Since taking office, President Donald Trump has issued several executive orders (EOs) and actions that may have an impact on group health plans. These EOs provide insight into the US administration’s policies and outline potential actions that regulatory agencies and Congress may take to implement these policies.
The Executive Orders
- Regulatory Freeze Pending Review – This EO institutes a regulatory freeze, which is a standard procedure for any new administration. This EO prevents the proposal or issuance of any new rule, withdraws any rules sent for publication in the Federal Register, and delays (for at least 60 days) the effective date of all newly published federal rules in the Federal Register until the new administration can approve them. This EO may impact and freeze the notice of proposed Rulemaking issued by the US Department of Health and Human Services (HHS) on the HIPAA Security Rule, which we previously discussed in a LawFlash.
- Defending Women from Gender Extremism and Gender Ideology and Restoring Biological Truth to the Federal Government – This EO sets the policy where the federal government recognizes only two sexes, male and female, and removes any reference to the term “gender” or “gender ideology” from all federal policies and documents. This EO may impact group health plan administration, particularly those group health plans that allow participants to identify as non-binary.
- Enforcing the Hyde Amendment – This EO sets the policy to prevent the use of federal money to fund or promote elective abortions and revokes the EOs issued under the Biden administration protecting and securing access to reproductive healthcare services. This EO may impact group health plans that provide coverage and travel benefits to make reproductive healthcare available to participants in jurisdictions where it remains legal, as well as removing the additional protections and restrictions imposed on the confidentiality of reproductive healthcare.
- Protecting Children from Chemical and Surgical Mutilation – This EO sets the policy to prohibit gender-affirming care for children ages 18 or younger. The EO also prohibits federal funding of hospitals and research institutions that provide gender-affirming care to minors and further directs the HHS to take appropriate actions to end Section 1557 nondiscrimination protection and essential health benefit requirements. (We previously discussed the HHS’s final regulations on Section 1557 and the implication for health plans.) Any regulatory actions taken to enforce the policies in this EO will directly impact group health plan coverage and the delivery of gender-affirming care. Note that in conjunction with this EO, the HHS issued a letter rescinding Section 1557 regulations given that those regulations do not reflect the view and policies of the current administration.
- Expanding Access to In Vitro Fertilization – This EO calls for policy recommendations to reduce the costs associated with IVF and eliminate unnecessary regulatory barriers. It remains to be seen how this directive will be implemented.
- Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing – President Trump issued EOs during his first term in office that introduced transparency requirements under the Affordable Care Act. This EO reinforces those requirements and goes further directing the regulatory agencies to take action and (1) require the disclosure of actual prices of items and services (not estimates); (2) issue updated guidance or proposed regulatory action ensuring pricing information is standardized and easily comparable across hospitals and health plans; and (3) issue guidance updating enforcement policies designed to ensure compliance with these requirements. Any guidance issued by the regulatory agencies will require plan sponsors to work closely with the health plan’s third-party service providers to meet these updated transparency requirements. While not expressly stated, the purpose is to empower patients with meaningful price information, reduce healthcare costs, and improve the quality of care by fostering a competitive and innovative healthcare environment.
Plan Sponsor Actions
While the EOs outlined above are not law, plan sponsors should expect legislation and a new regulatory framework that will begin to implement the administration’s agenda and policies as outlined in the EOs. Although most plan sponsors may not need to take any immediate action, they should nonetheless be prepared to consider the impact of the current administration’s policies, including as they relate to gender-affirming care, access and privacy rights related to reproductive healthcare, and additional transparency reporting obligations. The emphasis on healthcare price transparency may require updates to plan communications and tools to ensure participants have access to the necessary pricing information.
If you have questions about the EOs or how they impact your health and welfare plans, please feel free to contact the authors of this blog post or your usual Morgan Lewis contacts.