What This Bill Does
This bill would require group health plans and health insurance issuers offering group or individual coverage to cover 3 primary care visits and 3 behavioral health care visits each year without any cost-sharing. That means eligible enrollees could see a primary care clinician and a mental health or substance-use provider for those visits without paying deductibles, copays, or coinsurance. The requirement would apply across employer-sponsored plans and individual market coverage subject to federal health insurance rules. Its main effect is to make a small set of routine medical and mental health visits more affordable and easier to use.
- Requires 3 primary care visits with no cost-sharing
- Requires 3 behavioral health visits with no cost-sharing
- Applies to group health plans and health insurance issuers
- Covers both group and individual health insurance coverage
- Targets routine medical and mental health access
Who This Bill Affects
If you are enrolled in a group health plan or individual market coverage, this bill would make up to 3 primary care visits and 3 behavioral health visits available each year with no copay, deductible, or coinsurance. That could reduce your out-of-pocket spending for routine checkups, follow-up care, counseling, or other early mental health treatment, especially if you tend to avoid visits because of cost. The main offset is that plans may respond to the added mandate through higher premiums or other cost shifts.
See how this bill affects you — sign in for a personalized analysisWho Supports & Opposes This
- People with chronic conditions or ongoing care needs Free early visits can help patients catch problems sooner, stay on medications, and avoid more expensive emergency or specialty care later. Even a small number of no-cost visits can make a meaningful difference for people who skip care because of out-of-pocket costs.
- Mental health patients and families Removing cost-sharing for behavioral health visits lowers one of the biggest barriers to starting counseling or follow-up treatment. Supporters argue this can improve access to care during a period of high demand for mental health services.
- Primary care clinicians No-cost visits can encourage patients to come in earlier for preventive care, follow-up, and care coordination. That can improve continuity of care and help clinicians address issues before they become more serious.
- Employers that sponsor health plans Mandated free visits can increase plan spending, which may show up in higher premiums or higher overall benefit costs. Employers may worry about having less flexibility to design benefits that fit their workforce and budget.
- Health insurers Insurers may argue that adding a required no-cost benefit increases utilization and raises claims costs. They may also contend that repeated federal benefit mandates make coverage design more complex and expensive to administer.
- Consumers focused on premium costs Some enrollees may prefer lower premiums over additional mandated first-dollar coverage. They may worry that spreading the cost of these visits across the whole risk pool could increase monthly premiums for everyone.
Key Implications
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““provide for 3 primary care visits ... without application of any cost-sharing requirement””
For three visits, patients would not owe copays, deductibles, or coinsurance. That lowers the immediate price of seeing a doctor for routine care or follow-up.
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““3 behavioral health care visits””
Mental health and substance-use appointments would receive the same no-cost treatment. This can make it easier to start counseling or get an initial evaluation without paying out of pocket.
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““group health plans and health insurance issuers””
The mandate would reach both employer-sponsored coverage and insurance sold in the individual market. That broadens the effect beyond one type of plan or one category of enrollee.
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““title XXVII of the Public Health Service Act””
This places the requirement within the federal health insurance rules that govern many private plans. In practice, it would be a nationwide coverage standard rather than a state-by-state option.
Latest Status
June 11, 2026
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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Ask AI about this billData sourced from api.congress.gov.