H.R. 7227 — Mental Health and MAMA Act of 2026

This section requires group health plans and health insurance issuers offering group or individual coverage that provide mental health or substance use disorder benefits—including telehealth—to eliminate cost-sharing requirements for such in-network services furnished from pregnancy diagnosis (as defined by the Secretary) through the 1-year period beginning the day after pregnancy ends (or the enrolled portion thereof), for plan years beginning 2 years after enactment. It also amends continuity-of-care requirements under the Public Health Service Act and Employee Retirement Income Security Act (ERISA) by (1) expanding the definition of continuing care patient to include individuals who are pregnant and undergoing pregnancy treatment from the provider or facility, or who require postpartum mental health or substance use disorder services from a provider or facility where they received treatment while pregnant within the prior year; and (2) modifying the transitional coverage period to end, for postpartum patients under the new criteria, when they are no longer continuing care patients with respect to the provider or facility (previously, a fixed period such as 90 days). (Thus, plans must offer continued in-network benefits on the same terms during transition for these patients.)