Three Democrats in Congress are trying to lighten the load of high deductibles on people with commercial health coverage.

The lawmakers have reintroduced the Primary and Behavioral Healthcare Access Act bill, which would require health insurers and employers’ self-insured plans to cover at least three primary care visits per year before the patient had reached the deductible, and without imposing co-payment requirements, coinsurance requirements or other out-of-pocket costs on the patient.

The bill would apply the “free” visit mandate to employers’ self-insured health plans, as well as to fully insured plans, by adding a section to the Employee Retirement Income Security Act.

The full text of the new bill is not yet available at Congress.gov, but the version introduced in 2024 used standard Healthcare Common Procedure Coding System codes to define the services that would be classified as primary care services.

The bill is under the jurisdiction of the House Energy and Commerce Committee, the House Education and Workforce Committee, and the House Ways and Means Committee and under the jurisdiction of the Senate Health, Education, Labor and Pensions Committee in the Senate.

King and Underhill have been introducing similar bills since 2020.

What it means: Lawmakers have held several health care cost hearings recently and have been talking about health care cost bills. The hearings and bill introductions may be a sign that members of Congress think they have a chance to pass some kind of health care cost legislation package in the next few months.

The backdrop: Major medical coverage designers have responded to Affordable Care Act benefits requirements and other plan requirements by using high deductibles to keep premiums low.

The Affordable Care Act requires major medical plans to cover basic preventive services, including checkups, without imposing cost-sharing requirements on the insureds.

Defenders of high-deductible plans argue that people should use insurance mainly to pay for catastrophic care and that they should use health savings accounts to pay for everyday expenses.

Critics of high-deductible plans note that some now have deductibles over $10,000, meaning that the plans may provide no coverage for routine sick care, or efforts to follow up on bad results coming out of the “free” preventive care screenings, for patients with those plans.

King said in a comment included in the bill introduction announcement that paying for some routine outpatient care should help plans hold expenses down.

“The cheapest medical procedure is the one that doesn’t have to happen because the problem was caught early,” King said.