HR1096-119

In Committee

HOPE and Mental Wellbeing Act of 2025

119th Congress Introduced Feb 6, 2025

Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.

Summary

What This Bill Does

The bill amends Medicare and Medicaid law to require 100% coverage (zero cost sharing) for the first 3 primary care visits per year beginning 2026. It relies on exemptions and product standards. The main policy areas are Healthcare and Finance.

Who Benefits and How

Primary care physicians and clinics could gain revenue opportunities, Mental and behavioral health service providers could gain revenue opportunities, and Care coordination service providers could gain revenue opportunities.

Who Bears the Burden and How

Federal Medicare program could face higher costs, State Medicaid programs could face higher costs, and Medicare Advantage plans (HMOs, PPOs) could face higher costs.

Key Provisions

  • Amends Medicare and Medicaid law to require 100% coverage (zero cost sharing) for the first 3 primary care visits per year beginning 2026.

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.

At a Glance

What This Bill Does

The bill amends Medicare and Medicaid law to require 100% coverage (zero cost sharing) for the first 3 primary care visits per year beginning 2026.

Key Policy Areas

Healthcare, Finance

Primary Purpose

The bill amends Medicare and Medicaid law to require 100% coverage (zero cost sharing) for the first 3 primary care visits per year beginning 2026.

Policy Domains

Healthcare Finance

Section 2 - Medicare Coverage Requirements

Identified Gains
  • Primary care physicians and clinics
  • Mental and behavioral health service providers
  • Care coordination service providers
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
Care coordination service providers:
Primary care physicians and clinics:
Mental and behavioral health service providers:
Identified Costs
  • Federal Medicare program
  • State Medicaid programs
  • Medicare Advantage plans (HMOs, PPOs)
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
State Medicaid programs:
Federal Medicare program:
Medicare Advantage plans (HMOs, PPOs):

Legislative Progress

In Committee
Introduced Committee Passed
Feb 6, 2025

Ms. Salinas (for herself, Mrs. Watson Coleman, Ms. Norton, Mr. …

Feb 6, 2025

Referred to the Committee on Energy and Commerce, and in …

Feb 6, 2025

Introduced in House

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

Offices Of Physicians
1 mention across 1 clause
+1 positive

Primary care physicians and clinics

Outpatient Mental Health Centers
1 mention across 1 clause
+1 positive

Mental and behavioral health service providers

Home Health Care Services
1 mention across 1 clause
+1 positive

Care coordination service providers

Financial Services
1 mention across 1 clause
-1 negative

Medicare Advantage plans (HMOs, PPOs)

Government
1 mention across 1 clause
-1 negative

Federal Medicare program

State & Local Government
1 mention across 1 clause
-1 negative

State Medicaid programs

1/2
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare Finance
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
Domains
Healthcare Medicaid
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services

Key Definitions

Terms defined in this bill

1 term
"primary care visit" §1861(nnn)

Outpatient mental and behavioral health services, nonspecialty medical services, and care coordination services furnished for the prevention, diagnosis, treatment, or management of a physical, mental, or behavioral health condition

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology