Sponsors (4)
The bill substantially expands affordable, continuous in‑network mental health and SUD care for pregnant and postpartum people (including via telehealth) and reaches most insured markets, but it may raise premiums, takes two years to take effect, and still leaves access gaps if networks are narrow or care is out‑of‑network.
Pregnant and postpartum people will pay $0 in cost‑sharing for in‑network mental health and substance use disorder (SUD) services from pregnancy diagnosis through one year postpartum, increasing affordability of critical care.
Pregnant and postpartum patients can continue treatment with their existing mental health/SUD providers during pregnancy and for one year postpartum, improving continuity of care and treatment outcomes.
Including telehealth in the coverage expansion increases access to remote MH/SUD care for enrollees who cannot attend in‑person visits, helping rural and mobility-limited patients get treatment.
Insurers and employers may face higher plan costs from eliminated cost‑sharing, which could lead to higher premiums or increased employer contributions for many workers and families.
Because the prohibition applies only to in‑network care and plans may narrow networks or limit covered services to control costs, pregnant and postpartum people may still face cost‑sharing or reduced choice if in‑network capacity is limited.
A two‑year delay before plans must comply postpones access to the new cost‑sharing protections, delaying benefits for currently pregnant and recently postpartum individuals.
Based on analysis of 2 sections of legislative text.
Bans cost‑sharing for in‑network mental health and SUD care (including telehealth) for pregnant and postpartum people through 1 year postpartum and expands continuity‑of‑care protections.
Introduced January 27, 2026 by Jeanne Shaheen · Last progress January 27, 2026
Eliminates copayments, deductibles, and other cost‑sharing for in‑network mental health and substance use disorder (SUD) services — including telehealth — for people from pregnancy diagnosis through one year after the pregnancy’s last day. It also expands continuity‑of‑care protections so pregnant and postpartum individuals who were receiving mental health or SUD treatment can continue care with in‑network providers. The rule applies to group health plans and health insurance issuers subject to federal law (including ERISA plans) and takes effect for plan years beginning two years after enactment, giving plans time to adjust benefits and administration.