S. 3698

119 S3698 IS: Mental Health and Making Access More Affordable Act of 2026
 U.S. Senate
 2026-01-27
 text/xml
 EN
 Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
 II  119th CONGRESS  2d Session  S. 3698  IN THE SENATE OF THE UNITED STATES   January 27, 2026   Mrs. Shaheen  (for herself,  Ms. Baldwin ,  Ms. Duckworth , and  Mr. Heinrich ) introduced the following bill; which was read twice and referred to the  Committee on Health, Education, Labor, and Pensions    A BILL
To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require that group health plans and health insurance issuers offering group or individual health insurance that provide coverage for mental health services and substance use disorder services provide such services without the imposition of cost-sharing from the diagnosis of pregnancy through the 1-year period following such pregnancy, and for other purposes.
1.
Short title
This Act may be cited as the   Mental Health and Making Access More Affordable Act of 2026   or the   Mental Health and MAMA Act of 2026  .
2.
Cost-sharing with respect to mental health services and substance use disorder services for pregnant and postpartum individuals
(a)
PHSA
(1)
In general
Part D of title XXVII of the Public Health Service Act ( 42 U.S.C. 300gg–111 et seq. ) is amended by adding at the end the following new section:
2799A–11.
Cost-sharing requirements with respect to mental health services and substance use disorder services for pregnant and postpartum individuals
(a)
In general
In the case of a group health plan or a health insurance issuer offering group or individual health insurance coverage that provides a benefit for mental health services or substance use disorder services (including such services which are telehealth services and are provided under such plan or coverage) with respect to plan years beginning on or after the date that is 2 years after the date of enactment of this section, the plan or coverage shall not impose any cost-sharing requirement for such services that are furnished by an in-network provider to a participant, beneficiary, or enrollee under the plan or coverage from the diagnosis of pregnancy (as defined by the Secretary) through the 1-year period beginning on the day after the last day of such pregnancy of such participant, beneficiary, or enrollee (or, in the case of an individual enrolled in such plan or coverage for a portion of such period, during such portion).
(b)
Definitions
In this section:
(1)
The terms  mental health services  and  substance use disorder services  have the meaning given such terms for purposes of section 2726.
(2)
The term  telehealth service  means a service that is furnished through telehealth technologies (as defined in section 330I(a)).
 .
(2)
Continuity of care
Section 2799A–3 of the Public Health Service Act ( 42 U.S.C. 300gg–113 ) is amended—
(A)
in subsection (a)(2)(C), by inserting  , in the case of a continuing care patient described in subsection (b)(1)(D)(ii), the date on which such individual is no longer such a continuing care patient with respect to such provider or facility, or in the case of a continuing care patient described in subsection (b)(1) other than in subparagraph (D)(ii) of such subsection,  after  is provided and ending on ; and
(B)
by amending subsection (b)(1)(D) to read as follows:
(D)
(i)
is pregnant and undergoing a course of treatment for the pregnancy from the provider or facility; or
(ii)
(I)
requires mental health services or substance use disorder services from a provider or facility following a pregnancy;
(II)
received a course of mental health or substance use disorder treatment from such provider or facility while pregnant; and
(III)
the last day of such pregnancy occurred during the previous 1-year period; or
 .
(b)
ERISA
(1)
In general
Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185 et seq. ) is amended by adding at the end the following new section:
726.
Cost-sharing requirements with respect to mental health services and substance use disorder services for pregnant and postpartum individuals
(a)
In general
In the case of a group health plan or a health insurance issuer offering group health insurance coverage that provides a benefit for mental health services or substance use disorder services (including such services which are telehealth services and are provided under such plan or coverage) with respect to plan years beginning on or after the date that is 2 years after the date of enactment of this section, the plan or coverage shall not impose any cost-sharing requirement for such services that are furnished by an in-network provider to a participant or beneficiary under the plan or coverage from the diagnosis of pregnancy (as defined by the Secretary) through the 1-year period beginning on the day after the last day of such pregnancy of such participant or beneficiary (or, in the case of an individual enrolled in such plan or coverage for a portion of such period, during such portion).
(b)
Definitions
In this section:
(1)
The terms  mental health services  and  substance use disorder services  have the meaning given such terms for purposes of section 712.
(2)
The term  telehealth service  means a service that is furnished through telehealth technologies (as defined in section 330I(a) of the Public Health Service Act).
 .
(2)
Continuity of care
Section 718 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185g ) is amended—
(A)
in subsection (a)(2)(C), by inserting  , in the case of a continuing care patient described in subsection (b)(1)(D)(ii), the date on which such individual is no longer such a continuing care patient with respect to such provider or facility, or in the case of a continuing care patient described in subsection (b)(1) other than in subparagraph (D)(ii) of such subsection,  after  is provided and ending on ; and
(B)
by amending subsection (b)(1)(D) to read as follows:
(D)
(i)
is pregnant and undergoing a course of treatment for the pregnancy from the provider or facility; or
(ii)
(I)
requires mental health services or substance use disorder services from a provider or facility following a pregnancy;
(II)
received a course of mental health or substance use disorder treatment from such provider or facility while pregnant; and
(III)
the last day of such pregnancy occurred during the previous 1-year period; or
 .
(3)
Clerical amendment
The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1001 et seq. ) is amended by inserting after the item relating to section 725 the following new item:
Sec. 726. Cost-sharing requirements with respect to mental health services and substance use disorder services for pregnant and postpartum individuals.
  .
(c)
IRC
(1)
In general
Subchapter B of  chapter 100  of the Internal Revenue Code of 1986 is amended by adding at the end the following new section:
9826.
Cost-sharing requirements with respect to mental health services and substance use disorder services for pregnant and postpartum individuals
(a)
In general
In the case of a group health plan that provides a benefit for mental health services or substance use disorder services (including such services which are telehealth services and are provided under such plan) with respect to plan years beginning on or after the date that is 2 years after the date of enactment of this section, the plan shall not impose any cost-sharing requirement for such services that are furnished by an in-network provider to a participant or beneficiary under the plan from the diagnosis of pregnancy (as defined by the Secretary) through the 1-year period beginning on the day after the last day of such pregnancy of such participant or beneficiary (or, in the case of an individual enrolled in such plan for a portion of such period, during such portion).
(b)
Definitions
In this section:
(1)
The terms  mental health services  and  substance use disorder services  have the meaning given such terms for purposes of section 9812.
(2)
The term  telehealth service  means a service that is furnished through telehealth technologies (as defined in section 330I(a) of the Public Health Service Act).
 .
(2)
Continuity of care
 Section 9818  of the Internal Revenue Code of 1986 is amended—
(A)
in subsection (a)(2)(C), by inserting  , in the case of a continuing care patient described in subsection (b)(1)(D)(ii), the date on which such individual is no longer such a continuing care patient with respect to such provider or facility, or in the case of a continuing care patient described in subsection (b)(1) other than in subparagraph (D)(ii) of such subsection,  after  is provided and ending on ; and
(B)
by amending subsection (b)(1)(D) to read as follows:
(D)
(i)
is pregnant and undergoing a course of treatment for the pregnancy from the provider or facility; or
(ii)
(I)
requires mental health services or substance use disorder services from a provider or facility following a pregnancy;
(II)
received a course of mental health or substance use disorder treatment from such provider or facility while pregnant; and
(III)
the last day of such pregnancy occurred during the previous 1-year period; or
 .
(3)
Clerical amendment
The table of sections for subchapter B of  chapter 100  of the Internal Revenue Code of 1986 is amended by adding at the end the following new item:
Sec. 9826. Cost-sharing requirements with respect to mental health services and substance use disorder services for pregnant and postpartum individuals.
  .
(d)
Effective date
The amendments made by subsections (a), (b), and (c) shall apply with respect to plan years beginning on or after the date that is 2 years after the date of enactment of this Act.
(e)
FEHBP
(1)
In general
Section 8902(p) of title 5, United States Code, is amended—
(A)
by striking  and 2799A–7  and inserting  2799A–7, and 2799A–11 ;
(B)
by striking  and 722  and inserting  722, and 726 ; and
(C)
by striking  and 9822  and inserting  9822, and 9826 .
(2)
Effective date
The amendments made by paragraph (1) shall apply with respect to contracts entered into or renewed for contract years beginning on or after the date that is 2 years after the date of enactment of this Act.