Congress proposes federal insurance plan to compete with private insurers
H.R. 7023 — Affordable CHOICE Act · Filed by Jan Schakowsky (D-IL) · 6 cosponsors · Introduced Jan 12, 2026 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill creates a federal public health insurance option that would be offered through the Affordable Care Act's insurance marketplaces starting in 2027. The plan would offer bronze, silver, and gold coverage tiers, set premiums to cover its own costs, negotiate provider payment rates (defaulting to Medicare rates if negotiations fail), and be administered by the federal government without transferring insurance risk to private contractors. It aims to provide affordable coverage and increase competition in the insurance market.
Why we flagged it
The bill's core mechanism is the establishment and operation of a federal public health insurance plan competing in the ACA marketplace. This is a direct government entry into the insurance market, not a regulatory carve-out or subsidy to private actors.
What the text implies
- Provider participation is largely automatic for Medicare/Medicaid providers unless they opt out, potentially creating sudden enrollment surges and network adequacy challenges if providers do not participate.
- The bill defaults to Medicare fee-for-service rates if negotiation fails, which may be below private-plan rates and could reduce provider willingness to participate, especially in rural or underserved areas.
The full analysis lists 5 implications of this text.
Who stands to gain
uninsured and underinsured individuals (lower-cost coverage option); health care providers accepting Medicare rates (guaranteed payment source)