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The administration of President Donald Trump has backed away from trying to implement new mental health parity regulations that were adopted by the administration of former President Joe Biden — but it left open the possibility that it might try to change the regulations instead of simply rescinding them.
The regulations would require employer-sponsored health plans to show that their plans offered comparable "non-quantitative treatment limits" — such as rules for what kinds of providers can treat patients and in what settings — for mental health care and other forms of health care.
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U.S. District Court Judge Timothy Kelly agreed Friday to approve a motion by lawyers for the Trump administration to provide a "stay," or suspension of action, on the case, The ERISA Industry Committee v. U.S. Department of Health and Human Services et al.
In addition to HHS, the list of departments involved in the case includes the U.S. Treasury Department and the U.S. Labor Department.
Related: MHPAEA: Feds post final mental health parity regulations
Administration officials were not immediately available to comment on the stay.
James Gelfand, president of ERIC, the group that filed the suit, welcomed approval of the stay.
"Despite extensive efforts to work with the previous administration, the final rule requirements are wholly unworkable, and litigation became the only path to protecting employees and their access to quality, affordable benefits," Gelfand said. "We are pleased that the Trump administration has responded to the lawsuit, will not penalize employers under the rule while the case is pending, and is reconsidering the rule to address the concerns ERIC expressed throughout the regulatory process."
ERIC would like to see the Trump administration develop parity regulations that are more clear and more flexible, Gelfand said.
The history: The non-quantitative treatment limitations regulations involved in the order to implement part of the Mental Health Parity and Addiction Equity Act of 2008 and the mental health parity provisions in the Consolidated Appropriations Act, 2023.
The law does not require large employer health plans or self-insured employer plans to cover mental health care and addiction treatment, but it requires plans that cover that kind of care to provide coverage that's similar to the coverage for other forms of health care.
The parity requirements apply to small, fully insured employer plans because federal regulators have included behavioral health coverage in the standard "essential health benefits" package" for individual major medical insurance and small-group major medical insurance.
Insurance, benefits and employer groups have been clashing with federal regulators over how the regulators might draft and implement the NQTL provisions for years. Industry and employer groups have asked for clear-cut NQTL rules. Patient and provider groups have mostly asked for more general guidelines, in an effort to reduce the likelihood that health plans would use loopholes to avoid providing real parity for mental health care and addiction treatment.
The Biden administration's own regulation impact review team acknowledged that complying with the NQTL regulations could be difficult and costly for employer plans.
The impact review team predicted that implementation would cost $656 million in the first year and $131 million per year in later years.
The current situation: Trump has signed an executive order that could let federal departments rescind the non-quantitative treatment limits regulations quickly, but, so far, his administration has avoided including the regulations in its early wave of efforts to rescind Biden administration regulations.
The general goal of improving mental health care has strong, bipartisan support. The list of Republican members of the Congressional Mental Health Caucus includes Rep. Buddy Carter, R-Georgia, and Rep. Gus Bilirakis, R-Fla.
Carter is the chair of the Health Subcommittee at the House Energy and Commerce Committee. Bilirakis is one of the longest-serving members of the Health Subcommittee.
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