The "Affordable CHOICE Act" proposes to amend the Patient Protection and Affordable Care Act (ACA) by establishing a public health insurance option (PHIO). This new option would be offered exclusively by the Secretary of Health and Human Services through the ACA Exchanges, beginning on January 1, 2027. Its primary goal is to provide value, choice, competition, and stability of affordable, high-quality health coverage across the United States, with a focus on creating an affordable plan without compromising quality or access to care. The PHIO is designed to operate on a level playing field with private health plans, complying with most ACA requirements regarding benefits, networks, consumer protections, and cost-sharing, and offering bronze, silver, and gold plan levels. Premiums will be geographically adjusted and set by the Secretary to fully cover health benefits and administrative costs, including a contingency margin. To control costs, the Secretary will negotiate provider reimbursement rates, defaulting to Medicare fee-for-service rates for equivalent services if negotiations are unsuccessful, and will also negotiate prescription drug prices. To facilitate its operation, the Secretary may contract for administrative functions, and states have the option to establish advisory councils to provide recommendations on operations, quality improvement, and cost containment. A dedicated Treasury account will manage the PHIO's finances, with initial start-up funding authorized to be repaid over ten years. Furthermore, health care providers participating in Medicare or Medicaid will automatically be included in the PHIO network unless they opt out, ensuring broad access to care.