New York Attorney General Letitia James, along with 20 other states, has filed a lawsuit against a new federal regulation that they claim threatens health care coverage for millions of Americans. The rule, from the U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS), is said to violate federal law by removing gender-affirming care from the Affordable Care Act’s essential health benefits.
Attorney General James criticized the rule as an “illegal and dangerous attack on health care access,” stating it would strip coverage from working families and target low-income and transgender Americans. She emphasized New York’s success in expanding coverage and improving affordability.
The Patient Protection and Affordable Care Act (ACA), enacted in 2010, aimed to increase access to health insurance. It created marketplaces for affordable plans requiring all plans to cover essential health benefits. Over the past five years, ACA enrollment has doubled, with more than 24 million Americans signing up this year.
The new rule, finalized in June by HHS and CMS, is set to take effect in August. It could strip coverage from up to two million people by shortening enrollment windows, eliminating year-round enrollment for low-income individuals, adding paperwork requirements, limiting automatic reenrollment, and imposing charges on zero-dollar premium plans. These changes are argued to undermine the ACA’s mission of expanding affordable health care access.
Additionally, the rule prohibits states from including gender-affirming care as essential benefits under the ACA when related to gender dysphoria but allows coverage for other purposes like treating endocrine disorders. This policy is claimed to lack justification and harm transgender youth.
In New York alone, over 220,000 people use the ACA marketplace. If implemented, an estimated 12,000 New Yorkers may lose their insurance while premiums rise statewide. The state would also incur significant costs updating systems per the new rule.
Attorney General James contends that HHS’s rule violates both the Administrative Procedure Act and the ACA itself. The coalition seeks court intervention to block parts of the rule from taking effect due to potential financial burdens and public health impacts on states running their own exchanges.
Joining Attorney General James in this legal action are attorneys general from Arizona, California, Colorado, Connecticut, Delaware, Illinois, Maryland, Massachusetts, Maine, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon Rhode Island Vermont Washington Wisconsin as well as Pennsylvania’s governor.
