Ways and Means Committee, Energy and Commerce Committee
Introduced
In Committee
On Floor
Passed Chamber
Enacted
This legislation aims to significantly enhance access to primary healthcare services for beneficiaries of federal health programs. It mandates that both Medicare and Medicaid cover the first three primary care visits each year without any cost sharing, beginning in 2026. Specifically, for Medicare beneficiaries, this means traditional Medicare and Medicare Advantage plans will be required to pay 100 percent of the approved amount for these initial visits, waiving deductibles and copayments. Similarly, Medicaid programs will be prohibited from imposing cost sharing for these first three primary care visits annually. A "primary care visit" is broadly defined to include essential services such as outpatient mental and behavioral health services , nonspecialty medical services, and care coordination. These services are intended for the prevention, diagnosis, treatment, or management of a wide array of physical, mental, or behavioral health conditions, thereby promoting earlier intervention and better overall health outcomes.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Health
Health care coverage and accessHealth promotion and preventive careMedicaidMedicareMental health
HOPE and Mental Wellbeing Act of 2025
USA119th CongressHR-1096| House
| Updated: 2/6/2025
This legislation aims to significantly enhance access to primary healthcare services for beneficiaries of federal health programs. It mandates that both Medicare and Medicaid cover the first three primary care visits each year without any cost sharing, beginning in 2026. Specifically, for Medicare beneficiaries, this means traditional Medicare and Medicare Advantage plans will be required to pay 100 percent of the approved amount for these initial visits, waiving deductibles and copayments. Similarly, Medicaid programs will be prohibited from imposing cost sharing for these first three primary care visits annually. A "primary care visit" is broadly defined to include essential services such as outpatient mental and behavioral health services , nonspecialty medical services, and care coordination. These services are intended for the prevention, diagnosis, treatment, or management of a wide array of physical, mental, or behavioral health conditions, thereby promoting earlier intervention and better overall health outcomes.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.