Ways and Means Committee, Energy and Commerce Committee, Education and Workforce Committee
Introduced
In Committee
On Floor
Passed Chamber
Enacted
This bill proposes significant amendments to the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHSA), and the Internal Revenue Code of 1986 (IRC). Its primary goal is to enhance access to essential healthcare services by requiring health plans and issuers to cover specific visits without patient cost-sharing. The legislation mandates that, for each plan year, individuals receive coverage for three primary care visits and three behavioral health care visits . A crucial aspect of this bill is the prohibition of any cost-sharing requirements, such as deductibles, copayments, or coinsurance, for these six specified visits. Furthermore, the bill stipulates that treatment limitations applied to these visits cannot be more restrictive than those for other covered primary or behavioral health services. Reimbursement rates for these visits must also be equivalent to those for other similar services covered by the plan or coverage, ensuring fair compensation for providers. The bill defines a "primary care visit" as an in-person visit to a designated primary care provider for services identified by specific HCPCS codes, while a "behavioral health care visit" involves a qualified provider addressing behavioral health conditions. Qualified providers for both types of visits include a broad range of medical and mental health professionals. The amendments will apply to plan years beginning two years after the Act's enactment, and notably, the bill also modifies the Internal Revenue Code to allow these visits to be covered by high deductible health plans without affecting their deductible status.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and 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 Committees on Education and Workforce, and 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
Primary and Behavioral Health Care Access Act of 2026
USA119th CongressHR-9257| House
| Updated: 6/11/2026
This bill proposes significant amendments to the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHSA), and the Internal Revenue Code of 1986 (IRC). Its primary goal is to enhance access to essential healthcare services by requiring health plans and issuers to cover specific visits without patient cost-sharing. The legislation mandates that, for each plan year, individuals receive coverage for three primary care visits and three behavioral health care visits . A crucial aspect of this bill is the prohibition of any cost-sharing requirements, such as deductibles, copayments, or coinsurance, for these six specified visits. Furthermore, the bill stipulates that treatment limitations applied to these visits cannot be more restrictive than those for other covered primary or behavioral health services. Reimbursement rates for these visits must also be equivalent to those for other similar services covered by the plan or coverage, ensuring fair compensation for providers. The bill defines a "primary care visit" as an in-person visit to a designated primary care provider for services identified by specific HCPCS codes, while a "behavioral health care visit" involves a qualified provider addressing behavioral health conditions. Qualified providers for both types of visits include a broad range of medical and mental health professionals. The amendments will apply to plan years beginning two years after the Act's enactment, and notably, the bill also modifies the Internal Revenue Code to allow these visits to be covered by high deductible health plans without affecting their deductible status.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and 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 Committees on Education and Workforce, and 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.