Attorney General Kwame Raoul, along with 21 other attorneys general, has submitted a letter opposing proposed changes to the Affordable Care Act (ACA) that could render health insurance coverage more difficult and expensive for many individuals. These changes would also prevent Deferred Action for Childhood Arrivals (DACA) recipients from purchasing health insurance through federal and state exchanges.
The proposal could result in up to two million Americans losing their health insurance by 2026 and would likely increase health and economic burdens on states due to a rise in uninsured individuals.
“These proposed changes to the Affordable Care Act are unnecessary and disturbing,” Raoul stated. “Everyone in this country deserves access to lifesaving health services and these changes could cause hundreds of thousands of Americans to be uninsured. I will continue to collaborate with other attorneys general to preserve access to care that saves lives, reduces disparities in health care and improves public health in our communities.”
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) had previously enacted a Final Rule allowing DACA recipients, known as Dreamers, to purchase affordable health insurance on ACA exchanges. This rule was targeted for reversal last month by the Trump Administration, which seeks to restrict insurance access for DACA recipients.
Raoul and his colleagues argued that preventing access to insurance harms public health and economic stability. Loss of preventive medical care access could lead to increased reliance on expensive emergency room services.
Additional proposals from the Trump Administration include reducing the open enrollment periods for state ACA exchanges and potentially allowing insurers to deny coverage to individuals who missed even a single payment. Raoul and the attorneys general highlighted the lack of required notice to consumers about such enforcement.
Finally, the proposed rule would remove coverage for gender-affirming care as an essential health benefit. The administration claims gender-affirming care is rarely covered by employer-based health plans, though surveys indicate that coverage had expanded, with 72% of Fortune 500 companies offering these benefits by 2024.
The attorneys general joining Raoul in opposing these changes include representatives from states such as California, New York, and Washington, among others.