On February 11, 2026, the Trump administration published the proposed 2027 Notice of Benefit and Payment Parameters, the annual rule governing coverage under the Affordable Care Act (ACA). One proposal in the rule would permit Marketplace participation by plans that do not maintain a network of contracted providers who agree to accept the plan’s payment amounts. Instead, non-network plans would determine what they pay for services; if a provider wished to be paid more than that amount, the patient would be financially responsible for paying the balance. As proposed, non-network plans would violate minimum requirements of the ACA, harm consumers, and significantly destabilize the ACA Marketplaces, leaving consumers with fewer and more expensive coverage options.