“This would seem to hand a big negotiating advantage to providers.”
Maybe. But when have you ever seen the Obammunists “negotiate” with anyone? Fascists don’t negotiate; all they know how to do is intimidate or make false promises, and I strongly suspect all the crony capitalists who initially helped get obamacare passed are having second and third thoughts about all of the false promises that have already been made to them.
It is the insurance companies that have to negotiate, all the government did was to dictate that networks have to be up to 50% more inclusive. Providers who were too expensive will now have to be included, the exiting providers will be wanting increases too. The spiral accelerates.