Insurers can no longer drop your doctor or medication mid-year without letting you switch plans

What it does

This bill prevents Medicare Advantage and individual health insurance plans from suddenly dropping doctors or medications mid-year without giving patients a way out. If a patient has seen a doctor in the past 2 years and that doctor was in-network when they enrolled, the plan cannot drop that doctor without triggering a special enrollment period allowing the patient to switch plans. Similarly, if a plan removes a medication the patient is currently taking from its formulary, the patient gets a special enrollment window to find different coverage.

Why we flagged it

The bill's core function is to restrict insurers' ability to make adverse mid-year changes to networks and formularies without patient recourse. It is fundamentally a consumer protection measure that constrains insurer discretion and expands patient choice.

What the text implies

• Plans may respond by narrowing networks or formularies at the annual enrollment period (before the 2-year lookback applies), shifting adverse changes to times when patients have less recourse.
• The 2-year in-person/telehealth visit requirement may disadvantage patients with chronic conditions managed primarily via mail or phone, or those with infrequent care needs.
• Special enrollment periods triggered by formulary changes could increase plan-switching churn, raising administrative costs that may be passed to remaining enrollees.
• Insurers may increase premiums or reduce plan generosity at renewal to offset the cost of retaining providers and drugs mid-year, creating a hidden cost shift to the broader pool.

Who it affects

Ordinary patients gain meaningful protections against sudden loss of access to their doctors and medications mid-year, reducing medical disruption and out-of-pocket costs. The bill creates enforceable escape routes when plans make adverse changes, shifting power back toward patients and away from insurers' unilateral mid-year decisions.

Who stands to gain

• patients with chronic conditions requiring stable medication access
• patients with established provider relationships
• healthcare providers (reduced mid-year patient loss)

Named in the bill

Medicare Advantage plans, MA-PD plans (Medicare Advantage Prescription Drug), Part D prescription drug plans, individual health insurance issuers, Health Insurance Exchanges, Social Security Act Section 1851, Social Security Act Section 1860D-1, Public Health Service Act Section 2702, Patient Protection and Affordable Care Act Section 1311, FDA (Federal Food, Drug, and Cosmetic Act Section 505), Code of Federal Regulations 42 CFR 423.100

Where it stands

1 cosponsor: 1 Republicans.

• Jun 24, 2026 — Introduced · Congress.gov: “Introduced in Senate”
• Jun 24, 2026 — Referred to Senate Committee on Health, Education, Labor, and Pensions · Congress.gov: “Read twice and referred to the Committee on Health, Education, Labor, and Pensions”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.