Medicare, Medicaid to cover 3 primary care visits free annually

What it does

This bill requires Medicare and Medicaid to cover the first 3 primary care visits each year without any cost-sharing (copayments, coinsurance, or deductibles) starting in 2026. Primary care visits include mental health services, routine medical care, and care coordination. The bill applies to both traditional Medicare and Medicare Advantage plans, and to Medicaid beneficiaries.

Why we flagged it

The bill's operative mechanism is straightforward: it removes cost barriers to primary care visits in Medicare and Medicaid. The title accurately reflects the substance—expanding access to mental and behavioral health services alongside routine primary care.

What the text implies

• The definition of 'primary care visit' is broad and includes mental/behavioral health services, care coordination, and nonspecialty medical services—potentially capturing services beyond traditional primary care, which may create ambiguity in claims processing and provider billing.
• No explicit funding mechanism or appropriation is stated in the text; the bill does not specify how Medicare/Medicaid will absorb the cost of eliminating cost-sharing for these visits, raising questions about whether this is a mandate without dedicated funding.
• The 3-visit annual limit may create perverse incentives: patients may front-load visits early in the year or providers may bundle services to maximize the free-visit benefit, potentially distorting utilization patterns.
• Medicaid's state-by-state variation means implementation and enforcement will differ across states, potentially creating disparities in access and provider participation.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Eliminating cost-sharing for 3 primary care visits per year removes a financial barrier to preventive and mental health care for Medicare and Medicaid beneficiaries, potentially increasing access to early intervention and reducing downstream emergency care. The benefit is direct and broadly distributed across all eligible beneficiaries.

Who stands to gain

• Medicare beneficiaries (reduced out-of-pocket costs)
• Medicaid beneficiaries (reduced out-of-pocket costs)
• Primary care providers and mental health service providers (increased volume of covered visits)

Named in the bill

Centers for Medicare & Medicaid Services (CMS), Medicare, Medicare Advantage, Medicaid, Social Security Act (Title XVIII, Title XIX), Primary care providers, Mental health providers

Where it stands

8 cosponsors: 8 Democrats.

• Feb 6, 2025 — Introduced · Congress.gov: “Introduced in House”
• Feb 6, 2025 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

6 lobbying clients named this bill on 9 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $3,681,974 in lobbying spend. A filing names 21 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 82% of bills with at least one filing.

Andrea Salinas, the sponsor, reported $700,715 in PAC receipts in the 2026 cycle.

• America's Health Insurance Plans Inc (ahip) — $3,010,000 on 1 filing
• American Psychiatric Association — $391,974 on 1 filing
• National Association of Social Workers — $110,000 on 2 filings
• American Counseling Association — $100,000 on 2 filings
• National Association of Social Workers — $50,000 on 2 filings

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.