How new executive orders will impact FEHB coverage next year

President Trump recently issued two executive orders, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” and “Protecting Children from Chemical and Surgical Mutilation.” Acting on these orders, the Office of Personnel Management released new guidance to FEHB carriers that will impact available benefits and plan function for plan year 2026.

Gender Identity

The first executive order requires that all policies and documents from federal agencies list two genders, male and female, with no additional options or gender identity requests. Carriers must comply in time for plan year 2026.

Gender-Affirming Care

Under the second executive order, all carriers “will exclude coverage for pediatric transgender surgeries or hormone treatments” for the purpose of gender transition. This policy applies to covered dependents under the age of 19. Carriers are also required to identify any resulting premium reductions and incorporate them into their benefit and rate proposals for plan year 2026.

Carriers may choose to continue offering gender-affirming care services for individuals aged 19 and older, but they are not required to do so. Since January 2016, OPM has mandated that no FEHB carrier exclude services, drugs, or supplies related to gender dysphoria treatment. Federal employees who rely on these services should carefully review plan brochures this fall to determine which FEHB plans will continue to offer coverage and at what levels.

Obesity Management

On Jan. 15, OPM introduced a requirement for all carriers to offer a comprehensive obesity management program in plan year 2026, including screening and support services, a specialized care team featuring a dietitian and an obesity-trained physician, patient monitoring, medication review, and more. OPM's latest guidance removes this carrier requirement for next year.

The Final Word

OPM allows carriers to offer additional plan benefits for 2026 provided they align with applicable laws and guidance. However, OPM’s guidance emphasizes that FEHB plans should deliver the best possible coverage at the lowest cost to plan members. As always, federal employees and annuitants should carefully review their options this fall when selecting an FEHB plan.

Kevin Moss is a senior editor with the Guide to Health Plans for Federal Employees provided by Consumers’ Checkbook. Watch more of his free advice and check here to see if the Guide is available for free from your agency. You can also purchase the Guide and save 20% with promo code GOVEXEC.