Executive Orders and Your Benefit Planning

PUBLISHED FEBRUARY 2025

Recent executive orders by President Trump introduced drastic changes within employer-sponsored health benefits, from prescription-drug costs to complying with the Affordable Care Act. Many of these changes may puzzle employers and benefits administrators; however, they must stay informed about them to ensure compliance and adjust their benefits strategies. 

A New Mandate to Look into Requiring IVF Coverage. The newest executive order directed Vince Haley, the assistant to the president for domestic policy, to find a way to increase access to IVF treatments and reduce out-of-pocket and health plan costs for IVF treatments in about three months. A fact sheet released with the order also appears to indicate that the administration has concerns about the limited number of employers that cover IVF for their employees, potentially opening the door for a push to make such coverage a requirement.  

Fixed-Indemnity Plan Notice Requirements Rescinded. The most immediate impact of these new executive orders is the rescission of notice requirements for fixed-indemnity plans. Previously, a consumer notice was required to clarify that these plans do not serve as primary health insurance. However, this requirement was eliminated, and employers are no longer obligated to provide this notice.

This change underscores the importance of educating employees on the role and limitations of fixed-indemnity coverage. Given no mandated notice, employers should consider proactive communication strategies to help employees understand their benefit options.

Prescription Drug Costs and ACA Subsidies. An executive order recently revoked health-related initiatives from the Biden administration. The abolishment of enhanced ACA enrollment and marketing subsidies may result in reduced marketplace enrollment in 2026. 

On top of this, other efforts to decrease prescription drug costs for Medicaid and Medicare have been rescinded.

While these two changes don’t have direct impacts on employer-sponsored group health plans, any change in marketplace and government coverage is likely to have ancillary impacts on employer-sponsored coverage. These impacts may become clearer as we move through 2026.

Revocation of Gender-Affirming Care Funding. An additional executive order removed federal funding for gender-affirming care, which affected employer-sponsored health plans. Under the ACA, many employer plans were required to include gender-affirming care as an essential health benefit. Yet, the latest executive order has been scrutinized regarding these requirements.

ACA Compliance and Preventive Health Services. Another executive order redefines key ACA terms, such as gender identity and sex, which could impact compliance requirements for employer-sponsored plans. These changes can affect preventive health services secured by the ACA, including screenings and treatments previously mandated under broader interpretations of the law.

Employers may need possible revisions on their health plan policies and should consult with legal and benefits experts to ensure compliance with the latest regulatory definitions. These changes in coverage requirements could impact benefit offerings and access to essential healthcare services for employees.

Taking Steps Forward. As these—and possibly more—executive orders roll over, it’s imperative that employers stay alert about their health benefits. Changes to IVF coverage, indemnity-plan requirements, prescription drug costs, gender-affirming care, ACA compliance, and preventive health services have implications for work-force health coverage. By staying ahead and monitoring these changes, organizations can better support their employees while ensuring compliance with the latest regulatory developments.