Even Obamacare losses are bigger in Texas. So who’s to blame — Washington or ourselves? About 10 million Americans, including 1 million in Texas, get health insurance through the exchanges created by the Affordable Care Act. Those customers, along with the expansion of Medicaid in most states, added $86 billion in annual revenue for insurers nationwide. Unfortunately for them, most of the business has been a money-loser. And Texas’ largest insurer, Blue Cross Blue Shield of Texas, has been hit hard — over twice as hard, in fact.