did Ken Paxton sue to keep DACA recipients off Obamacare?
Yes. Texas, represented by Attorney General Ken Paxton, was one of the 19 states whose suit led a federal judge to block the rule letting DACA recipients buy marketplace plans, and DACA recipients in those states who had enrolled in 2024 Marketplace coverage "had their Marketplace enrollment terminated" and had no 2025 marketplace coverage. In January 2025 the Marketplace sent them letters saying they were ineligible.
Last updated: 2026-10-25