A federal judge in Massachusetts turned down a request to freeze the Biden administration’s new Affordable Care Act Marketplace Integrity and Affordability rules. Twenty state attorneys general, with Massachusetts in the lead and Pennsylvania Gov.
Josh Shapiro joining, argued the regulations were unlawful and harmful, but the court said they failed to show immediate injury.
The rules, finalized by the Centers for Medicare & Medicaid Services, reshape how ACA enrollment works. Monthly special enrollment periods for certain individuals are gone. Open enrollment is standardized. Income verification becomes stricter.
A $5 monthly premium will apply to people auto-reenrolled in zero-premium plans. The package also excludes certain sex-trait modification procedures from essential health benefits coverage.
CMS says the measures are designed to curb fraud and misuse of the marketplace.
Plaintiffs argued the changes will strip coverage from 1.8 mn people and drive premiums higher.
They also claimed the rules violated the Administrative Procedure Act and ignored statutory limits. But the Massachusetts federal court dismissed most of those arguments, noting revenue impacts wouldn’t hit states until February 2026 at the earliest.
The judge said the agencies followed proper rulemaking procedures, including a full notice-and-comment window, and confirmed the HHS Secretary holds authority to revise essential health benefits.
Along with denying the injunction, the court granted federal agencies a 30-day extension to respond to the underlying complaint, with the clock starting Oct. 1.
Attempts to reach the Massachusetts attorney general’s office for comment weren’t successful.
Legal battles continue elsewhere. A separate challenge in Maryland federal court, backed by cities, medical associations, and small business advocates, claims the rules saddle consumers with surprise fees, added red tape during enrollment, and weaker coverage standards. Government lawyers must file a response by Oct. 16.
