Oregon Moves to Stop Trump-Backed Rule That Risks Insurance Loss for 1.8 Million Americans
Oregon joined a multistate coalition lawsuit challenging a new Trump Administration rule that would make it harder for Americans to access health coverage under the ACA. The Trump Administration estimated the rule would result in up to 1.8 million people losing their health insurance.
Oregon Joins Challenge To HHS Rule Limiting ACA Healthcare Coverage
Oregon Attorney General Dan Rayfield confirmed that the lawsuit challenges an unlawful final rule announced by the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS).
The Trump Administration’s final rule would create significant barriers to obtaining healthcare coverage under the Affordable Care Act (ACA) through several amendments to existing rules that govern federal and state health insurance marketplaces.
Millions of Americans would face increased insurance premiums as well as out-of-pocket costs, such as copays and deductibles, and up to 1.8 million people would lose their health insurance.
In addition, gender-affirming care would be excluded as an essential health benefit (EHB) under the ACA. Congress enacted the ACA in 2010 to grow the number of Americans with health insurance and lessen the cost of healthcare.
AG Rayfield said, “Health care is a lifeline, not a privilege.”
The coalition argues in the lawsuit that the HHS and CMS rule is arbitrary and capricious, contrary to law. It violates the Administrative Procedure Act (APA). ACA continues to meet its goals some 15 years after being enacted.
Annual enrollment on the ACA marketplace has doubled over the past five years, with over 24 million people signing up for health insurance coverage in plan year 2025.
Source: CMS 2025 Open Enrollment Report / State Health and Value Strategies rule summary / Oregon DOJ coalition lawsuit release
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Plan year enrollment- which starts in under four months, would be severely curtailed by the Trump Administration’s final rule which places a series of new barriers to enrollment that will significantly drive up the costs incurred by the Plaintiff States in providing healthcare, including increasing state expenditures on Medicaid, uncompensated emergency care, and funding other services offered to newly uninsured residents.
| Change | Timing | Why it matters |
|---|---|---|
| Pre enrollment verification for many Special Enrollment Period signups on the federal platform | Plan year 2026 (sunsets end of 2026) | Adds steps and delays that can reduce signups |
| Repeals monthly Special Enrollment Period for people at or below 150% of federal poverty level | 60 days after final rule / applies for 2026 plan year | Removes a major low income enrollment pathway |
| Automatic re enrollment change: some $0 premium re enrollments move to $5 unless eligibility is confirmed | Plan year 2026 (sunsets end of 2026) | People can lose coverage if they do not respond |
| Shortens federal platform open enrollment window (HealthCare.gov) | Starting open enrollment for plan year 2027 | Less time to enroll can lower total coverage |
| Limits Essential Health Benefits rule: specified sex trait modification procedures cannot be covered as an EHB | Plan year 2026 | Changes how coverage is classified under ACA benefit rules |
This means more people in Oregon could end up uninsured, which can lead to worse health outcomes.
The coalition also wants preliminary relief in the form of a stay to prevent the challenged portions of the final rule from taking effect in their states before the effective date of August 25.