The City of Columbus, the Mayor and City Council of Baltimore, the City of Chicago, Doctors for America, and Main Street Alliance have challenged the new 2025 Marketplace Integrity and Affordability Rule promulgated by the Centers for Medicaid and Medicare Services (CMS) and implemented by the U.S. Department of Health and Human Services (HHS). Plaintiffs argue that this rule undermines the availability of insurance under the Affordable Care Act (ACA) and violates the Administrative Procedure Act. Plaintiffs seek temporary and permanent injunctions to vacate the 2025 Rule.