WASHINGTON, D.C. — U.S. Senator Angus King is introducing legislation to ensure Maine people have access to affordable and preventative mental health and behavioral healthcare services. The Primary and Behavioral Healthcare Access Act would require private insurance plans to cover three annual primary care visits and three annual outpatient mental health or outpatient substance use disorder treatment visits, without charging a copayment, coinsurance, or deductible-related fee. This common sense legislation would cover private insurance under Affordable Care Act (ACA) and employer-sponsored plans.
Currently, the Federal Reserve estimates one-in-four Americans skip medical care due to cost — though more regular check-ups can often catch health issues early before they become costly problems. On average, primary care visits cost an average of $170 out of pocket and the cost of a single day of outpatient substance use treatment is estimated between $250 and $350. Under existing law, private group health plans, regulated by the Employee Retirement Income Security Act (ERISA), are not obligated to provide no-cost coverage for primary care, or mental and behavior health services. More than 180 million Americans receive health insurance coverage through employer-sponsored plans regulated by ERISA, who otherwise are not entitled to no or low-cost primary care. Over 46% of Maine people are covered through employer-sponsored plans.
“Affordable and accessible healthcare is essential to keeping Maine people healthy,” said Senator King. “However, high or unexpected costs can often deter people from seeking care, such as annual preventative checkups that can identify health issues at an early stage. The Primary and Behavioral Healthcare Access Act would require private insurance plans to cover three annual primary care visits and three mental health visits — ensuring folks feel confident they can get the care they need without breaking the bank.”
Congresswoman Lauren Underwood (D-IL) has introduced a companion bill in the House of Representatives.
The Primary and Behavioral Healthcare Access Act is supported by the American Association on Health and Disability, Lakeshore Foundation, No Health Without Mental Health, Physician Assistant Education Association, National Association of Pediatric Nurse Practitioners, International OCD Foundation, March of Dimes, American Psychological Association, National Alliance on Mental Illness (NAMI), American Psychiatric Association, American Psychological Association Services Inc., Global Alliance for Behavioral Health and Social Justice, American Association of Colleges of Nursing, Association of Community Health Nursing Educators, Faces & Voices of Recovery, National Behavioral Health Association of Providers, IC&RC and the National Association of Behavioral Healthcare.
Senator King has consistently worked to reduce healthcare costs for Maine people. The Inflation Reduction Act has laid the groundwork for — and in some cases already implemented — long-term changes in federal policy that will keep people healthier and deliver higher quality care at a lower cost to patients. These benefits are delivered while simultaneously reducing the deficit by finally allowing Medicare to negotiating bulk discounts on the price it pays for prescription drugs. This will save taxpayers hundreds-of-billions.
Additionally, Senator King has worked to reduce prescription drug costs. He has previously introduced legislation to prohibit pharmaceutical drug manufacturers from claiming tax deductions for consumer advertising expenses and also introduced bipartisan legislation to require price transparency in prescription drug advertisements. Most recently, he introduced the bipartisan Physician Fee Stabilization Act to protect seniors’ access to healthcare.