Patient Choice and Access Act of 2026

119th Congress Introduced by Troy Balderson and 3 co-sponsors

The bill would remove the obligation for qualified health plans to operate with a provider network.

Introduced in House

Summary of HR 9107 (119th Congress)

Purpose and intent

HR 9107 seeks to amend the Patient Protection and Affordable Care Act (ACA) to clarify or mandate that qualified health plans (QHPs) are not required to use a provider network. In other words, the bill would remove or modify any existing obligation for ACA-compliant health plans to operate with a designated network of healthcare providers.

Key provisions

Amends the ACA to ensure that qualified health plans are not required to establish or maintain a provider network as a condition of being a QHP.

(Details not provided in the summary) The bill may alter the regulatory framework governing provider networks, network adequacy standards, or claims processing related to network participation, but the exact mechanisms are not specified in the information available.

The bill’s language could affect how insurers design plan offerings, potential out-of-network coverage, and cost-sharing structures if networks are not mandated.

Affected parties and entities

Eligible individuals and families enrolled in or seeking enrollment in qualified health plans under the ACA.

Health insurers and issuers offering QHPs through ACA marketplaces or other ACA-compliant channels.

Providers and healthcare systems that participate in or interact with QHP networks.

State insurance regulators and the federal regulatory framework overseeing ACA plans (to the extent the bill preempts or modifies existing network requirements).

Procedural and timeline aspects

Introduced in the House and referred to the Committee on Energy and Commerce on June 2, 2026.

Sponsors (co-sponsors) include Morgan Griffith, Troy Balderson, Michael Rulli, and Aaron Bean.

As of the provided information, no floor action or passage dates are listed; the bill would proceed through committee consideration, potential amendments, and then to the House floor for voting, with possible subsequent steps in the Senate and signature by the President.

Potential implications and considerations

If enacted, insurers could offer QHPs without mandatory provider networks, which might broaden or alter provider access, out-of-network practices, and consumer cost-sharing dynamics.

The change could impact patient access to timely care, negotiation leverage with providers, and overall plan affordability depending on accompanying regulatory and consumer protections.

State regulators may need to adjust licensing, network adequacy guidelines, and consumer disclosures to align with any new federal requirements.

Note: The summary reflects the bill’s stated aim to remove a requirement for QHPs to use a provider network. Specific regulatory text, definitional clarifications, and the scope of any accompanying protections or transition provisions are not provided in the available information.