Federal pause on new mental health parity rules creates uncertainty for insurers.
A recent legal development has stirred uncertainty among employers, health insurance companies, and mental health advocates. In January 2025, a business group representing large employers filed a lawsuit challenging new federal rules meant to improve access to mental health and addiction treatment under existing laws. These rules were part of a broader effort to make sure insurance coverage for mental health and substance use is treated the same as coverage for physical health. But with the case pending, the federal government announced it would pause enforcement of the new rules for now, leaving many people wondering what happens next.
On May 15, 2025, federal agencies responsible for health and labor oversight made it clear that they would hold off on enforcing the updated rule that came out in 2024. This announcement followed a court request to pause the legal case, which the court approved. The new stance follows a White House directive asking federal departments to review existing rules and ease burdens that may harm small businesses or carry high costs without proven benefits. As a result, the agencies will not act against companies or insurers that fail to meet the 2024 rule—at least not until the legal case is settled, plus another year and a half on top of that. In the meantime, the older 2013 rule is back in play.
Several key requirements from the 2024 update have now been put on hold. One of them was a rule that required insurance plans to use real-world data to prove they offered equal access to mental health care. That is no longer required, at least for now. Another part that’s been suspended is the rule saying plans must offer real, helpful mental health treatment wherever they also offer physical health coverage. Plans had to show that they covered basic, evidence-based care for mental health in every area they cover for physical conditions. That is also on pause.
A third requirement—the “fiduciary certification”—is no longer being enforced either. This would have required the people who manage benefit plans to sign off on a formal review proving they met mental health coverage rules. They also would have had to keep an eye on any outside company they hired to help with that task. With enforcement suspended, these extra steps are no longer required for now.
However, not everything is off the table. Employers and insurers are still expected to do a side-by-side comparison of how they cover mental health versus physical health, especially when it comes to rules that are hard to measure, like treatment limits. These comparisons must be written out and ready to show to regulators if asked. This requirement comes from a different law passed in 2021, and it is still in effect.
What’s less clear is what the enforcement process will look like during this pause. The government hasn’t said much about how it will handle audits or ongoing investigations, and there is no word yet on whether states will follow the federal lead. In most cases, state agencies are in charge of making sure insurance companies follow mental health parity laws. The agencies said they will re-examine their approach to enforcing these rules and might release more guidance down the road.
For now, companies and insurers are being told to keep doing their best to follow the laws that are still active. That means keeping paperwork in order, comparing how different benefits are handled, and making sure mental health care is not unfairly limited. Even though some rules are paused, the expectation is still there: mental health coverage must be taken seriously, and it should be treated the same as other medical care. The path forward may not be completely clear, but that basic idea hasn’t changed.
Sources:
Department of Justice Mental Health Parity Regulations Suspended
New Lawsuit Challenges Final MHPAEA Rule and Tests Limits of Federal Agency Authority
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