Twelve years of data show that the Affordable Care Act’s health insurance marketplace (marketplace) has helped significantly reduce the number of uninsured Texans. State and federal policy changes have helped more people in Texas obtain affordable health insurance coverage in the last four years. In 2025, policymakers have the opportunity to continue helping Texans. This brief discusses the state and federal policy changes that accelerated the growth in Texas enrollment and identifies the risks and opportunities to this trend