H.R. 9107

119 HR 9107 IH: Patient Choice and Access Act of 2026
 U.S. House of Representatives
 2026-06-02
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 I  119th CONGRESS  2d Session  H. R. 9107  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.
1.
Short title
This Act may be cited as the   Patient Choice and Access Act of 2026  .
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.
 .