Sidecar Health Supports CMS Decision to Remove Network Requirement for ACA Exchange Plans

ACA exchange enrollees will now have access to insurance models built around transparency and open access, not networks

The Centers for Medicare and Medicaid Services (CMS) today removed the requirement that health plans offered on the ACA exchanges operate with a provider network. The decision opens the individual market to competition from network-free insurance models.

In response to the decision, Patrick Quigley, Co-founder and CEO of Sidecar Health, issued the following statement:

Networks were established with the goal of keeping costs down and ensuring that members have access to the care they need. It’s become clear that they can’t reliably do either.

Anyone who’s navigated healthcare recently knows that it can be hard to find an in-network provider — especially for specialty care and mental health. And wait times are often long — now an average of more than 40 days for something as fundamental as an OB-GYN.

The cost-control promise has equally fallen short. Hospital pricing data shows that providers of comparable quality within the same network and city often charge wildly different prices for the same procedure.

Unfortunately, these price inconsistencies often find their way to patients’ wallets. And given the lack of price transparency, they typically don’t know what their cost-share will be until months later, when the last bill finally arrives. Many American families simply can’t absorb an unexpected bill and when the primary purpose of insurance is financial protection, we should all be concerned that medical debt is now a leading cause of bankruptcy for American families.

The exchanges are falling short in large part because the network requirement has meant that every plan available is based on the same struggling model. This decision opens the door to real competition between genuinely different models. The more adoption we see of a transparent, shoppable, network-free model, the more providers can compete for patients’ business, shining a light on cost and quality — ultimately improving both.”

— Patrick Quigley, Co-founder and CEO, Sidecar Health

Sidecar Health has operated a network-free insurance model since its founding in 2018, currently serving large employers with members in 48 states. The company’s model provides members with clear, guaranteed costs before care, the ability to visit any licensed provider in the country, and an incentive to shop for value. When members choose providers who charge less than the plan pays — which is set to the local average cost in each market — they keep half the savings. Sidecar Health members report accessing care previously unavailable to them under traditional network-based coverage, and the company’s data shows underlying medical costs approximately 20 percent lower than legacy plans. Sidecar Health plans to pursue participation on the ACA Exchanges beginning in 2028.

About Sidecar Health

Sidecar Health is a major medical insurance company on a mission to make high-quality healthcare more affordable and accessible for everyone. We lower costs by putting people in control of their health decisions — no prior authorizations, no referrals, no networks. Members can visit any provider and pay directly with the Sidecar Health Visa card. And because they see what their plan covers upfront, members are empowered to treat healthcare dollars like their own — making informed, cost-conscious choices without sacrificing access or coverage. If they spend less, they keep half of the savings; if they spend more, they pay the difference. This model reshapes behavior, reduces costs, and cuts through the red tape that defines traditional insurance. With fewer than 1% of claims clinically denied, Sidecar Health puts people — not insurers — at the center of the system. The result: better access, greater transparency, and more empowered consumers. Learn more at sidecarhealth.com.

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Sidecar Health Supports CMS Decision to Remove Network Requirement for ACA Exchange Plans. ACA exchange enrollees will now have access to insurance models built around transparency and open access, not networks.