Attorney General Platkin Co-Leads Multistate Effort to Protect Affordable Care Act From Attack

Comment Letter

TRENTON – Attorney General Matthew J. Platkin, along with the Attorneys General of California and Massachusetts, co-led a multistate letter regarding a raft of proposed changes that would undermine the Affordable Care Act (ACA), making it more difficult and expensive for individuals to enroll in health coverage on federal and state exchanges.

The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make a number of regulatory changes impacting access to insurance via the ACA. If allowed to take effect, the proposed changes would reduce access to ACA exchanges and risk causing between 750,000 and two million Americans to lose health insurance coverage in 2026. That would impose harms on States and their residents, both insured and uninsured, as when more individuals are forced to go without insurance, costs are driven up for everyone.

“The Trump Administration, in one of its first proposed regulations, is trying to make it harder to access health insurance for New Jerseyans and across the country,” said Attorney General Platkin. “That decision harms vulnerable populations and those who count on the Affordable Care Act, and it hurts everyone else too—because it drives up costs for all the States and our residents. I am proud to lead the fight against this idea, and I will continue to fight against any unlawful changes that deprive New Jerseyans of access to quality, affordable health care.”

“Taking health insurance away from people is not only cruel, it’s also bad policy. If we want to lower health care costs, we need more people to have coverage—not less,” said New Jersey Health Commissioner Kaitlan Baston, MD, MSc, DFASAM. “Everyone gets sick. But without insurance, people don’t get routine preventive care, and they wait to seek treatment until they’re much sicker. That makes their treatment more expensive—and when people can’t afford the hospital bill, we all end up paying for it.”

“New Jersey established GetCoveredNJ with the promise of providing residents with improved access to quality, affordable health coverage. Over the last five years we delivered on that promise, implementing numerous consumer focused policies leading to record enrollment each year. Now, due to the proposed federal rule, the flexibilities that allowed New Jersey to tailor GetCoveredNJ to best serve our residents is at risk,” said Justin Zimmerman, Commissioner, New Jersey Department of Banking and Insurance, which operates Get Covered New Jersey, and which submitted its own comment letter on the rule. “This proposal would severely impact our ability to maintain the current access to quality, affordable health coverage for over a half a million residents and derail the tremendous progress we have made in connecting New Jerseyans with the health coverage and care they deserve.”

Among other things, the proposal would force all state ACA exchanges to shorten their open enrollment periods, instead of allowing them to run for longer periods. New Jersey would have to shorten its open enrollment period by about six weeks and end on December 15. This would drastically reduce the time to enroll and likely decrease the number of enrollments, shrinking the pool of those who have health coverage.

That reduction would come on the heels of New Jersey experiencing its strongest year yet of enrollments through Get Covered New Jersey, the state’s Official Health Insurance Marketplace. New Jersey’s 2024-2025 open enrollment period ran from November 1, 2024, to January 31, 2025 and saw a nearly 30% increase from the prior period.

Another part of the rule would allow health insurance plans to deny enrollment to anyone who once missed even a single payment for a health insurance premium, no matter how long ago the missed payment occurred. The rule does not require insurers to notify their consumers if they implement this policy—meaning consumers could be denied coverage without being aware that their denial is because they owe a past-due premium. In previous rulemaking, the federal government understood that nonpayment could be due to a variety of factors and that insurers currently have sufficient methods to collect past-due payments.

The proposal would also end the low-income special enrollment period (SEPs) for individuals whose projected annual household income is at or below 150 percent of the federal poverty level, and add paperwork and bureaucratic hurdles for residents who seek enrollment during a life event such as the birth of a child or job loss.

The States’ comment, led by Attorney General Platkin and the Attorneys General of California and Massachusetts and joined by 21 Attorneys General, explains that these changes are all arbitrary and capricious and are therefore unlawful if ultimately adopted.

The latest proposal also reverses a CMS and HHS rule from late 2024 to allow DACA recipients to have access to state and federal exchanges under the ACA. DACA recipients, also known as Dreamers, are allowed to live and work in this country pursuant to deferred action. If the rule is allowed to take effect, they would lose the ability to purchase affordable health insurance through the exchanges. The comment explains that these changes are also unlawful.

Besides New Jersey, California, and Massachusetts, the other states signing the comment letter include Arizona, Colorado, Connecticut, District of Columbia, Delaware, Hawaii, Illinois, Maryland, Maine, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, and Wisconsin.

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