119th (2025–2027)
S. 4754
The Primary and Behavioral Health Care Access Act of 2026 requires all group health insurance plans and individual health insurance policies to cover three primary care visits and three behavioral health care visits per year without any cost-sharing requirements such as copayments, coinsurance, or deductibles. The bill applies to employers offering group coverage and insurance companies offering both group and individual plans, affecting millions of insured Americans. Primary care visits include routine appointments with doctors like family physicians, internists, and pediatricians, while behavioral health visits cover mental health and substance abuse treatment from providers like psychiatrists, therapists, and social workers. The coverage requirements take effect two years after the law is enacted and must be provided on equal terms with other medical visits, meaning insurers cannot impose stricter limitations or lower reimbursement rates specifically for these visits.