A Maryland federal judge has blocked parts of recently finalized Affordable Care Act (ACA) Marketplace rules, delaying provisions that would have changed enrolment and verification requirements, while allowing other updates to remain in place.
The ruling followed a lawsuit brought by a coalition of trade groups, small business advocates and cities, led by Columbus, Ohio, with Baltimore and Chicago also joining as plaintiffs.
The challengers argued that the US Department of Health and Human Services issued the rules without proper process in violation of the Administrative Procedure Act. They also argued that the measures would create surprise costs for consumers, add bureaucratic hurdles and reduce coverage standards, according to a report from BestWire.
The rules, finalized in June and set to take effect Aug. 25, included eliminating monthly special enrolment periods for some individuals, tightening income verification, standardizing open enrolment and introducing a $5 monthly premium for people automatically re-enroled in zero-premium plans. They also excluded coverage for sex-trait modification procedures and barred Deferred Action for Childhood Arrivals (DACA) recipients from marketplace coverage and subsidies.
The court stayed seven provisions, including the $5 premium, premium and actuarial adjustment changes, and new household income verification rules. It allowed other provisions to proceed, such as the updated formula for premium adjustment percentages and the removal of a 60-day grace period for income data corrections.
Advocacy group Doctors for America said the ruling protects millions of consumers from higher costs and coverage losses. “By blocking the Trump-Vance administration’s dangerous rule, the court has protected millions of Americans from losing coverage, facing higher costs and being denied essential benefits,” said Christine Petrin, the group’s board president.
Industry groups expressed concern about the broader uncertainty. AHIP, the national health insurance trade association, said clarity is essential for insurers as they finalize rates and plan designs for 2026. “Frequent shifts in ACA regulations create instability for consumers and insurers alike,” a spokesperson said, adding that predictable rules are necessary to ensure affordable and sustainable coverage. The Blue Cross Blue Shield Association also noted that verification and re-enrollment standards must strike a balance between program integrity and accessibility.
A similar lawsuit filed by 20 states is moving forward in the District of Massachusetts, suggesting continued legal challenges to the administration’s approach to ACA oversight.
The Centers for Medicare & Medicaid Services did not immediately respond to a request for comment, the BestWire report said.
