New York Attorney General Letitia James is spotlighting an existing multistate lawsuit against Health Secretary Robert F. Kennedy Jr. over an ACA rule that critics say could make marketplace coverage harder to keep, harder to afford, and easier to lose. The renewed attention comes as the case narrows toward a handful of unresolved questions that could still shape enrollment and benefits nationwide.
James joined 20 other states in filing the case on July 17, 2025, arguing that HHS and CMS exceeded their authority by piling new verification demands and restrictions onto the Affordable Care Act. Her office says the rule could strip coverage from millions and push up costs; the original announcement cited a federal estimate that up to 2 million people could lose coverage in 2026.
Robert F. Kennedy, Jr. is trying to illegally use bureaucratic tricks to sabotage the ACA and strip health insurance from up to five million people.
— NY AG James (@newyorkstateag) July 31, 2026
I'm suing because health care is not a privilege for the wealthy or the healthy. It's a right that I'll always fight to protect.
What James Says Kennedy’s Rule Is Doing
In her Friday post on X, James described the effort as an attempt to use bureaucracy to sabotage the ACA and said health care should not be reserved for wealthy or healthy people. That is her characterization of the administration’s actions, not a court finding that Kennedy acted illegally.
The challenged package would shorten enrollment opportunities, eliminate a year-round special enrollment path for some low-income consumers, add income and special-enrollment verification, tighten tax-filing reconciliation rules, and limit automatic reenrollment for some zero-premium plans. HHS has said the changes are meant to close loopholes and ensure subsidies go to eligible consumers, while projecting that they could reduce premiums, as Axios reported.
Why The Five-Million Figure Needs Unpacking
James’s post uses a figure of up to five million people, but the formal 2025 announcement from her office cited HHS’s estimate that up to 2 million could lose coverage in 2026. Separately, the rule relied on a disputed estimate that 4 million to 5 million people may have been improperly enrolled in subsidized plans; challengers argued that the underlying comparison was methodologically flawed, according to the Maryland court opinion.
The Case Is Still Alive After A Major Court Ruling
On July 27, the parties told the Massachusetts federal court that a June 12 Maryland ruling had made several overlapping claims moot. The joint notice says four issues remain: changes to ACA essential health benefits, tax-reconciliation rules, actuarial-value ranges, and the length of open enrollment.
The Maryland ruling vacated several provisions of the rule, but the federal government is appealing some of them; Georgetown’s case tracker lists the Massachusetts litigation as ongoing. That means James’s post is best read as a legal and political update on a continuing case, not as notice of a brand-new lawsuit filed on July 31.
New Yorkers Are Already Feeling Coverage Pressure
The local stakes are not abstract: James’s office said about 450,000 New Yorkers were set to lose Essential Plan eligibility starting July 1 because of federal funding changes, with many expected to move into more expensive ACA marketplace plans. That policy shift is separate from the lawsuit, but it helps explain why fights over subsidy rules and enrollment paperwork are landing with unusual force in New York, according to AG guidance.
This is part of a broader series of clashes between James and HHS under Kennedy; earlier coverage tracked her push to challenge federal health-funding cuts. The immediate question is whether the remaining ACA claims can keep more barriers from taking effect before the next enrollment cycle.
