A coalition of twenty-one states have filed this lawsuit against the U.S. Department of Health and Human Services (HHS), and the U.S. Centers for Medicare & Medicaid Services (CMS). Plaintiffs challenge a June 2025 Final Rule promulgated by HHS, which they allege imposes multiple new barriers to enrollment under the Affordable Care Act (ACA). The Final Rule shortens open enrollment periods, increases verification requirements for special enrollment, imposes a $5 monthly charge on certain $0-premium enrollees, and excludes gender-affirming care from coverage defined as Essential Health Benefits. Plaintiffs contend that the rule violates the Administrative Procedure Act (APA) because it is arbitrary and capricious, inconsistent with the ACA, and was issued after only a 23-day comment period without adequate justification. Plaintiffs seek declaratory and injunctive relief, including vacatur of the Final Rule, to prevent its implementation.
