About 174,242 of the 735,209 people under 65 in El Paso County had no coverage at all in 2024 — 23.7%, against a Texas average of 19.1%. A gap of 4.6 points is large, and it is the 43rd highest of the 254 counties in Texas. Local uninsured rates this far above a state average almost always trace back to the mix of employers rather than to the plans for sale, which are the same ones sold across the rating area.
El Paso County against Texas, and against the counties we cover
| El Paso County | Texas | Covered counties | |
|---|---|---|---|
| Uninsured, under 65 | 23.7% | 19.1% | 13.0% |
| Marketplace enrollees per 1,000 | 184 | — | 127 |
| Insurers selling here | 7 | 6 (median) | 5 |
| Individual plans offered | 110 | — | 84 |
State uninsured rate from the Census SAHIE series; the final column is the median across the 104 counties covered on this site. Enrollment density is CMS plan selections per 1,000 under-65 residents.
What you can actually buy here
7 insurers sell into El Paso County. This is a crowded market by national standards. Crowded markets are cheaper on average and much harder to shop, because the plan names stop meaning anything by the third carrier and the differences that matter get buried in documents nobody opens. Between them they offer 110 plans, about 16 for each insurer, which is a normal-sized list to work through once you know which network you need. The count is unchanged from last year, so the networks you compared previously still stand.
135,308 marketplace plan selections were recorded in El Paso County for 2026, or 184 per thousand under-65 residents — above the 127 typical of the counties covered here. Enough people locally have done this that the process is not unfamiliar territory. 27,252 of them were new consumers and 108,056 were renewals — a 20% new share, close to the national pattern. Roughly one in six enrollees here arrived within the year.
Nearest counties on coverage
The counties we cover in Texas whose uninsured rate sits closest to El Paso County. Worth a look if you are comparing across a county line or moving.
| County | Uninsured | Insurers | Enrollees |
|---|---|---|---|
| Dallas County | 24.2% | 10 | 452,075 |
| Ector County | 24.4% | 4 | 36,589 |
| Harris County | 22.8% | 9 | 731,300 |
| Webb County | 26.2% | 3 | 51,727 |
| Smith County | 21.0% | 4 | 27,596 |
| Cameron County | 26.6% | 5 | 78,862 |
Everything that applies in Texas · How COBRA works · Work out your COBRA premium · After a job ends
Common questions
How many people are uninsured in El Paso County?
About 174,242 people under 65, out of 735,209 in that age group — 23.7%, the 43rd highest of the 254 counties in Texas. The Texas average is 19.1%. Census Bureau estimates for 2024, the most recent published.
How many health insurers sell in El Paso County?
7 insurers offer individual marketplace plans in El Paso County for 2026, unchanged from the year before, and between them they sell 110 individual medical plans. The median across the counties covered on this site is 5 insurers and 84 plans.
How many people in El Paso County buy marketplace coverage?
135,308 plan selections for 2026 — 27,252 new consumers and 108,056 renewals. That works out at 184 per thousand under-65 residents, against a median of 127 across the counties covered here. New consumers are the group most likely to have lost a job during the year.
Talk it through with a licensed agent
Which option is right depends on your state, your income and which doctors you need to keep. A licensed agent can walk through it with you in about eight minutes.
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Sources
- U.S. Census Bureau, Small Area Health Insurance Estimates, 2024 (released August 2026)
- Centers for Medicare & Medicaid Services, 2026 Marketplace Open Enrollment County-Level Public Use File
- Centers for Medicare & Medicaid Services, 2026 Service Area Public Use File
- Centers for Medicare & Medicaid Services, 2026 Plan Attributes Public Use File
- U.S. Department of Labor, FAQs on COBRA Continuation Health Coverage for Workers