On January 28, 2025, the Trump administration issued Executive Order 14187, which declares that it is the policy of the United States not to “fund, sponsor, promote, assist, or support” gender transition for people under 19, which includes 18-year-olds who are legal adults in the states where they reside. Among other things, the order requires federal agencies, such as HHS, to take all appropriate actions to end the “chemical and surgical...

In a brief filed on February 18, 2025, the Trump-appointed secretaries of the DOL, IRS, and HHS (the departments) asked the US Supreme Court to reverse the Fifth Circuit Court of Appeals (Fifth Circuit) decision in Braidwood Management Inc. v. Becerra (Braidwood), which found some ACA preventive care coverage requirements to be unlawful.

On February 11, 2025, the Congressional Research Service (CRS) published an updated report on HSAs. The report noted that HSA-qualified HDHP enrollment generally increased from the mid-2000s to 2020. Large employers had a higher percentage of covered employees enrolled in HDHPs with a savings option in 2024 relative to small employers (28% to 23%). The report also cited a review by the Bureau of Labor Statistics, which was based...

The DOL, HHS, and IRS (the departments) issued FAQs Part 69, which provides additional guidance regarding the CAA 2021 gag clause prohibition and attestation requirement.

The DOL issued an opinion letter clarifying the “substitution” provision under the FMLA when it intersects with a state paid family and medical leave (PFML) program or local paid leave (e.g., paid sick leave) law. The term “substitute” means that either the employer or employee, on their own, can decide to have employer-provided paid leave (e.g., PTO, sick leave, vacation) run concurrently with the unpaid FMLA leave.

A federal court in the Northern District of Texas issued a preliminary injunction against HHS in a case concerning the 2024 HIPAA Privacy Rule to Support Reproductive Healthcare Privacy, preventing that agency from enforcing that rule against the plaintiffs pending the resolution of litigation.

The court found that the plaintiff participant had failed to establish standing as required under Article III of the US Constitution. Generally, the court’s ruling and opinion are good news for plan sponsors, and highlight the many challenges plaintiffs will face in establishing Article III standing to pursue similar fiduciary breach claims.

The executive orders do provide a general road map on where the Trump administration may go with its health policy, including potential impacts on employer group health plans.

The 2024 Report highlights ongoing efforts of the departments to enforce protections of MHPAEA and, more specifically, the CAA 2021 nonquantitative treatment limitation (NQTL) comparative analyses requirements.

The DOL and CMS recently released the 2023 Mental Health Parity and Addiction Equity Act (MHPAEA) Enforcement Fact Sheet that summarizes MHPAEA enforcement efforts for fiscal year 2023.