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Attorney General William Tong today joined a multistate coalition filing a lawsuit challenging a final rule from the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) that would impose certain changes for obtaining healthcare coverage under the Affordable Care Act (ACA).
Key finalized policies in the rule, per CMS, include: revised standards relating to strengthening income verification processes; modifying eligibility redetermination procedures; removing Deferred Action for Childhood Arrivals (DACA) recipients from the definition of “lawfully present” for eligibility and enrollment in Exchanges and Basic Health Program (BHP) coverage in states that elect to operate a BHP; and pre-enrollment verification for special enrollment periods (SEPs) aimed at reducing improper enrollments and improving the risk pool.
The final rule also excludes coverage of "gender affirming care" as an essential health benefit (EHB) under the ACA, something the lawsuit describes as "medically necessary treatments for transgender individuals." As a reminder "gender affirming care" has been described as "a grotesque social and scientific experiment on American children" by the Trump Administration, which instead refers to such "care" as "chemical and surgical mutilation services."
In the lawsuit, the attorneys general argue that the HHS and CMS rule is arbitrary and capricious, contrary to law, and violates the Administrative Procedure Act (APA). 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.
“Inflated premiums, more copays and deductibles, new junk fees and red tape. These rules are designed to jack up healthcare costs for American families and cause upwards of 1.8 million people to lose their health insurance entirely. And why? So that Trump and his cronies can have more money to pay for tax breaks for billionaires. These rules were rushed through with no legal process or planning, in violation of numerous laws. We’re suing, and we’re doing everything we can to protect access to affordable healthcare,” complained Attorney General Tong.
The statement alleges the changes would "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."
The final rule by HHS would make changes 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 lawsuit specifically promises that, "if gender-affirming care is explicitly barred from inclusion as an EHB, then States requiring coverage of gender-affirming care services would themselves be responsible for defraying the increased cost to cover those services and comply with state mandates."
In filing the lawsuit, Attorney General Tong is joined by the attorneys general of Arizona, California, Colorado, Delaware, Illinois, Maryland, Massachusetts, Maine, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, and Wisconsin, as well as Pennsylvania Governor Josh Shapiro, on behalf of the Commonwealth of Pennsylvania.
A copy of the complaint is available here.
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