H.R. 7227

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7227 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 7227

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.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

January 22, 2026

Ms. Moore of Wisconsin (for herself, Mrs. Dingell, Mrs. McBath, Ms. 
Stansbury, Mr. Torres of New York, Mrs. Watson Coleman, Ms. DelBene, 
Ms. Sewell, Mr. Horsford, Ms. Dean of Pennsylvania, Ms. Tlaib, Mr. 
Cohen, Ms. Lee of Pennsylvania, Mr. Gottheimer, Mr. Johnson of Georgia, 
Ms. Titus, Mr. Thanedar, and Ms. Norton) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committees on Education and Workforce, Ways and Means, 
and Oversight and Government Reform, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

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.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 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''.

SEC. 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:

``SEC. 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 
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:

``SEC. 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 
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:

``SEC. 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 
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) 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 section.
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