Nurse and Doctor Team of Congresswomen Underwood and Schrier Unveil New Legislation to Make Primary Care, Mental health care, and Substance Use Disorder Treatment More Affordable

January 13, 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 Lauren Underwood (IL-14) and Kim Schrier, M.D. (WA-08) 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. Approximately one in four Americans skip 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 health care 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.”

“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. 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,” said Rep. Kim Schrier, M.D.

 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.

“While we have seen some advances in insurance coverage for behavioral health, we must also be cognizant of burdens that remain, such as out-of-pocket costs. Illinois has a strong commitment to accessible health care – including behavioral health – as is evidenced by one of the strongest parity laws in the country. Our state has established mandatory behavioral health benefits, as well as limits on prior authorization.  We are pleased that Illinois’ own Representative Lauren Underwood has chosen to champion this cause in Washington, and we support her in this critical effort,” said Sara Moscato Howe, CEO of the Illinois Association of Behavioral Health.

“Getting the right care at the right time is critical for both physical and mental health. NAMI congratulates Congresswoman Underwood for bringing forward this important legislation to expand access to care and early intervention while eliminating costly barriers,” said Angela Kimball, Acting CEO of the National Alliance on Mental Illness (NAMI).

“Association of Women’s Health, Obstetric and Neonatal Nurses members understand the financial hardship experienced by women and their families in pursuit of medical care.  AWHONN commends Rep. Lauren Underwood for introducing the Primary and Behavioral Health Care Access Act of 2020 which will remove barriers and improve access to health care for women and newborns,” said Rebecca L. Cypher, MSN, PNNP, President of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN).

The legislation is also endorsed by the American Psychiatric Association, American Psychological Association, American College of Nurse-Midwives (ACNM), American Association of Child & Adolescent Psychiatry (AACAP),  Clinical Social Work Association, Association of Women's Health, Obstetric & Neonatal Nurses (AWHONN), American Association of Colleges of Nursing, 2020 Mom, Mom Congress, National Association of Social Workers, National League for Nursing, Association of Community Health Nursing Educators, American Foundation for Suicide Prevention, National Association for Rural Mental Health, American Association of Neuroscience Nurses, American Association on Health and Disability, American Association for Psychoanalysis in Clinical Social Work, National Council for Behavioral Health, National Association of State Mental Health Program Directors, National Association of County Behavioral Health and Developmental Disability Directors, Depression and Bipolar Support Alliance, National Register of Health Service Psychologists, SMART Recovery, No Health without Mental Health, Centerstone, EMDR International Association, Lakeshore Foundation, Behavioral Health Association of Providers, Association for Behavioral and Cognitive Therapies, American Association for Men in Nursing, International OCD Foundation, American Art Therapy Association, Oncology Nursing Society, Global Alliance for Behavioral Health and Social Justice, The Ohio State University College of Nursing, , the American Nephrology Nurses Association, and the National Association for Behavioral health care.