Colorado sues to stop Trump health insurance exchange rule that will raise costs, leave 1.8 million uninsured

July 17, 2025 (DENVER) – Attorney General Phil Weiser today joined a coalition of 21 states in filing a lawsuit challenging a final rule from the U.S. Department of Health and Human Services and Centers for Medicare & Medicaid Services that would create significant barriers for people purchasing health care coverage under the Affordable Care Act. According to the administration’s own estimates, the change will cause up to 1.8 million people to lose their health insurance.

The Trump administration’s final rule would make numerous amendments to rules governing federal and state health insurance marketplaces. In addition to the large number of people who are estimated to lose health care coverage, millions more will pay increased insurance premiums and out-of-pocket costs like copays and deductibles. The rule also excludes coverage for gender-affirming care as an essential health benefit under the ACA, leaving states like Colorado responsible for paying for the portion of insurance premiums attributable to any such coverage.

In the lawsuit, the attorneys general argue that the rule is arbitrary and capricious, contrary to law, and violates the Administrative Procedure Act. The coalition is also seeking preliminary relief, and a stay, to prevent the challenged portions of the final rule from taking effect in the suing states before the August 25 effective date.

“At a time when Coloradans are already dealing with high costs of living, if this illegal move by the Trump administration stands, it means many people will now also be facing the prospect of paying more for doctor visits and medicine, or even losing their coverage entirely,” said Attorney General Weiser. “I’ve vigorously defended the Affordable Care Act during my time as attorney general because I know how many people in our state rely on its protections to get the care they need. I will continue fighting for access to affordable health care for Coloradans.”

Congress enacted the ACA in 2010 to increase the number of Americans with health insurance and decrease the cost of healthcare. Fifteen years later, it continues to meet its goals, with annual enrollment on the ACA marketplace doubling over the past five years, resulting in over 24 million people signing up for health insurance coverage for 2025 on the ACA exchanges and receiving subsidies to make such coverage affordable, including millions of people in Colorado and the other states that are suing.

With less than four months until open enrollment for coverage in 2026 begins, the final rule would abruptly reverse that trend, creating a series of new barriers to enrollment that will deprive people of insurance coverage, and significantly drive up the costs incurred by states in the coalition in providing health care, including increasing state expenditures on Medicaid, uncompensated emergency care, and funding other services provided to newly uninsured residents.

According to the most recent annual report from Connect for Health Colorado, the state’s insurance exchange (PDF), the 2025 open enrollment period was a major success with nearly 300,000 Coloradans signing up for health insurance through the exchange, which was a 19% increase from 2024. As of July 2025, more than 305,000 Coloradans have coverage through the exchange. Underscoring the need to keep out-of-pocket costs from rising, of those who enrolled in a health insurance plan, 80% received financial help to lower premiums.

The final HHS rule would make substantial changes and create bureaucratic barriers to the operation of the ACA marketplaces, including adding new verification requirements, imposing an automatic monthly charge on all automatically reenrolled consumers who qualify for $0 premiums, shortening the open enrollment period for signing up for health coverage, and making other changes which will make coverage less affordable for millions nationwide.

All the challenged marketplace changes implemented by the final rule will be harmful to individual consumers and state and local governments. The final rule imposes burdensome and costly paperwork requirements, limits the opportunities to sign up for health coverage, substantially increases cost-sharing limits, and forces exchanges and consumers to spend hundreds of millions of dollars to prove eligibility for coverage and subsidies.

In filing the lawsuit, Attorney General Weiser joins the attorneys general of Arizona, California, Connecticut, Delaware, Illinois, Maryland, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, and Wisconsin, as well as the governor of Pennsylvania.

Read a copy of the lawsuit (PDF).

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Media Contact:
Lawrence Pacheco
Chief Communications Officer
(720) 508-6553 office
lawrence.pacheco@coag.gov