Written by Maria Trapenasso, SVP, National Practice Leader, Human Capital Solutions
Menopause is moving from whispered conversations to being broadcast at the center of public policy, reverberating through statehouses, Congress and workplaces alike.
Amplifying that message, actor and advocate Halle Berry launched her “Turn Up the Heat” campaign in September 2025 with Respin Health and Perelel Health, mobilizing Californians and spotlighting the broader need for legislative change, as Politico reported. She has also joined senators in Washington to back federal menopause legislation, underscoring her message that menopause is a human rights issue and that half the population deserves better care and support.
Although the federal effort stalled in committee, California's AB 432 Menopause, the Menopause Care Equity Act, cleared the Legislature on September 12, 2025, and is now on Gov. Gavin Newsom's desk. If signed, the bill would require health plans covering outpatient prescription drugs to provide coverage for evaluation and treatment of perimenopause and menopause symptoms starting January 1, 2026. It also boosts continuing-education credit for physicians who complete menopause training and removes prior authorization for FDA-approved therapies, while allowing utilization management for non-FDA-approved options.
At the federal level, the Advancing Menopause Care and Mid-Life Women's Health Act (S.4246) was introduced to Congress in May 2024 with bipartisan sponsorship and would authorize $275 million over five years for research, provider training and public awareness. However, more than a year later, the bill has failed to advance, underscoring the reason states like California and Rhode Island are moving ahead on their own. Employers should take note and get on board. With Washington dragging its feet, both the opportunity – perhaps even the responsibility – falls to states and employers to lead the way.
For example, in June 2025, Rhode Island became the first state to pass a law explicitly requiring workplace accommodations for menopause and related conditions. That law adds menopause to the list of protected categories under fair-employment statutes and clearly signals that both compliance and employee expectations are shifting well beyond health plan coverage.
What These Policy Shifts Mean for Employers
These policy moves point to three areas where employers should be paying close attention:
Coverage design will tighten.
California's independent review of AB 432 projects that the bill would close current coverage gaps and modestly increase total premiums by about 0.05%. That is a relatively small price for plans to absorb when weighed against the scale of need and the potential productivity upside for employers.
Training expectations are rising.
Both California's bill and the federal proposal emphasize provider education. In practice, that raises the bar across the entire care ecosystem your employees navigate. For employers, the natural next step is to build comparable fluency among managers and HR teams so conversations about menopause are handled with the same confidence as any other health or leave issue.
Workplace policy is the next frontier.
Once coverage expands and clinical literacy improves, employees will expect clear, stigma-free pathways at work: scalable accommodations, flexible scheduling and leave coordination that treats perimenopause and menopause as routine health phases rather than exceptions. Rhode Island's new law previews the compliance dimension. For everyone else, brand reputation and retention pressures will drive change even before mandates arrive.
The Business Case: Your People are Already Asking
Our 2026 NFP U.S. Leave Management Trend Report highlights just how wide the gap remains between employee need and employer action. Despite the fact that nearly 20% of the U.S. female workforce is between 45 and 54 (the age range where menopause symptoms are most prevalent), 62% of employers say they are unlikely to offer menopause leave in the next five years.
Where employers are responding, the steps are incremental:
- 65% allow flexible worktime when symptoms flare (up from 50% in 2024).
- 37% provide workspace accommodations (up from 25%).
- 21% offer additional wellness programs, and 19% allow extra days off.
- Only 14% extend specialty benefits like hormone therapy coverage.
The message is clear: while some accommodations are gaining traction, comprehensive menopause support remains rare. Employers who act now can distinguish themselves, closing a benefits gap that directly affects retention, productivity and equity for a large portion of the workforce.
The costs of inaction are real — as our research shows, unmanaged symptoms create diffuse productivity loss and disengagement resulting in the kind of compounding drag that doesn't show up neatly on a profit and loss statement but erodes performance across teams.
What Employers Can Do Now
For employers, the opportunity is to act before mandates force your hand. That starts with small but meaningful steps:
Review leave and accommodation policies
to ensure menopause is addressed explicitly rather than left in a gray area.
Train managers and HR leaders
to handle conversations with empathy and confidence, reducing stigma and encouraging disclosure.
Engage ERGs or employee councils
to co-design solutions that reflect real needs, whether that means flexible scheduling, wellness resources, or access to specialty care.
These measures don't just mitigate compliance risk — they strengthen culture, retention and equity.
To further help employers navigate this evolving landscape, I encourage you to review the 2025 NFP U.S. Leave Management Trend Report. It provides deeper benchmarking data and actionable insights on menopause and other emerging leave topics. Through NFP's Human Capital Solutions, my team and I are partnering with employers every day to translate policy change into practical, people-first strategies.
Menopause policy and awareness are advancing quickly, and employees are watching. Employers who act now will not only be prepared for compliance but will also stand out as leaders in equity and culture.
Through NFP's Human Capital Solutions, we help employers navigate emerging policies like menopause care and workplace accommodations with practical strategies for compliance, culture, and retention. Let's build people-first solutions that keep you ahead of the game.
