H.R.1096 - Helping Out Patients for Emotional and Mental Wellbeing Act; HOPE and Mental Wellbeing Act of 2025 (119th Congress)
Summary
H.R.1096, the "Helping Out Patients for Emotional and Mental Wellbeing Act" or the "HOPE and Mental Wellbeing Act of 2025," aims to amend Title XVIII of the Social Security Act. The bill mandates Medicare and Medicaid coverage for three primary care visits per year without cost-sharing. This coverage begins in 2026 and includes outpatient mental and behavioral health services, non-specialty medical services, and care coordination services.
Expected Effects
The bill's passage would likely increase access to primary care services, particularly for mental and behavioral health, for Medicare and Medicaid beneficiaries. This could lead to earlier detection and treatment of health issues, potentially improving health outcomes. It may also increase the financial burden on the Medicare and Medicaid systems.
Potential Benefits
- Increased access to healthcare, especially mental and behavioral health services.
- Potential for early detection and treatment of health conditions.
- Reduced financial burden for beneficiaries regarding primary care visits.
- Improved health outcomes for Medicare and Medicaid recipients.
- Preventative care focus, potentially reducing long-term healthcare costs.
Potential Disadvantages
- Increased costs for the Medicare and Medicaid programs.
- Potential strain on primary care providers due to increased demand.
- Possible need for increased taxes or reallocation of funds to cover the additional costs.
- Risk of overutilization of services if not managed properly.
- Administrative complexities in implementing the new coverage requirements.
Most Disadvantaged Areas:
Constitutional Alignment
The bill aligns with the "general Welfare" clause of the Preamble of the US Constitution, as it seeks to improve the health and well-being of citizens. Congress has the power to tax and spend for the general welfare, as outlined in Article I, Section 8. The expansion of Medicare and Medicaid falls under this power, provided it does not violate any other constitutional provisions.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).