Sponsors
The bill strengthens plans' ability to steer patients and increase network competition to lower costs for enrollees and taxpayers, but imposes transition disruptions on coordinated provider organizations and administrative/compliance costs on states and plans.
Patients with chronic conditions and other enrollees: health plans can steer members to lower‑cost or higher‑quality providers and offer incentives that reduce out‑of‑pocket spending.
Taxpayers and plan enrollees: increases competition among provider networks by blocking contractual clauses that prevent third parties from negotiating lower rates, which may lower premiums or provider prices over time.
Hospitals, integrated HMOs, ACOs, and healthcare workers: disruption to existing contracting and coordinated care models could raise administrative transition costs and complicate care delivery during adjustment.
State governments and group health plans: will face compliance and contract‑renegotiation costs and regulators must issue implementing rules within one year, creating administrative and budgetary burdens.
Based on analysis of 4 sections of legislative text.
Prohibits plans and issuers from contractually accepting provider clauses that block steering, enrollee incentives, affiliate payment terms, or lower third‑party rates, with narrow exceptions and a state grandfather option.
Prohibits group health plans and health insurance issuers from agreeing with certain health system or provider entities to restrict plans or issuers from steering enrollees, offering enrollee incentives, or accepting lower third‑party rates. The changes amend three federal statutes, include narrow exceptions for some HMOs and value‑based arrangements, allow states to grandfather certain older contracts for up to 10 years, and take effect for contracts entered into, amended, or renewed 18 months after enactment, with implementing regulations required within 1 year.
Introduced March 9, 2026 by Jon Husted · Last progress March 9, 2026