Behavioral Health Crisis Services Expansion Act of 2026
Sponsored By: Representative McClellan, Jennifer L. [D-VA-4]
Introduced
Summary
Requires nationwide coverage and parity for behavioral health crisis response services across Medicare, Medicaid, private group plans, and key federal programs. It would define crisis response services and facility standards, require no-wrong-door access, and phase in coverage to expand timely, low-cost care for people in mental health and substance use crises.
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- Families and people in crisis: Would expand access to mobile crisis teams, walk-in urgent care, and 23-hour observation plus 48-hour stabilization beds, with sliding-scale payments and nondiscrimination rules for admissions.
- Medicare beneficiaries: Would create a Medicare benefit for crisis response services, reimburse at 80% of the lesser of the actual charge or a new payment amount, and cover ambulance or other qualified transport to crisis facilities beginning three years after enactment.
- Employers, private plans, and federal programs: Would require parity so cost-sharing and treatment limits for crisis services are no more restrictive than medical and surgical benefits, add coordinating tax-code language, and extend coverage requirements to TRICARE, VA programs, FEHBP, and CHIP with phased timing.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
Medicaid and CHIP crisis coverage
If enacted, Medicaid would have to cover defined crisis response services starting three years after enactment. Providers of crisis services would be allowed to make presumptive Medicaid eligibility decisions at the point of crisis. States may delay enforcement until after the close of their next regular legislative session if state law changes (special rules apply for two-year sessions). If enacted, CHIP would also add crisis response services to its covered services starting three years after enactment.
Federal, military, and veteran coverage
If enacted, FEHB carriers would have to cover crisis response services starting with the third contract year for chapter 89 contracts that begins three years after enactment. If enacted, the Secretary of Defense would be directed to provide TRICARE coverage for crisis response services (the excerpt does not state a start date). If enacted, the VA reimbursement rules would explicitly list crisis response services so veterans could be reimbursed when non-VA providers furnish them.
Private and employer plan parity
If enacted, group and individual health plans and ERISA-covered employer plans would have to provide crisis response services and treat them no more restrictively than medical and surgical benefits. Plans could not apply separate cost-sharing or separate treatment limits only for crisis services. The tax-code rules would also require the same coverage for group plans. These rules would apply for plan years beginning three years after enactment.
Rules for crisis centers and mobile teams
If enacted, the bill would define crisis response services and set standards for crisis receiving and stabilization facilities and mobile teams. Facilities would need 23-hour observation capacity and 48-hour stabilization beds with withdrawal management and 24-hour medical monitoring. Facilities would operate 24/7 on a sliding fee scale and could not refuse admission for inability to pay, residence, prior forensic involvement, age, or disability. These facility standards would take effect three years after enactment.
Medicare crisis services and transport
If enacted, Medicare would cover crisis response services starting three years after enactment. Medicare payments would be 80% of the lesser of the provider's actual charge or the payment amount set by the Secretary (new payment basis). You or your supplemental insurer could owe the remaining 20% as coinsurance. If enacted, ambulance and other qualified emergency transport to approved crisis facilities would also be covered starting three years after enactment.
Sponsors & CoSponsors
Sponsor
McClellan, Jennifer L. [D-VA-4]
VA • D
Cosponsors
Rep. Matsui, Doris O. [D-CA-7]
CA • D
Sponsored 9/3/2026
Rep. Trahan, Lori [D-MA-3]
MA • D
Sponsored 9/3/2026
Rep. Smith, Adam [D-WA-9]
WA • D
Sponsored 9/3/2026
Rep. Barragán, Nanette Diaz [D-CA-44]
CA • D
Sponsored 9/3/2026
Roll Call Votes
No roll call votes available for this bill.
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