Cities, Doctors, and Small Business Advocates Challenge Rule That Will Risk Health and Safety, Raise Costs, Undermine the ACA
Baltimore, MD — A coalition of cities, public health professionals, and small business advocates represented by Democracy Forward filed a lawsuit today to block the Trump-Vance administration’s sweeping attempt to gut the Affordable Care Act (ACA) and strip millions of Americans of their health care.
The lawsuit challenges a newly finalized rule that imposes surprise fees, weakens coverage standards, and creates bureaucratic burdens for people trying to access ACA health insurance.
The new “Marketplace Integrity and Affordability” rule, adopted by the Centers for Medicare and Medicaid Services (CMS), would result in more than 2.2 million Americans losing their health coverage. It imposes new fees, weakens coverage standards, and sets barriers that will make it harder—and in some cases impossible—for people to get and stay covered by insurance. The policy would disproportionately harm low-income families, communities of color, and patients with chronic or serious medical needs.
The coalition includes the City of Columbus, Mayor and City Council of Baltimore, City of Chicago, Doctors for America, and the Main Street Alliance.
“This unlawful rule will force families off their health insurance and raise costs on millions of Americans. This does nothing to help people – and instead harms Americans’ health and safety across our country,” said Skye Perryman, President and CEO of Democracy Forward. “Americans deserve a government that protects their health, not one that puts it at risk. We will continue to hold this administration accountable, and are proud to represent a broad coalition in pushing back to defend healthcare access for all, including those in vulnerable circumstances.”
“Paying more for less is always a bad deal, but that’s exactly what the president is proposing for health care coverage—a bad deal for working people, families, and cities that rely on the Affordable Care Act to decrease costs and increase accessibility. We’re standing up to these attacks and urge the Court to protect healthcare coverage for millions of Americans,” said Columbus City Attorney Zach Klein.
“Let’s be clear: this policy isn’t about ‘fiscal responsibility,’ which this administration clearly doesn’t care about,” said Baltimore Mayor Brandon M. Scott. “It isn’t about supporting the millions of hardworking Americans who will be left uninsured by this rule. It’s about taking from the middle class and giving to the richest among us—sacrificing affordable, accessible health care in order to give tax breaks to folks who are too rich to worry about the skyrocketing food prices, housing prices, child care costs, and health care costs of the Trump-Vance agenda. This rule is more of the same from this administration: it’s wrong, it’s illegal, and the City of Baltimore is proud to stand with our partners against it.”
“For thousands of Chicago’s working-class families, the ACA isn’t just health insurance–it’s peace of mind. These rule changes put that stability at risk, forcing families to choose between paying rent and seeing their doctor,” said Chicago Mayor Brandon Johnson. “Far too often we see those who work the hardest and earn the least being asked to carry the heaviest load. It’s just wrong. I am grateful to stand with advocacy groups and fellow cities to fight against this wrong and protect everyone’s access to healthcare.”
“This rushed ACA Marketplace rule claims to fix enrollment abuses, but instead of cracking down on predatory brokers, it punishes families,” said Dr. Janet Krommes, Doctors for America. “It makes coverage harder to get, more expensive, and less comprehensive — with higher co-pays, steeper deductibles, and fewer benefits. The CBO estimates over 2 million Americans could lose access to routine care. This rule is a direct attack on health equity and the promise of the ACA.”
“According to a recent survey of our membership, 45% of Main Street Alliance’s small business members access their health insurance via either Medicaid or the ACA marketplace. This CMS rule will gut the affordability and protections passed in 2010. Combined with the reconciliation package making its way through Congress, this amounts to sabotage of the US health insurance system. Raising prices for small business owners and staff is a betrayal by the Trump Administration of Main Street,” said Shawn Phetteplace, National Campaigns Director, Main Street Alliance.
The CMS admits the rule will increase premiums and destabilize the risk pool, undermining the ACA’s core goals of expanding access and lowering costs. It raises the cost of coverage by manipulating formulas that will raise premiums and out-of-pocket costs for millions, reduces benefits—meaning people will pay more for less—and allows insurers to refuse to enroll people over old debts as low as $10, without notice.
Among other harms, the new rule imposes a “junk fee” on people who auto-enroll in zero-premium plans, even though they qualify for full subsidies. It also undermines tax credits that make coverage affordable, cutting annual subsidies by hundreds of dollars per family. For a typical family of four, the rule is projected to increase the cost of coverage by $714 per year, even if they keep the same plan.
The case is City of Columbus et al. v. Department of Health and Human Services et al., and the legal team at Democracy Forward includes Joel McElvain, Cortney Robinson, and Christine Coogle.
Read the complaint here.
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Democracy Forward Foundation is a national legal organization that advances democracy and social progress through litigation, policy, public education, and regulatory engagement. For more information, visit www.democracyforward.org.