Any Trump administration efforts to cancel regulations based on Loper Bright could affect a new final rule, released in September 2024, that may affect how employer health plans and other health plans comply with the Mental Health Parity and Addiction Equity Act of 2008 when designing "non-quantitative treatment limits," or NQTLs.

Related: 2024 final mental health parity regulations: first impressions

Benefits law specialists at Groom Law Group suggested when the NQTL regulations came out that they would be an obvious target for lawsuits based on the Loper Bright ruling, because many employers believed the Labor Department had gone beyond the letter and intent of the MHPAEA when it developed the NQTL regulations.

"MHPAEA was not intended to be a benefit mandate," the Groom attorneys said.

NQTL basics: The MHPAEA itself does not require fully insured group health plans or self-insured employer health plans to cover mental health care or addiction treatment services.

If an employer plan with 51 or more participants does cover behavioral care, MHPAEA requires that the behavioral health coverage be comparable to the other health care coverage.

Federal and state regulators have used Affordable Care Act coverage rules to apply the MHPAEA standards to fully insured individual and group health insurance created or changed since 2010.

Well-established regulations already prohibit coverage providers from applying different deductibles, visit number limits or other "quantitative standards" for care for anxiety than for care for a broken leg.

A plan's "non-quantitative treatment limits," or NQTLs, affect plan features such as the structure of the provider network, the procedures a patient has to follow to get coverage for care, and the standards used to decide whether a plan will cover inpatient care for a condition.

The Labor Department's September 2024 MHPAEA rule explains what a health plan has to do to achieve parity for NQTLs for behavioral health care and other forms of care.

Network adequacy requirements in the final rule create procedures a plan would have to follow to show that it had enough behavioral health providers.

Early NQTL regulations reactions: The Biden administration's own impact review team acknowledged that complying with the NQTL regulations could be difficult and costly for employer plans.

The impact review team predicted that implementation would cost $656 million in the first year and $131 million per year in later years.

The American Benefits Council and the ERISA Committee have argued that the NQTL regulations are unrealistic, partly because network adequacy standards in the final rule fail to account for the current shortage of behavioral health providers willing to accept health insurance.

The Trump administration's approach: Trump administration officials have not talked about how they see the NQTL regulations.

The administration used an early wave of executive orders to begin the process of overturning some Biden-era benefits regulations, such as regulations that established warning-label requirements for sellers of supplemental health benefits products.

The early executive orders did not mention the NQTL regulations.

Lori Chavez-DeRemer, the new Labor secretary, could keep the existing regulations in place and use information letters, fact sheets and other "guidance" to ease compliance concerns.

She could also use the new executive order to kill the regulations without bothering to replace them, or she could kill the regulations and begin an effort to develop new, easier-to-implement NQTL regulations.

The long-term executive order impact: Attorneys at Wiley said in a commentary on the new executive order that efforts to allow quick elimination of old regulations could be a mixed blessing for the regulated entities.

Regulated entities may like the idea of getting immediate relief from burdensome regulations, but the executive order "creates the risk that beneficial regulations may be repealed without an opportunity to raise objections or defend the utility, application, or legality of a targeted regulation," the Wiley attorneys said. "Another risk is that regulatory repeals undertaken without notice and comment may face additional legal obstacles in court, potentially creating regulatory uncertainty — at least in the short term."