Patient Choice and Access Act of 2026

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:

Nothing in; and

(3) by adding at the end the following new subparagraph:

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).

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.

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.