Congress mandates free primary care and mental health visits—but only 3 per year
H.R. 9257 — Primary and Behavioral Health Care Access Act of 2026 · Filed by Lauren Underwood (D-IL) · 1 cosponsor · Introduced Jun 11, 2026 · Referred to committee
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What it does
This bill requires health insurance plans to cover 3 primary care visits and 3 behavioral health visits per year with zero cost-sharing (no copays, coinsurance, or deductibles). The visits must be treated identically to other covered visits—same reimbursement rates, no separate limits—and applies to employer plans, individual insurance, and high-deductible health plans. It takes effect 2 years after enactment.
Why we flagged it
The bill's core function is to mandate zero-cost-sharing coverage for a defined set of primary and behavioral health visits across all group and individual health plans. It is a straightforward consumer protection and public health measure, not a tax provision, subsidy, or deregulation.
What the text implies
- The 3-visit annual limit may be insufficient for individuals with chronic conditions or frequent mental health needs, potentially creating a false sense of 'free' access while leaving significant out-of-pocket exposure for additional visits.
- Reimbursement-rate parity requirement may incentivize plans to lower rates for all primary/behavioral visits to offset the cost of free access, potentially reducing provider participation or quality.
The full analysis lists 4 implications of this text.
Who stands to gain
health insurance plans (reduced utilization of expensive downstream care); primary care and behavioral health providers (increased volume of covered visits); employers offering group health plans (potential long-term savings from preventive care)