"This memorandum sets forth EBSA's enforcement priorities and guiding principles. These priorities and principles are designed to ensure that EBSA's enforcement is fair, even-handed, responsive, and focused. The four priorities address: [1] Focusing enforcement on the most egregious conduct and significant harm; [2] Ensuring, whenever possible and consistent with our mission, that EBSA does not regulate by enforcement and instead promotes fairness, prior notice, and clarity to the regulated community; [3] Requiring proper review by senior agency officials of all critical enforcement initiatives; and [4] Committing to timely and responsive enforcement. These principles will ensure that the Department's enforcement authority is used in a manner that promotes transparency, consistency, and the rule of law." MORE >>
"The White House requested a discretionary budget of $9.9 billion for the DOL as a whole. The DOL enacted budget for 2026 was $13.7 billion.... [EBSA] would receive $181.1 million in funding, a cut of $10 million from 2026 enacted levels, and the same as the requested level from last year by the White House.... The IRS requested $9.8 billion in funding, a cut of $1.4 billion from the enacted level for 2026. The White House blueprint adds that ... agency staffing was reduced by 27%." MORE >>
30 pages. "This reform agenda is designed as a 'bill of rights' to ban abuses that deny care, lower deductibles, and stop premium shocks -- in other words, to respond to the growing feeling that health insurance costs too much and offers too little value or protection. A key theme of this report is that markets in health care are highly concentrated, driving up medical prices and premiums." MORE >>
"From implementing new tax laws, a flurry of executive orders with implications for both retirement and welfare plans, updated agency guidance, increased litigation and enforcement activity, and updates to longstanding requirements, plan fiduciaries have a great deal to manage as they work to stay current. Layered onto these federal developments is a growing patchwork of state and local regulation. Jurisdictions continue to expand mandated benefits, including insurance coverage requirements and state retirement savings programs. For plan sponsors operating across multiple jurisdictions, coordinating compliance has become not only an administrative challenge, but a strategic one." MORE >>
"West Virginia’s Public Employees Insurance Agency enrolls nearly 215,000 people — state workers, as well as their spouses and dependents. The new law, which will take effect June 10, will allow plan members who have been approved for a course of treatment to pursue an alternative, medically appropriate treatment of equal or lesser value without the need for another approval from the state-based health plan." MORE >>
"Recent statements by the EBSA leadership and Assistant DOL Secretary, Daniel Aronowitz, frame ERISA litigation as abusive,' 'frivolous,' and in need of increased structural restrictions.... This position ... is inconsistent with ERISA's statutory design, controlling Supreme court precedent, and the legislative history of ERISA itself. Properly understood, ERISA depends upon participant-driven litigation as a primary enforcement mechanism.... [E]fforts to restrict access to the courts undermine -- not further -- ERISA's core purposes." MORE >>
"Democrats are casting about for new health reform ideas in the hope that they can gain traction in the run-up to 2028 and be enacted afterward.... There are at least three equally important big priorities Democrats will be thinking about that are in themselves challenging and, in a world of limited dollars and political capital, will be in tension." MORE >>
"The success of any regulation depends on its details. Policymakers must move from the abstract to the concrete when they strive to implement a policy goal, such as lowering prices for health care services in the commercial market. This requires them to address a series of issues ranging from whether pro-competitive strategies can substitute for a regulatory approach and, if price regulation is implemented, how it should be structured. [The authors] discuss ten issues that policy makers must confront." MORE >>
" 'Employer-sponsored coverage isn't one small part of the health care system -- it is the American health care system,' said Dan Aronowitz, assistant secretary of labor and head of the Employee Benefits Security Administration.... With premiums for families covered under employer plans exceeding $26,000 annually, Aronowitz said, 'We are spending more on health care and getting less in return.' " MORE >>
"David Marin, CEO of the PCMA, said ... that given the requirements signed into law in the funding deal, PBMs will soon be required to provide significant amounts of data to employers, unions and government agencies.... As these organizations adapt to the requirements including in the funding package, the [DOL] should roll back the proposed rule rather than 'forcing PBMs to comply with a Rube Goldberg regulatory machine,' Marin said." MORE >>
"The Health Care Affordability and Mitigation Working Group met for the first time last week. Members discussed a 2026 work plan, outlining a fast-paced schedule to develop affordability recommendations for regulators and lawmakers. The initiative will focus on examining factors that drive health care costs and insurance premiums, including expenses within the health system that ultimately flow into insurance pricing." MORE >>
"More than five years into an era with price transparency requirements on the books, TiC data, along with related price transparency efforts ... are still in a lengthy and iterative implementation phase.... Through the proposed rule amendments and related efforts, the Departments are responding to feedback from TiC data users about needed improvements.... [The authors] provide context on the broader array of recent federal price transparency efforts ... summarize the major changes being proposed in the new TiC amendment and discuss their likely effects." MORE >>
"There are only so many tools payers have now to throw at health care costs, and prior authorization is one of them. But in a health system plagued as much by complexity as high costs, it is now public enemy number one for health care consumers ... The serious question we are not asking is whether the benefits it has for short-term cost control for insurers and their clients are worth the costs to patients and health professionals in an already labyrinthian health care system?" MORE >>
"[AHIP] recommend[s] HHS work closely with states to consider legislative schedules and delay implementation of defrayal requirements until plan year (PY) 2028.... [S]ome additional verification proposals should be deferred until HHS can evaluate whether the Working Families Tax Cut (WFTC) pre-enrollment verification requirement and other recently enacted measures are achieving their intended program integrity effects.... HHS should not finalize provisions allowing non-network plans to receive QHP certification. The proposal raises important questions about consumer protection, balance billing, claims processing, adverse selection and compliance with existing ACA requirements." MORE >>
"Seven percent of adults who currently take prescription medication say they have visited the TrumpRx website to compare prescription drug prices, rising to one in six (16%) of those who currently or have ever taken a GLP-1 medication ... [A] majority of the public (59%) is worried about affording prescription drugs for themselves and their families, the largest share since KFF first polled this question in 2018.... About four in 10 (43%) U.S. adults say they have not taken their medication as prescribed in the past year due to costs." MORE >>
"For over 50 years, [ERISA] has served as the foundation around which employer benefit plans are built. That foundation, however, has shown cracks in recent years as the cost of healthcare continues to rise and many states try to take regulatory matters into their own hands. From Alabama to California, state houses have passed legislation intent on keeping pharmaceutical costs in check. Many of these laws are being challenged in the courts. How those cases play out could mean change and greater complexity in the ways that employers manage health and welfare benefits." MORE >>
"While federal policymakers continue to debate broader reforms to the pharmaceutical supply chain, state attorneys general and insurance commissioners have begun taking matters into their own hands. Recent enforcement actions involving two of the nation's largest PBMs, CVS Caremark and Express Scripts, illustrate how states are increasingly regulating PBMs and challenging practices that they believe harm independent pharmacies and drive up drug costs." MORE >>
"The White House and Congress have coalesced around a health reform concept: promoting high-deductible health plans linked with subsidized spending accounts to pay for out-of-pocket costs. A central argument is that shifting costs from insurance companies to consumers will encourage them to shop for services, lowering health care utilization, prices, and thus costs.... [This] article reviews the evidence and arguments for this approach, concluding that it should be abandoned rather than expanded. Policy makers could start where the current policy debate is centered: lowering deductibles in the [ACA] health insurance marketplace plans." MORE >>
"Lawmakers continue to advance a wide range of approaches designed to enhance prescription drug access and affordability for both states and consumers. Even as the legislative landscape evolves, initiatives including PBM and 340B reform are likely to be enacted this year. " MORE >>
"The net effect [of price transparency] is therefore ambiguous and depends on market structure, benefit design, and -- crucially -- who can practically use the information.... In many administered-price systems such as the UK and many EU countries, published prices already exist; transparency is more likely to operate through benchmarking, audit, and governance rather than consumer price shopping.... [The authors] argue that, in the US, transparency must be paired with steerage and competition guardrails to realize savings without inadvertently enabling coordination." MORE >>
"Tucked within the Consolidated Appropriations Act, 2026 (HR 7148), signed on February 3, 2026, are structural mandates that will reshape Pharmacy Benefit Manager (PBM) operations in Medicare Part D and the commercial sector by 2028. The legislation targets three primary pillars: revenue delinking, rebate transparency, and pharmacy network equity." MORE >>
"In addition to no formal meetings, there was 'no correspondence, no communications, no nothing' in 2025. Multiple members inquired about the status of the EAC in 2025 and none of those inquiries were answered ... The website for the Council confirms there was no output for 2025 and lists no nominees or an agenda for 2026." MORE >>
"The brief urges the Court to allow the plaintiff's case to proceed by rejecting the defendant's motion to dismiss.... The suit ... alleges the defendants illegally exploited the IDR system by overwhelming the IDR process with hundreds of disputes they knew were ineligible, resulting in millions of dollars in improperly obtained awards. Plaintiffs' claims include violations of [ERISA, RICO], California's Unfair Competition Law, and common law fraud." [Anthem Blue Cross v. Halomd, No. 25-1467 (C.D. Calif. amicus brief filed Feb. 6, 2026)] MORE >>
