A federal judge in Massachusetts has refused to grant a preliminary injunction against new Affordable Care Act Marketplace Integrity and Affordability rules, turning aside a challenge brought by 20 state attorneys general and Pennsylvania Gov. Josh Shapiro.
Massachusetts served as lead plaintiff. The plaintiffs argued the rules are arbitrary, capricious, unlawful, and violate the Administrative Procedure Act.
Their complaint projected 1.8mn people could lose coverage, with higher premiums and out-of-pocket costs for ACA enrollees.
CMS, in its defense, said the changes target fraud and improper enrollments. The rules end monthly special enrollment periods for certain groups, standardize open enrollment, tighten income verification, and tack on a $5 monthly premium for individuals auto-enrolled into zero-premium plans.
They also exclude specific sex-trait modification procedures from essential health benefits coverage.
The court dismissed most claims tied to the injunction request. It ruled that plaintiffs had not demonstrated immediate harm, noting any loss of revenue wouldn’t appear until February 2026 at the earliest.
Judges also pointed out that regulators had followed proper rulemaking procedures, with an adequate notice-and-comment window.
Changes to essential health benefits were upheld as lawful under the Secretary of Health and Human Services’ authority.
Along with denying the injunction, the court granted the government a 30-day extension to respond to the full complaint, effective Oct. 1, the day the injunction decision was filed.
