Office of the
Illinois Attorney General
Kwame Raoul

Federal Rule Makes Harmful Changes to Affordable Care Act Protections; Attempts to Reinstate Provisions Already Blocked by a Federal Court 

Chicago – Attorney General Kwame Raoul joined a coalition of 20 attorneys general in filing a lawsuit to challenge a federal rule that once again illegally undermines the Affordable Care Act (ACA) and would make health insurance more expensive and harder to obtain for millions of Americans. 

Raoul and the coalition’s lawsuit seeks to block provisions of the U.S. Department of Health and Human Services’ (HHS) and Centers for Medicare & Medicaid Services’ (CMS) 2027 Notice of Benefit and Payment Parameters, a federal rule that sets standards for health plans offered in 2027, which was opposed by the coalition in a March 2026 comment letter. 

“Since the Affordable Care Act became law, millions of people throughout the country have signed up for health insurance coverage. The Trump administration’s relentless attacks on the ACA and attempts to block access to affordable healthcare are attacks on Illinois’ most vulnerable residents,” Raoul said. “I am proud to join my fellow state attorneys general to oppose this arbitrary and illegal rule, and we will continue to fight the Trump administration’s continued unlawful orders.”   

Among other harmful changes, the rule expands eligibility for catastrophic health insurance plans that are ineligible for premium tax credits, offer only limited coverage and can leave consumers facing significantly higher out-of-pocket costs than standard ACA plans. The rule also allows catastrophic and bronze plans to exceed ACA limits on maximum annual out-of-pocket costs, increasing the financial burden on consumers, and attempts to reinstate several provisions a federal court recently found to be unlawful. 

Raoul and the attorneys general argue these and other provisions unlawfully undermine the ACA’s goal of expanding access to affordable healthcare by increasing costs, reducing enrollment, and shifting financial burdens onto consumers, states and healthcare providers. 

Congress enacted the ACA to expand access to affordable health insurance, and more than 23 million Americans currently receive coverage through its marketplaces. Today’s lawsuit follows the Raoul and coalition’s challenge to the Trump administration’s similar 2025 ACA Marketplace rule. Earlier this week, the U.S. District Court for the District of Massachusetts held a hearing on the parties’ cross-motions for summary judgment in that case, with a final decision expected at a later date. 

In related litigation, a federal court last month vacated several provisions of the administration’s 2025 rule, including provisions at issue in this case, after finding they violated the Administrative Procedure Act. The administration’s new rule setting standards for 2027 health plans, which is the subject of this lawsuit, brings back many of the same provisions and adds new changes that further undermine the ACA. HHS estimates the new rule will cause 2 million people to lose coverage in 2027 and a total of 5 million by 2030. 

In today’s lawsuit, the coalition argues that the new rule: 

• Reimposes provisions a federal court has already vacated, including additional income verification requirements and penalties for consumers who do not complete tax-credit paperwork, without addressing the court’s legal concerns.
• Unlawfully expands eligibility for catastrophic health plans beyond the limits established by Congress in the ACA.
• Unlawfully allows catastrophic and bronze plans to exceed ACA limits on maximum annual out-of-pocket costs.
• Will increase costs, reduce enrollment and shift financial burdens onto consumers, healthcare providers and states.
• Was adopted without adequate explanation or a meaningful response to the coalition’s comments, making it arbitrary and capricious under the Administrative Procedure Act. 

Joining Attorney General Raoul in this lawsuit are attorneys general of Arizona, California, Colorado, Connecticut, Delaware, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Virginia, Washington and Wisconsin, as well as the state of Pennsylvania.