Mental Health and MAMA Act of 2026
- Bill Number
- S. 3698
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-01-27: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- Last Updated
- 2026-02-20T13:44:57Z
AI-Generated Summary
Purpose
The "Mental Health and Making Access More Affordable Act of 2026" (or "Mental Health and MAMA Act of 2026") aims to improve access to mental health and substance use disorder services for pregnant and postpartum individuals by eliminating out-of-pocket costs (known as cost-sharing, like copays or deductibles) for these services during a specific period. It builds on existing requirements for health insurance to cover mental health and substance use disorder benefits equally to physical health benefits, focusing on maternal health needs.
Key Provisions
- No Cost-Sharing Requirement: Group health plans and health insurance issuers offering group or individual coverage that includes mental health or substance use disorder services (including telehealth services) must provide these services without any cost-sharing when delivered by in-network providers. This applies from the diagnosis of pregnancy through the 1-year period after the end of the pregnancy.
- Coverage is prorated if an individual enrolls partway through this period.
- "Diagnosis of pregnancy" will be defined by the Secretary of Health and Human Services.
- Continuity of Care Expansion: Updates rules to ensure ongoing access to the same provider or facility for pregnant individuals undergoing pregnancy treatment, and extends this to postpartum individuals needing mental health or substance use disorder services if they received such treatment during pregnancy and the pregnancy ended within the past year.
- Applicability:
- Covers plans under the Public Health Service Act (PHSA), Employee Retirement Income Security Act (ERISA) for employer-sponsored plans, and Internal Revenue Code (IRC) for tax purposes.
- Includes the Federal Employees Health Benefits Program (FEHBP) for federal workers.
- Effective Date: Applies to plan years starting 2 years after the bill's enactment.
Significant Changes to Existing Law
- New Sections Added: Introduces specific sections (e.g., Section 2799A-11 in PHSA, Section 726 in ERISA, Section 9826 in IRC) mandating zero cost-sharing for mental health and substance use disorder services during the pregnancy and postpartum period, which was not previously required under mental health parity laws (laws ensuring mental health coverage matches physical health coverage).
- Amendments to Continuity of Care: Modifies existing provisions (e.g., PHSA Section 2799A-3, ERISA Section 718, IRC Section 9818) to explicitly include postpartum mental health and substance use disorder needs as qualifying for continued coverage with the same provider, extending protections beyond general pregnancy care.
- Clerical Updates: Adds entries to tables of contents in ERISA and IRC for the new sections.
- These changes align with but expand the Mental Health Parity and Addiction Equity Act of 2008 by targeting cost barriers specifically for maternal mental health.
Potential Impacts
- On Citizens: Pregnant and postpartum individuals (especially those at risk for conditions like postpartum depression or substance use issues) will face no out-of-pocket costs for in-network mental health and substance use disorder services, potentially increasing utilization, early intervention, and better health outcomes for mothers and infants. This could reduce financial barriers to care during a vulnerable time.
- On Government Agencies: The Department of Health and Human Services, Department of Labor, and Internal Revenue Service will need to enforce and oversee compliance, including defining terms and monitoring plans. FEHBP contracts will incorporate these rules, affecting federal employee benefits.
- On Health Insurers and Employers: Insurers and group plan sponsors (like employers) must adjust coverage to eliminate cost-sharing, which may raise premiums or administrative costs but promotes equitable access. No direct international relations impacts are noted.
- Broader Effects: Could lower long-term societal costs by preventing severe mental health crises, though initial implementation may strain provider networks if demand surges.
Main Stakeholders Affected
- Pregnant and Postpartum Individuals: Primary beneficiaries, gaining cost-free access to essential services.
- Health Insurance Issuers and Group Health Plans: Required to modify policies and absorb costs without passing them to enrollees during the covered period.
- Employers: As sponsors of group plans under ERISA, they must ensure compliance, potentially affecting plan design and costs.
- Healthcare Providers: In-network mental health and substance use disorder providers (including telehealth) will see increased demand but assured payment without patient cost barriers.
- Federal Government and Agencies: Oversee enforcement; federal employees under FEHBP are directly impacted.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens enforcement of mental health parity laws by removing financial hurdles, with built-in definitions tying back to existing statutes (e.g., telehealth under PHSA Section 330I). Potential for litigation if plans challenge the scope of "in-network" requirements or definitions, but it aligns with federal preemption over state insurance laws for self-insured plans.
- Constitutional: No apparent conflicts; it operates within Congress's authority under the Commerce Clause to regulate health insurance and promote public health.
- Political: Highlights bipartisan focus on maternal mental health (introduced by Senators Shaheen, Baldwin, Duckworth, and Heinrich), potentially influencing future expansions of postpartum care coverage. Referred to the Senate Committee on Health, Education, Labor, and Pensions for further review.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (3)
Sen. Baldwin, Tammy [D-WI], Sen. Duckworth, Tammy [D-IL], Sen. Heinrich, Martin [D-NM]
Recent Actions
- 2026-01-27: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- 2026-01-27: Introduced in Senate
Bill Versions
- Mental Health and Making Access More Affordable Act of 2026 — issued 2026-01-27 — PDF (10 pages)