United States HR 9798: To amend the Employee Retirement Income Security Act of 1974 and the Public Health Service Act to exempt certain employer-sponsored group health plans governed by ERISA from the Affordable Care Act's Essential Health Benefits requirements, and for other purposes.

Summary

This bill allows employer-sponsored health plans governed by ERISA to opt out of providing the Affordable Care Act's Essential Health Benefits, which include coverage for hospitalization, prescription drugs, preventive care, and other core services. The bill affects employees who receive health insurance through their employers, potentially allowing companies to offer more limited health plans while still requiring employers to disclose which benefits are not covered and comply with other federal health requirements like mental health parity and nondiscrimination rules. The exemption would take effect starting in 2028.

Bill Text

I 
119THCONGRESS 
2
DSESSION 
H. R. 9798 
To  amend  the  Employee  Retirement  Income  Security  Act  of  1974  and  the  
Public  Health  Service  Act  to  exempt  certain  employer-sponsored  group  
health  plans  governed  by  ERISA  from  the  Affordable  Care  Act’s  Essen-
tial Health Benefits requirements, and for other purposes. 
IN  THE  HOUSE  OF  REPRESENTATIVES  
JULY21, 2026 
Mr.  A
LLENintroduced  the  following  bill;  which  was  referred  to  the  Committee  
on  Education  and  Workforce,  and  in  addition  to  the  Committee  on  En-
ergy  and  Commerce,  for  a  period  to  be  subsequently  determined  by  the  
Speaker,  in  each  case  for  consideration  of  such  provisions  as  fall  within  
the jurisdiction of the committee concerned 
A  BILL  
To  amend  the  Employee  Retirement  Income  Security  Act  
of  1974  and  the  Public  Health  Service  Act  to  exempt  
certain  employer-sponsored  group  health  plans  governed  
by   ERISA   from   the   Affordable   Care   Act’s   Essential   
Health  Benefits  requirements,  and  for  other  purposes.  
Be  it  enacted  by  the  Senate  and  House  of  Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Employer Health Plan 4
Flexibility Act’’. 5
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•HR  9798  IH
SEC.    2.    EXEMPTING    CERTAIN    EMPLOYER-SPONSORED    1
GROUP  HEALTH  PLANS  FROM  THE  AFFORD-2
ABLE  CARE  ACT’S  ESSENTIAL  HEALTH  BENE-3
FITS REQUIREMENTS. 4
(a)  A
MENDMENT   TOERISA.—Section  715  of  the  5
Employee  Retirement  Income  Security  Act  of  1974  (29  6
U.S.C.  1185d)  is  amended  by  adding  at  the  end  the  fol-7
lowing: 8
‘‘(c)  Notwithstanding  any  other  provision  of  Federal  9
law,  a  group  health  plan  sponsored  by  an  employer  and  10
governed  by  this  Act  shall  not  be  required  to  provide  cov-11
erage  for  the  Essential  Health  Benefits  described  in  sec-12
tion  1302(b)  of  the  Patient  Protection  and  Affordable  13
Care  Act  solely  by  reason  of  such  Federal  requirement.’’.  14
(b)  A
MENDMENT  TO  THEPUBLICHEALTHSERVICE 15
A
CT.—Section  2707(a)  of  the  Public  Health  Service  Act  16
(42  U.S.C.  300gg–6(a))  is  amended  by  inserting  ‘‘This  17
section  shall  not  apply  to  any  employer-sponsored  group  18
health plan governed by the Employee Retirement Income 19
Security Act of 1974.’’ at the end. 20
(c)  C
ONFORMINGAMENDMENTS.—The  Secretary  of  21
Health and Human Services shall revise applicable regula-22
tions  to  reflect  the  exemption  established  under  this  Act.  23
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•HR  9798  IH
SEC.   3.   PRESERVATION   OF   OTHER   FEDERAL   REQUIRE-1
MENTS. 2
Nothing  in  this  Act  shall  be  construed  to  exempt  a  3
group health plan from compliance with— 4
(1)  the  portability  and  nondiscrimination  provi-5
sions  of  the  Health  Insurance  Portability  and  Ac-6
countability Act of 1996 (42 U.S.C. 201 et seq.); 7
(2) the Paul Wellstone and Pete Domenici Men-8
tal  Health  Parity  and  Addiction  Equity  Act  of  2008  9
(subtitle  B  of  title  V  of  division  C  of  Public  Law  10
110–343); 11
(3)   the   Consolidated   Omnibus   Budget   Rec-12
onciliation Act of 1985; 13
(4)  fiduciary  duties  under  the  Employee  Retire-14
ment  Income  Security  Act  of  1974  (29  U.S.C.  1001  15
et seq.); 16
(5)  Internal  Revenue  Code  requirements  appli-17
cable to employer-sponsored health plans; 18
(6)  Federal  nondiscrimination  requirements;  or  19
(7)  preventive  services  requirements,  unless  oth-20
erwise provided by law. 21
SEC. 4. EMPLOYER DISCLOSURE REQUIREMENTS. 22
A  group  health  plan  claiming  the  exemption  under  23
this  Act  shall  annually  provide  participants  with  a  notice  24
that includes— 25
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•HR  9798  IH
(1)  a  description  of  benefits  covered  under  the  1
plan; 2
(2)  identification  of  any  Essential  Health  Bene-3
fits not covered; 4
(3) information regarding cost-sharing; and 5
(4)   instructions   for   obtaining   the   Summary   6
Plan Description. 7
SEC. 5. RULE OF CONSTRUCTION. 8
Nothing in this Act shall— 9
(1)  prohibit  an  employer  from  voluntarily  pro-10
viding  all  or  part  of  the  Essential  Health  Benefits;  11
(2)  alter  existing  Employee  Retirement  Income  12
Security  Act  of  1974  (29  U.S.C.  1001  et  seq.)  pre-13
emption; or 14
(3)  affect  State  regulation  of  health  insurance  1