Attorney General Neronha joins lawsuit challenging Trump Administration rule that would make it harder for Americans to obtain health coverage under ACA

Published on Thursday, July 17, 2025

Attorney General Peter F. Neronha today joined a multistate coalition in filing a lawsuit challenging an unlawful final rule promulgated by the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) that would create significant barriers to obtaining healthcare coverage under the Affordable Care Act (ACA). 

The Trump Administration’s final rule would make amendments to rules governing federal and state health insurance marketplaces which the administration itself estimates will cause up to 1.8 million people to lose their health insurance, while causing millions more to pay increased insurance premiums and out-of-pocket costs like copays and deductibles.

“We should be making it easier, not harder, for Americans to obtain health care coverage,” said Attorney General Neronha. “And yet, this Administration is intent on making life harder for everyday Americans while lining the pockets of the ultra-rich. We know millions are already expected to lose health coverage under the President’s recent legislation, which cuts $1 trillion in federal health spending over the next 10 years. Now, with this final rule, over a million more could be one medical emergency away from bankruptcy. Further, this rule would increase insurance premiums and other medical expenses for Americans everywhere. This rule is unnecessary and irresponsible, and we will fight to make sure it doesn’t take effect.”

Congress enacted the ACA in 2010 to increase the number of Americans with health insurance and decrease the cost of healthcare. Fifteen years later, the Act continues to meet its goals, with annual enrollment on the ACA marketplace doubling over the past five years, resulting in over 24 million people signing up for health insurance coverage in plan year 2025 on the ACA exchanges and receiving subsidies to make such coverage affordable, including millions of people in the Plaintiff States. 

Now, with less than four months until open enrollment for plan year 2026 begins, the Trump Administration’s final rule would abruptly reverse that trend, erecting a series of new barriers to enrollment that will deprive up to 1.8 million people of insurance coverage by the administration’s own estimates, and significantly drive up the costs incurred by Plaintiff States in providing healthcare, including increasing state expenditures on Medicaid, uncompensated emergency care, and funding other services provided to newly uninsured residents.

According to HealthSource RI, if the final rule is implemented, enrollment would decrease by 3%, or approximately 1,380 Rhode Islanders. Because the majority of those who will drop coverage are likely to be younger and healthier, this would create a worsened insurance risk pool, which would then contribute to higher premiums for consumers.

The final rule by HHS would make substantial changes and create bureaucratic barriers to the operation of the ACA marketplaces, including adding new verification requirements, imposing an automatic monthly charge on all automatically reenrolled consumers who qualify for $0 premiums, shortening the open enrollment period for signing up for health coverage, and making other changes which will make coverage less affordable for millions of individuals nationwide. The final rule would also exclude gender-affirming care as an essential health benefit (EHB) on federal exchange plans, leaving states responsible for paying for the portion of insurance premiums attributable to any such coverage.  

In the lawsuit the attorneys general argue that the HHS and CMS rule is unlawful, arbitrary and capricious, and would cause significant harm to states and their residents. The coalition is also seeking preliminary relief, and a stay, to prevent the challenged portions of the final rule from taking effect in the Plaintiff States before the August 25 effective date.

Attorney General Neronha is joined in filing this lawsuit by the attorneys general of Arizona, California, Colorado, Connecticut, Delaware, Illinois, Maryland, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Vermont, Washington, and Wisconsin, as well as the governor of Pennsylvania. 

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