WeVote
Log In

Bill

Bill

S 2059

Establishes special enrollment period for individual health plan enrollees and dependents when health care providers become out-of-network.

2026-2027 Regular Session Introduced by Vince Polistina and 1 co-sponsor

Creates a special enrollment period allowing health plan members to switch plans when their providers become out-of-network, protecting care continuity outside standard enrollment windows.

Introduced in the Senate, Referred to Senate Commerce Committee
0
WeVote Research Nonpartisan
Bill Summary · S 2059

Legislative bill overview

S 2059 creates a special enrollment period allowing individuals and their dependents to switch health insurance plans without waiting for the standard annual enrollment window when their healthcare providers unexpectedly lose in-network status. This addresses situations where patients' doctors or hospitals become out-of-network mid-year, potentially forcing them to either switch providers or pay higher out-of-network costs.

Why is this important

Unexpected provider network changes can disrupt patient care continuity and create financial hardship. Currently, people are generally locked into their plans until the next annual enrollment period, sometimes forcing them to absorb higher costs or abandon established healthcare relationships. This bill aims to reduce these disruptions and protect consumers from sudden, involuntary changes to their coverage.

Potential points of contention

  • Insurance industry costs: Allowing mid-year switches could increase administrative costs and enrollment volatility for insurers, potentially leading to higher premiums for all members
  • Definition and triggers: The bill's effectiveness depends on clear definitions of what constitutes a qualifying "out-of-network" event and whether routine network adjustments qualify
  • Implementation challenges: Coordination with federal regulations (ACA rules already allow some special enrollment periods) and determining if this creates conflicts or duplicates existing protections

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.