The Trump administration paused newly issued mental health insurance protections during its second term, despite having backed mental health funding during his first presidency. The action threatens to undermine enforcement of the 2008 Mental Health Parity and Addiction Equity Act, which requires insurers to treat mental and physical health care equally.
Rules released in September 2024 required health plans to gather and report detailed data on how they restrict or deny mental health claims and explain disparities compared with medical care. The Trump administration placed these regulations on hold for 18 months while considering rescission or modification. Days before Trump’s inauguration, the ERISA Industry Committee (ERIC), a trade group representing large employers on benefits policy, sued to block the regulations. The judge granted the Trump administration’s request to pause litigation.
Funding cuts compound the impact. Congress allowed temporary supplemental funding for the Employee Benefits Security Administration (EBSA)—which enforces mental health parity in most employer-sponsored plans—to expire. This funding had been approved shortly after Biden’s election. EBSA’s workforce is now set to decline from 831 employees in 2024 to 687 or fewer in 2026. Positions fell hardest in two key areas: benefit advisers fielding coverage denial calls dropped 30 percent, and investigative staff shrank nearly 40 percent.
ProPublica’s investigation documented that insurers often block mental health care, underpay providers, and make it difficult for patients to find help—sometimes with fatal consequences. Ali Khawar, former EBSA deputy director, warned the agency lacks resources for rapid investigations: “With less money and fewer employees, the agency isn’t equipped to open new investigations quickly.” Between February 2021 and July 2024, EBSA conducted only 150 investigations and issued 70 violation findings, despite overseeing 150 million Americans’ workplace benefits. Federal employees and experts warn that suspending rules and cutting enforcement could lead to longer waits challenging insurance denials, fewer investigations, and more people going without legally entitled care.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.propublica.org/article/mental-health-insurance-trump-rules