Doctor and Nurse Team of Reps. Schrier and Underwood Unveil New Legislation to Make Primary Care, Mental Health Care, and Substance Use Disorder Treatment More Affordable

January 15, 2020
Press Release
Primary and Behavioral Health Care Access Act would require insurance to cover three primary care visits and three mental health or substance use disorder treatment visits per year without charging patients out-of-pocket

WASHINGTON— Today, Representatives Kim Schrier, M.D. (WA-08) and Lauren Underwood (IL-14) introduced new legislation to help more Americans access the care they need. The Primary and Behavioral Health Care Access Act (H.R. 5575) 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.

“I came to Congress to fight for quality, affordable health care for every American because as a doctor, I saw too many patients who were worried about the future of their care,” said Rep. Schrier. “I’ve seen patients delay care because of the cost of an office visit, and no family should have to decide between taking their child to the doctor and putting food on the table. Not just that — delaying a visit can turn a simple condition into more serious one. The most expensive care is in the hospital. Making it easier — and affordable — to get care at their primary care doctor’s office keeps people out of the hospital. This is commonsense legislation that will ensure people get the care they need, when they need it.”

Approximately one in four Americans skips necessary medical care because of costs. Out-of-pocket costs, which can be over $200 per visit, are a key barrier to seeking care. By reducing financial barriers for these visits, the Primary and Behavioral Health Care Access Act would help patients access the care they need to improve their health and well-being.

“It’s pretty simple: Out-of-pocket healthcare costs are too high, and they keep too many people from seeking the care they need. Especially after the first of the year when deductibles have reset, Illinoisans are asked to pay hundreds of dollars out of their pockets just to see their primary care doctor for a cold or get treatment for a mental health condition like anxiety, depression, or addiction—the kind of care that benefits individuals, but also keeps our communities well,” said Rep. Underwood, a trained nurse. “I’m proud to introduce this bill with a physician, Rep. Schrier, to make us all healthier, and keep money in the pockets of our families.”

The Primary and Behavioral Health Care Access Act has received endorsements from over 40 leading health and nursing organizations, including Illinois Association of Behavioral Health, American Association of Nurse Practitioners, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, National Alliance on Mental Illness, and March of Dimes.

“Even with insurance coverage, families can still face financial barriers to accessing primary care and behavioral health services like treatment for an ear infection or help managing asthma. The American Academy of Pediatrics is pleased to support the Primary and Behavioral Health Care Access Act, which builds on the Affordable Care Act to ensure children and families can get the care they need. We thank Reps. Kim Schrier (D-Wash.) and Lauren Underwood (D-Ill.) for their leadership on this important child health issue,” added Sara Goza, MD, FAAP, President, American Academy of Pediatrics.