HR-2591-119
Received in the Senate and Read twice and referred to the Committee on Commerce, Science, and Transportation.
Sponsored by Sean Casten (D-IL)
What it does
This bill would require the FAA to update its medical certification regulations within two years to encourage pilots and air traffic controllers to seek and disclose mental health conditions without fear of losing their certifications. It would also require annual reviews of the "special issuance" process (the pathway by which aviation workers with certain medical conditions can still obtain certification), expand the list of approved medications, improve training for aviation medical examiners, and direct the FAA to implement recommendations from a 2024 rulemaking committee on mental health. The bill would set aside approximately $13.74 million per year for fiscal years 2026–2028 to hire and train additional aviation medical examiners, and $1.5 million per year for the same period for a public information campaign to reduce stigma around mental health care in the aviation industry.
Who benefits
Pilots and air traffic controllers who currently avoid seeking mental health treatment out of fear it will cost them their medical certification or career. Aviation medical examiners who would receive additional training and resources. Passengers and the flying public who may benefit from a workforce that is more likely to proactively address mental health conditions. Mental health professionals and psychiatrists who could be newly authorized as aviation medical examiners, expanding their practice. Airlines and aviation employers who may see a healthier, more stable workforce. Prospective aviation workers who might otherwise be deterred from entering the field due to mental health concerns.
Who is hurt
Taxpayers who fund the approximately $45.7 million in total appropriations over three years. Aviation medical examiners under the current system who may face increased oversight and expanded responsibilities. Pilots or controllers whose conditions are disclosed and who may still face certification consequences depending on how updated regulations are written. Competing priorities within the FAA's existing budget, which could be crowded out by the set-aside funding requirements.
Supporters argue
Supporters argue that current FAA regulations create a powerful disincentive for pilots and air traffic controllers to seek mental health care, because disclosure can trigger loss of medical certification and, effectively, one's career. They contend this "chilling effect" means mental health conditions go undetected and untreated in the cockpit — a direct safety risk — and point to National Transportation Safety Board recommendations and the 2024 Mental Health Aviation Rulemaking Committee report as evidence that the existing system is broken. Supporters argue the bill addresses a documented gap by aligning aviation mental health policy with modern clinical standards, expanding the pool of qualified medical examiners, and creating a pathway for treatment without automatic career penalty.
Opponents argue
Opponents argue that loosening mental health disclosure requirements and expanding approved medications for active pilots and controllers could introduce unacceptable safety risks in a zero-tolerance industry where a single incapacitation event can be catastrophic. They contend that the bill delegates broad discretion to the FAA Administrator to reclassify medications and expand examiner authority without specifying clear safety standards, and that the two-year implementation timeline may be too compressed for rigorous clinical vetting. Opponents may also argue that the $45.7 million appropriation is an inefficient use of funds if the underlying regulatory framework — which ties certification to fitness for duty — is not fundamentally restructured alongside the stigma-reduction effort.