From Pearland to Friendswood and Manvel, Brazoria County households are getting squeezed by rising health insurance costs. Families buying plans on the ACA marketplace say premiums and deductibles have crept into budget-breaking territory over the past several years. Even public employers and school districts that offer coverage report tougher budget math as employee contributions and overall benefit costs climb.
Marketplace premiums climb fast
Between 2022 and 2026, the average monthly premium for an individual mid-tier ACA Silver plan jumped about 63% in Brazoria County and more than 76% in neighboring Galveston County. Those county-level increases come from CMS plan filings compiled by PlainHealthPlan and PlainHealthPlan, which show Silver plan averages moving from the high $300s into the mid $600s in just four years.
Residents say premiums are pinching household budgets
Pearland resident Violet Solano told Community Impact that she and her husband switched to marketplace coverage after retiring and have watched their bill rise from roughly $500 a month to more than $600. “This past year … everything has just gotten so much more expensive,” she said.
Even with the sticker shock, most residents in these cities are still insured, according to public data. In Pearland, about 93% of people have coverage, and in Friendswood the figure is roughly 94%, according to Data USA and Data USA.
Regulators and employers point to medical cost drivers
State regulators say the culprit is not some behind-the-scenes rate manipulation in Austin but the basic price of health care and how insurers fare financially. “When premiums increase, it’s primarily driven by underlying health care costs and insurer experience, not by the state setting rates,” Texas Department of Insurance spokesperson Mistie Hinote told Community Impact.
Local employers are feeling it too. Friendswood ISD, for example, has reported double-digit percentage increases in employer premiums over the past two years, forcing school officials to juggle insurance costs alongside classroom needs.
Hospital care and prescriptions are major drivers
National data help explain why premiums keep marching upward. The 2025 Milliman Medical Index finds that inpatient facility care costs rose about 167% from 2005 to 2025, while pharmacy spending climbed roughly 234% over the same period. Those increases put steady pressure on both premiums and out-of-pocket costs. Milliman ties the trend to expanded outpatient care, the arrival of new high-cost drugs and more frequent use of expensive therapies.
What lawmakers and regulators are doing
Insurer trade groups and policymakers are chasing a mix of near-term relief and longer-term fixes. The Texas Association of Health Plans has warned that premiums in Texas have risen more than 5% a year for three straight years, a trend it connects to rising hospital and drug prices and an accumulation of new mandates.
On the federal side, protections such as the No Surprises Act are meant to shield patients from out-of-network surprise bills, and the Inflation Reduction Act gave Medicare limited power to negotiate prices for certain high-cost drugs. CMS reports that this negotiation program began producing negotiated prices with initial applicability in 2026 (CMS; CMS).
Local officials say they are watching closely to see whether Congress extends expanded ACA premium tax credits and whether state or federal efforts to rein in drug and hospital costs eventually translate into lower marketplace premiums. Until then, families and school districts in Pearland, Friendswood and Manvel say they are bracing for another tough round of budgeting as 2027 health plan filings start to roll in.
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