This bill, titled the "Primary and Behavioral Health Care Access Act of 2026," aims to significantly improve access to essential health services by amending the Employee Retirement Income Security Act of 1974 (ERISA) , the Public Health Service Act (PHSA) , and the Internal Revenue Code of 1986 (IRC) . The core provision mandates that all group health plans and health insurance issuers, whether offering group or individual coverage, must cover a minimum of three primary care visits and three behavioral health care visits per plan year. These six visits must be provided without any cost-sharing requirements , such as deductibles, copayments, or coinsurance, thereby removing financial barriers to early intervention and preventive care. The legislation further stipulates that treatment limitations for these specific visits cannot be more restrictive than those applied to other primary or behavioral health care visits covered by the plan, and reimbursement rates must be consistent. It defines "primary care visit" as an in-person visit to a designated primary care provider for specific services, and "behavioral health care visit" as a visit to a qualified provider for diagnosis, treatment, screening, or prevention of a behavioral health condition. An important amendment to the Internal Revenue Code ensures that high deductible health plans can offer coverage for these six cost-free visits without jeopardizing their status. These changes are set to take effect for plan years beginning two years after the bill's enactment.
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Health
Primary and Behavioral Health Care Access Act of 2026
USA119th CongressS-4754| Senate
| Updated: 6/11/2026
This bill, titled the "Primary and Behavioral Health Care Access Act of 2026," aims to significantly improve access to essential health services by amending the Employee Retirement Income Security Act of 1974 (ERISA) , the Public Health Service Act (PHSA) , and the Internal Revenue Code of 1986 (IRC) . The core provision mandates that all group health plans and health insurance issuers, whether offering group or individual coverage, must cover a minimum of three primary care visits and three behavioral health care visits per plan year. These six visits must be provided without any cost-sharing requirements , such as deductibles, copayments, or coinsurance, thereby removing financial barriers to early intervention and preventive care. The legislation further stipulates that treatment limitations for these specific visits cannot be more restrictive than those applied to other primary or behavioral health care visits covered by the plan, and reimbursement rates must be consistent. It defines "primary care visit" as an in-person visit to a designated primary care provider for specific services, and "behavioral health care visit" as a visit to a qualified provider for diagnosis, treatment, screening, or prevention of a behavioral health condition. An important amendment to the Internal Revenue Code ensures that high deductible health plans can offer coverage for these six cost-free visits without jeopardizing their status. These changes are set to take effect for plan years beginning two years after the bill's enactment.