On February 9, 2026, the US Department of Health and Human Services (HHS) released the proposed Notice of Benefit and Payment Parameters (NBPP) for 2027. Under the proposed rule, non-network plans would be allowed to be certified as Qualified Health Plans (QHPs) and be able to offer Affordable Care Act (ACA) products on the Exchange starting as early as the 2027 plan year, even though they operate outside of a traditional contractual provider network. Functionally, these plans would set a fixed payment amount for each covered service, often as a percentage of Medicare or an average cash price.
To qualify as a QHP, a non-network plan must demonstrate that it offers a sufficient choice of providers who will accept these payment amounts in full, including Essential Community Providers and specialists such as mental health and substance use disorder providers. Enrollees may seek care from any provider willing to participate in the arrangement, but if the provider charges more than the fixed payment amount, the member would be responsible for paying the difference.
HHS positions non-network plans as a means of reducing overall healthcare costs. This proposal introduces considerations for state and federal regulators, operational considerations for plans and providers, and pricing implications for those who participate in the ACA Marketplace today. This paper summarizes these key concepts.
