Patient Choice and Access Act of 2026
HB9107, the Patient Choice and Access Act of 2026, would amend the Affordable Care Act to make clear that qualified health plans are not required to maintain a provider network beginning with plan years on or after January 1, 2027. The bill changes ACA exchange certification rules so that a plan cannot be denied certification solely because it does not use a network, and it clarifies that the Secretary of Health and Human Services may not require a provider network as a condition of meeting certain ACA exchange standards.
The bill also adds consumer-protection requirements for plans without networks. These plans would have to provide plain-language information about expected out-of-pocket costs and the possibility of balance billing, and they would need to offer adequate customer service or online search tools to help enrollees find providers in their area who will accept the plan’s benefit amounts as payment in full. In effect, the bill would expand the design options available to ACA marketplace plans while imposing disclosure and assistance obligations for non-network coverage.
If enacted, the bill would amend sections 1311(c)(1), 1311(c)(2), and 1311(e)(1)(B) of the Patient Protection and Affordable Care Act. It would remove any federal requirement that a qualified health plan maintain a provider network for ACA exchange participation, while preserving transparency obligations for plans that operate without networks. The main affected parties would be ACA marketplace insurers, exchange administrators, HHS, and consumers purchasing individual and family coverage through the exchanges.
The available record shows no committee transcript, vote tally, or recorded floor debate, so there is no documented opposition or support beyond the bill’s introduction and referral. Based on the bill’s title and structure, the measure appears to be framed as a patient-choice and access proposal, suggesting a pro-consumer and pro-market orientation. The absence of votes or hearing testimony means the overall sentiment cannot be measured from the provided materials.
The central policy issue is whether ACA marketplace plans should be allowed to operate without provider networks. Supporters are likely to argue that removing the network requirement could increase consumer choice and plan flexibility, especially if paired with clearer cost disclosures. Potential critics would likely focus on the risks of out-of-network care, balance billing, and consumer confusion, and may question whether plans without networks can provide meaningful access to care at predictable costs. The bill addresses some of those concerns through disclosure and provider-search assistance requirements, but the adequacy of those protections would likely be a point of debate.