H.R. 9107

[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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