Trump’s New Health Care Rules Face Legal Fire from Democratic Mayors
Freshly issued rules by the Trump administration are coming under legal fire, as Democratic mayors from across the country challenge what they call a dangerous rollback of the Affordable Care Act (ACA). These new regulations, introduced just last month, shrink the window millions of Americans have to sign up for health coverage under Obamacare.
The new rules undo a key Biden-era expansion, which had broadened access to health insurance through an extended enrollment period. That move had driven record-breaking ACA signups under the Democratic administration.
But now, the Department of Health and Human Services (HHS) has put forward a tightened set of restrictions—just as Congress is debating a bill that could further limit ACA coverage. The consequences? Nearly 2 million people—almost 10% of current enrollees—could lose their health insurance.
On Tuesday, the mayors of Baltimore, Chicago, and Columbus, Ohio filed a lawsuit against the HHS, warning that the policy shift will increase the number of uninsured Americans and strain city services.
“Disguised as efficiency and fraud control, the 2025 Rule creates new roadblocks to affordable coverage, completely undermining the ACA’s core mission of expanding health access,” states the legal complaint.
Doctors for America and Main Street Alliance, two progressive advocacy groups, have also signed onto the lawsuit.
Under the revised ACA guidelines, the enrollment period will be chopped down by a month—running only from November 1 to December 15 in 2026. Income verification will be stricter, and a $5 fee will hit some individuals who automatically re-enroll in zero-premium plans.
What’s more, insurers can now refuse coverage to individuals with unpaid premiums from previous plans. Around 100,000 immigrants, brought to the U.S. as children, are also barred from accessing ACA coverage under the new rule.
Despite backlash, HHS spokesperson Andrew Nixon defended the move, saying the changes will “protect the marketplace’s future” and reduce premiums for those who remain insured.
“This rule isn’t controversial – it’s common sense,” Nixon said. “It closes loopholes, tightens oversight, and ensures taxpayer dollars are reserved for those truly eligible.”
But the mayors argue the administration pushed these changes without a proper public comment process, violating administrative procedure.
“This illegal rule will kick families off their insurance and raise costs for millions,” said Skye Perryman, president of Democracy Forward, the group representing the plaintiffs. “It doesn’t help—it harms health and safety across America.”
Interestingly, the lawsuit does not challenge the immigration-related restrictions.
Under President Biden, the ACA saw a dramatic enrollment boost, with 24 million Americans signing up, thanks in part to tax credits offered through the Inflation Reduction Act of 2022—a key legislative win for the Democratic party.
In contrast, Donald Trump has consistently attacked Obamacare, calling it flawed and unaffordable without hefty subsidies. During his first term, enrollment dipped—a sign of his administration's lack of support for the program.
Description:
"Democratic mayors sue the Trump administration over new Affordable Care Act rules that could strip health coverage from millions. Discover how the latest ACA restrictions may affect enrollment, insurance access, and city services."