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Massachusetts AG Campbell Leads 20-State Legal Push Against Trump Administration’s Rule Threatening ACA Coverage

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Published on July 18, 2025
Massachusetts AG Campbell Leads 20-State Legal Push Against Trump Administration’s Rule Threatening ACA CoverageSource: Wikipedia/Office of the Massachusetts Attorney General, Public domain, via Wikimedia Commons

Massachusetts Attorney General Andrea Joy Campbell has amplified the resistance against the Trump administration's latest encroachment on healthcare accessibility by co-leading a battalion of 20 states in a legal challenge. The target is a contentious rule by the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS), which amendments could trigger a loss of health insurance for up to 1.8 million Americans, with millions more likely to face steeper premiums and out-of-pocket costs, as reported in a press release from the Massachusetts Attorney General's Office. The controversial rule also notably excludes gender-affirming care as an essential health benefit under the Affordable Care Act (ACA).

AG Campbell does not mince her words, asserting on the Massachusetts Attorney General's Office: "The Trump Administration’s unlawful and baseless rule not only threatens to rip away coverage from millions of Americans but leaves states on the hook once again to foot the bill for this Administration’s cruel and disastrous policies," a strong condemnation reflecting the gravity of the situation mere months before the pivotal open enrollment for the 2026 plan year is set to commence. These changes entail new verification requirements, an automatic monthly charge for certain reenrolled individuals, and a contracted open enrollment period, among others—all of which are maneuvered into place to destabilize the delicate balance maintained by the ACA.

Since its inception in 2010, the ACA has been instrumental in expanding health coverage, doubling its annual enrollment over the past five years, with over 24 million Americans drawn into its fold for more affordable health insurance options. In Massachusetts, the Health Connector, synonymous with the ACA marketplace, extends coverage to 375,000 residents through high-quality plans and subsidized premiums tailored for the low- and moderate-income populace. However, the imminence of projected premium spikes, accountable to the Trump administration's interference, puts future enrollments and state budgets at serious risk, potentially inflating state subsidy costs to an unsettling $10 million in 2026.

The collective lawsuit spearheaded by Campbell, alongside fellow attorney generals and Governor Josh Shapiro of Pennsylvania, criticizes the HHS and CMS legislation as "unlawful, arbitrary and capricious," citing grave concerns for the impending burdens on states and their citizens. The states are pushing back, seeking judicial relief and a stay to halt the new rule's activation before its August 25 effective date; the coalition's pursuit is to safeguard the healthcare sanctuary that the ACA represents to the countless who stands to lose the most. The complete list of attorneys general joining forces with AG Campbell was published in a press statement and includes representatives from California, New York, Illinois, Michigan, and more.