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Cities sue Trump administration over ACA changes The cities of Baltimore, Chicago and Columbus, Ohio, on Tuesday asked a federal court to overturn new regulations from Health Secretary Robert F. Kennedy Jr. that place tighter restrictions on Affordable Care Act enrollment. Why it matters: Shortening the enrollment period and other changes would increase the uninsured and underinsured population and place more financial pressure on city-funded public health programs, the cities argue in their complaint. They also argue that the loss of health insurance will make city residents less able to participate in civic life and have "cascading negative effects on city programs and communities." The Main Street Alliance — a small business advocacy group — and Doctors for America are also plaintiffs in the lawsuit, which was filed in the U.S. District Court for Maryland. State of play: Health and Human Services' regulation shortens the enrollment window for ACA plans on the federal insurance exchange and imposes a $5 monthly premium for consumers with fully subsidized coverage who are automatically reenrolled in ACA coverage, among other changes. HHS projects the policies will decrease ACA exchange plan enrollment by between 725,000 and 1.8 million people. The finalized rule "sets forth a wide range of changes that will render coverage on the Exchanges less affordable, less generous, and harder to obtain," the complaint reads. The complaint states that the Trump administration violated administrative law in finalizing the rule. But HHS maintains that its rule strengthens access to health insurance. "The rule closes loopholes, strengthens oversight, and ensures taxpayer subsidies go to those who are truly eligible — that's not controversial, it's common sense," HHS communications director Andrew Nixon said in an email. The agency has said the rule is necessary to improve program integrity in ACA markets and that it should lower enrollee premiums by 5% next year. https://www.axios.com/2025/07/02/cities-sue-trump-aca-changes