A key mental health parity regulation finalized by the Biden administration has been put on hold following a court ruling and mounting legal opposition. The rule, which was designed to ensure that mental health and substance use disorder (MH/SUD) benefits are covered on equal terms with medical and surgical care, is now under review by the Trump administration and will not be enforced while litigation is pending.
Announced in late 2023 and partially implemented in 2024, the final rule expanded on the Mental Health Parity and Addiction Equity Act of 2008, requiring health plans to closely examine how they deliver MH/SUD care. Plans found lacking in access or coverage were expected to improve provider networks, reduce prior authorization burdens, and adjust out-of-network payment practices. The goal was to increase access to mental health services and eliminate administrative barriers that can delay or discourage care.
However, in response to lawsuits from employer groups, including the ERISA Industry Committee (ERIC), the Departments of Labor, Health and Human Services, and the Treasury issued a joint statement on May 15, announcing they would pause enforcement of the rule. Employers will not face penalties for noncompliance prior to a final court decision — plus an additional 18-month grace period.
ERIC’s legal challenge argues that the rule oversteps regulatory authority and imposes unreasonable administrative and financial burdens on employers, many of whom already offer comprehensive benefit programs.
With enforcement now suspended, the future of the rule is uncertain. The Trump administration is considering whether to revise, scale back, or rescind the regulation altogether. For now, employers are not required to make changes to comply, but the legal and policy landscape surrounding mental health parity continues to evolve.