Sponsors (7)
The bill strengthens enforcement and accountability to protect people with mental‑health needs and those whose genetic information is at risk, but it raises compliance exposure for sponsors and providers and could lead insurers to tighten coverage or raise costs for enrollees.
People with mental health or substance use disorders gain stronger enforcement of parity rules because civil penalties can be imposed on plan sponsors, administrators, and service providers, improving compliance and access to covered mental‑health and substance‑use services.
Patients with chronic conditions and people with disabilities obtain clearer legal remedies against misuse of genetic information because civil penalties explicitly apply when genetic‑information protections are violated.
Hospitals, health systems, plan administrators, and service providers are more accountable because liable parties are expanded to include service providers and administrators, making enforcement reach more entities that manage plan operations and benefits decisions.
Small business owners, employers, and plan sponsors may face higher compliance costs and potential fines as a result of expanded enforcement, raising administrative burdens and operating costs.
Middle‑class families, Medicaid beneficiaries, and other enrollees could experience tighter coverage or higher premiums if health plans adjust benefits or pricing to offset increased enforcement risk and potential penalties.
Hospitals, health systems, and providers may face increased administrative and litigation activity because enforcement authority is broadened and some prior enforcement limits are removed.
Based on analysis of 2 sections of legislative text.
Allows civil monetary penalties under ERISA for mental health/substance use parity and genetic information violations and expands liable parties to sponsors, providers, and administrators.
Strengthens enforcement of mental health and substance use disorder parity and related genetic information protections in employer-sponsored group health plans by allowing civil monetary penalties for violations and expanding who can be held liable. The bill expands existing ERISA enforcement so penalties can apply to plan sponsors, service providers, and plan administrators, and allows federal enforcement of parity rules; the changes apply to plan years starting more than one year after enactment.
Introduced February 4, 2025 by Donald Norcross · Last progress February 4, 2025