Sponsors (4)
The bill greatly improves access to and affordability of mental health and SUD care for pregnant and postpartum people (including via telehealth and continuity protections), especially helping low‑income patients, but it could raise plan costs that may lead to higher premiums, narrower networks, or administrative burdens during rollout.
Pregnant and postpartum people: receive $0 cost-sharing for in‑network mental health and substance use disorder (SUD) care from pregnancy diagnosis through one year postpartum, explicitly including telehealth and with protections to keep existing treatment providers.
Low-income pregnant and postpartum people: face reduced out‑of‑pocket costs and lower financial barriers to accessing behavioral health treatment during pregnancy and the first postpartum year.
Insurers and employers: may incur higher plan costs that could be passed to consumers as higher premiums or offset by reducing other benefits.
Patients (including pregnant people with chronic conditions): plans may respond to added costs by narrowing provider networks or reducing covered services, which can limit provider choice despite continuity protections.
Plan administrators, employers, and some enrollees: will face administrative complexity and potential transitional confusion implementing compliance across group, individual, ERISA, FEHBP, and tax-code rules during the two-year phase‑in.
Based on analysis of 2 sections of legislative text.
Requires group and individual health plans to waive in-network cost-sharing for mental health and SUD services (including telehealth) for pregnant and postpartum individuals from diagnosis through one year after pregnancy end, effective two years after enactment.
Introduced January 27, 2026 by Jeanne Shaheen · Last progress January 27, 2026
Requires group and individual health plans to eliminate in-network cost-sharing (copays, coinsurance, deductibles) for mental health and substance use disorder services, including telehealth, for pregnant and postpartum individuals from pregnancy diagnosis through one year after the pregnancy ends. The rule applies to employer-sponsored (ERISA) plans and individual and group market insurance and takes effect for plan years beginning two years after enactment. It also expands continuity-of-care protections so pregnant patients can keep receiving treatment during pregnancy and for one year after pregnancy ends.