Sponsor
Jon Husted
Senator · R-OH
Senator · R-OH
The bill aims to lower consumer and employer costs and clarify federal rules by banning certain contract clauses and enabling steering to lower‑cost providers, but it shifts bargaining power away from some providers, may harm small/rural networks, and creates transitional compliance burdens for plans and states.
Patients (including those with chronic conditions), employers, and taxpayers may see lower out‑of‑pocket costs and premiums because health plans and employers can steer enrollees to lower‑cost providers and offer incentives while contracts that block lower rates are banned, promoting price competition.
Patients with complex or chronic needs and integrated care providers keep access to value‑based and coordinated care arrangements (ACOs, centers of excellence, certain HMOs), preserving continuity of high‑coordination models.
Group health plans, providers, and state governments gain clearer, unified federal regulatory guidance (PHSA, ERISA, IRC) and a single implementation timetable, making compliance planning more predictable.
Hospitals, provider organizations, and healthcare workers could lose negotiated protections and leverage, likely reducing payment rates and revenue for some providers.
Smaller and rural provider networks that relied on restrictive contracting to secure participation may be disadvantaged, which could reduce local network access for rural communities.
States that relied on existing contracts or grandfathering may face provider disruption and need to renegotiate arrangements if grandfathering is not allowed, imposing local transition costs and service uncertainty.
Based on analysis of 4 sections of legislative text.
Prohibits health plan contract clauses that restrict steering, require affiliate agreements or rates, or block lower rates by other plans; amends PHSA, ERISA, and the IRC.
Official title: Ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care.
Introduced March 9, 2026 by Jon Husted · Last progress March 9, 2026
Prohibits certain contract terms that limit health plans' ability to steer enrollees to lower‑cost or higher‑quality providers or to negotiate different rates. The bill amends the PHSA, ERISA, and the Internal Revenue Code to bar agreements that restrict plan network design, patient steering, enrollee incentives, requirements to contract with affiliates, and clauses that prevent other plans from paying lower rates. It creates limited exceptions, allows states to grandfather older contracts under conditions, requires agencies to issue coordinating regulations within one year, and takes effect for contracts entered, amended, or renewed 18 months after enactment.