Healthcare Is on the Line: How ACA Funding Cuts Will Affect North Texas

Healthcare is on the line, and our community will feel the impact.

Across Texas, more than 4 million people enrolled in ACA health coverage last year. Without Medicaid expansion in Texas, the ACA has been a safety net for thousands of people we serve. By 2026, that support may disappear.

This is part of a nationwide set of cuts that could take away affordable health coverage from millions of people, raise the amount of care hospitals have to give without payment, and put heavy strain on community health providers across the country. Many patients who rely on tax credits to afford coverage may face the difficult choice between paying their health insurance premium or buying groceries.

Additionally, Prism Health North Texas (PHNTX) is due to lose it’s ACA grant funding by the end of August. Starting September 1, our patients could have a very different experience in accessing the care they need, without your help.

What the ACA Grant Has Provided

For years, our ACA grant has underwritten certified navigators who help uninsured and underinsured patients understand their health insurance options, apply for coverage, and keep that coverage. This funding ends August 31, and the loss will be felt quickly.

Ismael Cruz, Director of ACA Navigation, leads a team that helps patients find the right plan. “With our help,” Ismael says, “patients can get the coverage they need to stay healthy and financially secure.” His team offers free, unbiased help and often overcomes language and literacy barriers.

Phil Matthews, Director of Financial Navigation, and his team make sure patients understand payment options before they arrive for care. His team verifies insurance, checks eligibility for our sliding fee scale or Ryan White funding, and connects patients to programs that help cover medication, birth control, and women’s health. “Yes, we’re able to get you through the doors,” Phil’s team members often tell patients. “We’re able to get you taken care of at a very reasonable rate.”

What Will Change on September 1

When the ACA grant ends, Ismael’s team will go from eight full-time navigators to only two part-time team members. “New patients that are unfamiliar with the system will have nowhere to turn for trusted, personalized guidance,” Ismael says. “People will miss enrollment deadlines and they will ultimately lose access to the care that they need. When the ACA grant goes away, the confusion crisis will be dire.”

Last year, ACA navigators found 645 patients new providers, helped 23,441 people better understand their health insurance, and answered 44,731 general questions about health insurance. When coverage is lost, many will turn to the emergency room as their only option.

Phil’s financial navigators are not funded by the ACA grant, but they will soon have considerably more work to do.

“When people lose their insurance, they lose access to their medications as well,” Phil says. “It could be very disruptive.” Both directors expect a large increase in calls in 2026 from people who did not know their coverage ended and do not know what to do. With our ACA funding ending August 31, we have a sizeable gap to fill in training representatives to answer their questions.

This Change Will Impact Our Whole Community

The ACA grant has been more than just funding. Navigators walk patients through every step of the enrollment process. “Patients can get the coverage they need to stay healthy and financially secure,” says Ismael. Without that help, many will go without coverage at all.

The loss of ACA coverage will be costly for everyone, not just PHNTX as an organization or our patients, but for our whole community:

Step 1: Without navigators, more people will lose coverage which will lead to people to avoid seeing their doctor to avoid paying the costs.

Step 2: Patients without insurance often seek help only when conditions become severe, which leads them to emergency room care.

Step 3: ER visits are much more expensive than preventive or primary care, making overall healthcare costs even more expensive for patients.

Step 4: Patients can’t afford to pay their hospital bills, so hospitals have to find a way to offset that loss. This can lead to higher costs for insured patients and strain local health systems.

Step 5: Community health suffers when untreated sicknesses spread, long-lasting conditions like asthma and diabetes worsen, and more people miss work and school.

Preventive care through insurance helps cut down costs, and health insurance navigation ensures people can access the right care at the right time, reducing overall system costs.

PHNTX Will Never Turn You Away

“While the loss of funding will present real challenges, we are doing everything we can to minimize the disruption in care,” says Ismael. “We remain committed to ensuring that no patient is left behind during this transition.”

PHNTX will keep providing care through our sliding fee scale, work with community groups to help patients get medical care, housing, and food, and guide them to programs that can make a real difference in their lives.

“People will lose access to their traditional way of accessing care, and they will have to apply for other-funded sources,” Phil says. “When they come to us, we will advise them to the programs that they are eligible for.”

If you have questions about your health insurance coverage or the Health Insurance Marketplace, our ACA navigators and Financial Coordinators can help. Call us at 214-910-5065 to speak with a trained representative. We want you to understand your options and avoid losing coverage.

How You Can Help

We have worked hard to remove cost barriers so everyone can get the care they need. Now we are facing a new one. Your support today can help fill this gap. It keeps care accessible even when the system falls short. When people cannot get care, North Texas will feel the impact, from crowded emergency rooms to missed school and work.

You can make sure no one has to choose between staying healthy and putting food on the table.