Preventive Care Mandate Stays, Big Beautiful Bill Becomes Law

Recent developments at the federal level bring certainty and new options for plan sponsors of group health plans. The U.S. Supreme Court held that the Affordable Care Act’s (ACA) preventive care mandate is lawful, which means plan sponsors do not need to make any changes to their plans’ preventive care coverage. New legislation offers an expansion of health savings account (HSA) eligibility, with permanent relief for first dollar coverage of telemedicine services, along with a long-awaited increase to the maximum contribution to a dependent care flexible spending account.

Preventive Care Mandate Stays in Place

In ACA news, the U.S. Supreme Court upheld the ACA’s preventive care mandate. The Court allowed the U.S. Preventive Services Task Force (USPSTF) to continue deciding which services will be available free of cost to Americans enrolled in plans covered by the ACA. Under the ACA, non-grandfathered group health plans and insurers must cover certain preventive health services with no cost-sharing on an in-network basis. The mandate requires in-network coverage of preventive services recommendations from three entities:

1. The USPSTF, which gives “A” or “B” ratings for specific evidence-based items and services.
2. The Health Resources and Services Administration (HRSA), which has guidelines regarding preventive care and screening for infants, children, adolescents, and women.
3. The Advisory Committee on Immunization Practices (ACIP), which issues recommendations on immunizations.

Bottom Line: Plan sponsors can now be certain that the ACA preventive care mandate will remain in place, with no need to reconsider or modify preventive care coverage.

Big Beautiful Bill Signed Into Law

The One Big Beautiful Bill Act (BBB) was signed into law on July 4, 2025. Although it is generally a tax and spending bill, it contains provisions that affect sponsors of health and welfare plans. Key changes include:

• Permanent relief allowing telemedicine to be excluded as disqualifying health coverage for high-deductible health plans with health savings accounts (HSAs). This allows these plans to pay for telemedicine as first-dollar coverage without impacting HSA eligibility. This change is retroactive to January 1, 2025.
• An increase in the dependent care flexible spending account maximum to $7,500 in 2026.
• Allowing Exchange Bronze and Catastrophic Plans and direct primary care arrangements to be used with an HSA without being considered disqualifying coverage.

Bottom Line: Plan sponsors now cover telemedicine under an HDHP with HSA plan on a pre-deductible basis without affecting HSA eligibility and know this option is permanent. They can also bring welcome news to employees that their dependent care account maximum has been increased for 2026. Call your Stephens Insurance representative if you have questions or need further information.