Patient Choice and Access Act of 2026

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9107 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 9107

To amend the Patient Protection and Affordable Care Act to provide that
   qualified health plans are not required to use a provider network.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                              June 2, 2026

 Mr. Rulli (for himself, Mr. Griffith, Mr. Balderson, and Mr. Bean of
   Florida) introduced the following bill; which was referred to the
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

To amend the Patient Protection and Affordable Care Act to provide that
   qualified health plans are not required to use a provider network.

    Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Patient Choice and Access Act of
2026''.

SEC. 2. PROVIDING THAT QUALIFIED HEALTH PLANS ARE NOT REQUIRED TO USE A
              PROVIDER NETWORK.

    (a) In General.--Section 1311(c)(2) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18031(c)(2)) is amended--
            (1) in the paragraph heading, by inserting ``;
        clarification on use of provider networks'' after ``Rule of
        construction'';
            (2) by striking ``Nothing in'' and inserting:
                    ``(A) Rule of construction.--Nothing in''; and
            (3) by adding at the end the following new subparagraph:
                    ``(B) Clarification on use of provider networks.--
                For plan years beginning on or after January 1, 2027,
                the Secretary may not require a plan to maintain a
                provider network in order to meet the criteria
                established under subparagraphs (B) and (C) of
                paragraph (1).''.
    (b) Exchange Certification.--Section 1311(e)(1)(B) of the Patient
Protection and Affordable Care Act (42 U.S.C. 18031(e)(1)(B)) is
amended--
            (1) in clause (ii), by striking ``or'' at the end;
            (2) in clause (iii), by striking the period at the end and
        inserting ``; or''; and
            (3) by adding at the end the following new clause:
                            ``(iv) for plan years beginning on or after
                        January 1, 2027, on the basis that the plan
                        does not maintain a provider network.''.
    (c) Transparency Requirements for Qualified Health Plans Without
Provider Networks.--Section 1311(c)(1) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18031(c)(1)) is amended--
            (1) in subparagraph (H), by striking ``and'' at the end;
            (2) in subparagraph (I), by striking the period at the end
        and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(J) for plan years beginning on or after January
                1, 2027, in the case of a plan that does not maintain a
                provider network--
                            ``(i) provide information in plain language
                        to plan enrollees and potential enrollees with
                        respect to expected out-of-pocket costs and the
                        potential for balance billing; and
                            ``(ii) provide adequate customer service or
                        online provider search assistance resources to
                        assist plan enrollees and potential enrollees
                        in finding providers in their area who will
                        accept the plan's benefit amounts as payment in
                        full for items and services for which benefits
                        are available under the plan.''.
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