ACA bill lets insurers drop provider networks, shifts balance-billing risk to patients
H.R. 9107 — Patient Choice and Access Act of 2026 · Filed by Michael Rulli (R-OH) · 3 cosponsors · Introduced Jun 2, 2026 · Referred to committee
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What it does
This bill amends the Affordable Care Act to allow health insurance plans sold on the ACA marketplace to operate without maintaining a contracted provider network, effective January 1, 2027. Plans choosing this model must disclose expected out-of-pocket costs, balance-billing risks, and provide customer service tools to help enrollees find providers willing to accept the plan's payment rates.
Why we flagged it
The bill removes a structural requirement (provider networks) that has been central to ACA plan design since 2010, shifting risk and administrative burden from insurers to consumers. While framed as 'choice,' the operative effect is deregulation of plan design standards.
What the text implies
- Balance-billing exposure increases sharply: without contracted rates, consumers become liable for the gap between plan payment and provider charges, with only weak disclosure requirements to warn them in advance.
- Transparency requirements are performative: 'adequate customer service' and 'online provider search assistance' are undefined and unenforceable standards; no penalty for inadequate disclosure or failed searches.
The full analysis lists 5 implications of this text.
Who stands to gain
health insurance companies (reduced network administration and contracted-rate obligations); providers with strong negotiating positions (can demand higher rates from unnetworked plans)