March 12, 2025

In late February, President Trump signed two executive orders that could have implications for employers: one focused on health care price transparency and another directing federal agencies to review and potentially rescind regulations deemed “unlawful” or “burdensome.” While the exact impact remains uncertain, these directives signal potential regulatory shifts that could affect plan sponsors in the months ahead.

Executive Order on Transparency in Health Care Pricing

The health care transparency order builds on prior efforts to require hospitals, insurers, and health plans to disclose more pricing data, with a particular focus on ensuring that patients and employers have clearer insight into health care costs. The order directs federal agencies, including the Departments of Health and Human Services (HHS), Labor (DOL) and Treasury to take all necessary steps to improve existing price transparency requirements and increase enforcement efforts. It also instructs agencies to explore opportunities to expand disclosure requirements, potentially including additional reporting obligations for health plans.

For large employer plan sponsors, this order likely foreshadows development of additional guidance pertaining to the machine-readable file for prescription drugs under the Final Transparency in Coverage (TiC) Rule issued in late 2020. The original Final TiC Rules require individual and group health plans and health insurance issuers offering non-ACA grandfathered health coverage to disclose the following information on a public website: (i) in-network rates for covered items and services, (ii) out-of-network allowed amounts and billed charges for covered items and services, and (iii) negotiated rates and historical net prices for covered prescription drugs. However, under previous guidance, enforcement of the requirement for plans to publish machine-readable files with prescription drug pricing data had been delayed indefinitely.

With the administration’s renewed emphasis on transparency, it is possible that regulators may take steps to end that delay, provide the file specification, and begin enforcement of the requirement for prescription drug pricing data. Plan sponsors may need to ensure compliance with these reporting requirements in the near future.

Executive Order on Regulatory Review

The second executive order, aimed at reviewing and rescinding certain types of regulations, could have broader implications for employer-sponsored plans. It instructs agencies to conduct a 60-day review of existing regulations and identify those that the administration consider unconstitutional, exceed statutory authority, or “impose significant costs upon private parties that are not outweighed by public benefits.” The order also highlights rules that address social, economic, or political issues without clear congressional authorization ought to be targeted for revision or repeal.

One regulation that may come under scrutiny is the final rule on the Mental Health Parity and Addiction Equity Act (MHPAEA) issued in September 2024. That rule introduced more detailed compliance requirements for employer-sponsored plans, particularly around the comparative analysis of nonquantitative treatment limitations (NQTLs) and special fiduciary certification requirements. The MHPAEA final rule has been subject to a legal challenge and general but significant scrutiny from a wide array of stakeholders; a common criticism of the 2024 regulations is that they go beyond the intent of the original statute.

Given the administration’s focus on regulatory rollback, it is possible that agencies may review whether the rule aligns with the new approach and consider scaling back certain provisions. While no immediate changes have been announced, the review process could lead to adjustments in enforcement priorities or modifications to the rule itself.

Next Steps

At this stage, the agencies have not taken action to rescind prior guidance but are undertaking review as directed in the Executive Order. Until the agencies provide additional information about which, if any, regulations they may address, plan sponsors will need to continue to comply with rules issued under the Biden administration. The Business Group will continue monitoring these developments and providing updates on any changes that may affect employer health plans.

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