Governors Pritzker, Polis, Moore, Lujan Grisham, and Kotek Unite Against Proposed Healthcare Rule Changes
Table of Contents
- 1. Governors Pritzker, Polis, Moore, Lujan Grisham, and Kotek Unite Against Proposed Healthcare Rule Changes
- 2. Key Concerns with the Proposed Rule
- 3. Potential Legal Challenges and Congressional Action
- 4. The Full Letter
- 5. What impacts, if any, do you foresee this rule change having on you and your family?
- 6. Interview: Healthcare Policy Expert Dr. Eleanor Vance on Proposed ACA Rule Changes
- 7. Introduction
- 8. Understanding the Proposed Rule’s Impact
- 9. Key Concerns and Potential Consequences
- 10. Economic and Social Implications
- 11. Legal and Political Landscape
- 12. Looking Ahead
- 13. Concluding Thoughts
- 14. Reader Engagement
Five governors are pushing back against a proposed federal rule they say threatens the Affordable Care Act and access to healthcare in their states.
CHICAGO—In a united front,Illinois Gov. JB Pritzker, Colorado Gov. Jared Polis, Maryland Gov. Wes Moore, New Mexico Gov. Michelle Lujan Grisham, and Oregon Gov.Tina Kotek have jointly addressed a letter to Peter Nelson, Director of the centers for Medicare & Medicaid Services (CMS), expressing deep concerns over the Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P), also known as the “proposed Rule.” The governors argue that the rule would significantly curtail states’ authority in regulating their health insurance marketplaces, leading to widespread consumer confusion, restricted enrollment options for low-income families, and an overall destabilization of local healthcare systems, ultimately diminishing healthcare accessibility for residents.
The governors are strongly urging Director Nelson to withdraw the Proposed Rule, emphasizing the critical need for states to maintain flexibility in managing their health insurance marketplaces. Their opposition comes at a time when, according to CMS, a record 24.2 million Americans enrolled in healthcare through the marketplaces in 2024, including nearly 4 million new customers. This underscores the reliance of Americans on the ACA and the potential ramifications of the proposed changes.
Once again,it is clear that the Trump Management will stop at nothing to restrict access to health insurance for Americans. This proposed rule will cause confusion, make it harder to enroll, and limit healthcare access for the most vulnerable Illinoisans.— governor JB Pritzker
Gov. Pritzker’s statement highlights a key concern: the potential erosion of healthcare access for vulnerable populations in Illinois. The proposed rule touches upon several critical aspects of state healthcare management, with potential ripple effects across the nation.
Key Concerns with the Proposed Rule
The governors’ letter outlines several key areas of concern regarding the “Proposed Rule”:
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Restrictions on States’ Ability to Set Open Enrollment Periods and Determine eligibility:
Governors argue that the Proposed Rule undermines states’ ability to tailor healthcare policies to meet the unique needs of their residents. This could lead to “inconsistency in eligibility, benefits, and open enrollment periods,” creating confusion among consumers. The stability of the insurance markets depends on accurate risk calculation, which the governors believe will be compromised if individuals and families are left without coverage. As an example,if a state like California,which has been proactive in expanding Medi-Cal (Medicaid) coverage,loses the ability to set its own eligibility criteria,it could face critically important challenges in managing its healthcare resources and ensuring access for its low-income residents. -
Eliminating Enrollment options for low-Income Families:
The governors fear that eliminating special enrollment options “will increase the likelihood that large numbers of our residents will return to being uninsured.” This will inevitably shift the financial burden of medical care to hospitals and providers, potentially impacting the overall quality and accessibility of healthcare services. This is concerning in states such as West Virginia, where populations are more vulnerable and have higher rates of chronic diseases. -
Increased Consumer Costs and Special Enrollment Limitations:
The Proposed Rule’s changes to premium adjustment calculations raise the specter of significantly increased costs for consumers and contribute to overall price inflation. The consequences of these limitations are especially alarming for low-income families who rely on special enrollment periods.
To illustrate the potential impact, consider a hypothetical scenario:
| Scenario | Current ACA | Proposed Rule Impact |
|---|---|---|
| Low-Income Family Needs Coverage After Job Loss | Special Enrollment Period Available | Potentially No Enrollment Option, Leading to Uninsurance |
| State Tailors Enrollment to Local Needs | Flexibility to Adjust Enrollment Periods | Restricted ability, Potential Consumer Confusion |
| Premium Adjustments | Calculations designed to Minimize Cost Burden | Potentially higher Premiums and Increased Inflation |
The Affordable care Act has helped hundreds of thousands of Coloradans connect to health care coverage they can afford. The rule being pushed could raise premiums and make it harder for Americans to continue to see their doctors and get the coverage they need. I urge the Trump administration and CMS not to raise health care premiums and to protect this vital coverage for millions of Americans.— colorado governor Jared Polis
Gov. Polis underscores the potential economic consequences of the Proposed Rule. Higher premiums could disproportionately affect middle-class families in states like Pennsylvania, forcing them to make difficult choices between healthcare and other essential needs.
The proposed rule will put record enrollment at risk. It will create more challenges that harm Colorado’s market if subsidies are also cut through the Congressional reconciliation process. The combination of this rule and the loss of subsidies could mean millions of Americans lose coverage when they see their insurance premiums increase.— Colorado Governor Jared Polis
When the Affordable Care Act took effect, roughly three-quarters of a million Marylanders lacked health coverage–as then our state has seen seven consecutive years of enrollment increases. This proposed rule would jeopardize the progress we’ve seen in Maryland, causing significant disruptions and limiting marylanders access to healthcare options. Marylanders rely on this affordable health care. We urge the Trump Administration to change course on this overreach,and allow Maryland and so many others to see continued progress.— Maryland Governor Wes Moore
The ACA marketplace has provided stable, affordable coverage for New Mexico families working hard to move up the economic ladder, ensuring continuity of care as incomes change. This proposed rule threatens to disrupt that progress, shift costs to New Mexicans, create needless administrative barriers, and limit access to essential health services, ultimately hurting working families across our state. I urge the Trump administration to reconsider this approach and allow states to continue building a healthier future for our communities.— New Mexico Governor Michelle Lujan Grisham
Potential Legal Challenges and Congressional Action
Experts predict potential legal challenges if the Proposed Rule is enacted.States may argue that the rule oversteps federal authority and infringes upon their rights to regulate healthcare within their borders. Similar challenges have been mounted against previous attempts to roll back ACA provisions. Moreover, the future of the Proposed Rule is highly likely to be influenced by ongoing debates in Congress regarding healthcare funding and subsidies.Any cuts to subsidies, as Gov.Polis noted, combined with the implementation of the Proposed Rule, could create a perfect storm, leading to significant coverage losses for millions of Americans.
The Full Letter
The full letter detailing the governors’ concerns can be accessed here.
What impacts, if any, do you foresee this rule change having on you and your family?
Interview: Healthcare Policy Expert Dr. Eleanor Vance on Proposed ACA Rule Changes
Introduction
Archyde News is joined today by Dr. Eleanor Vance, a leading healthcare policy analyst specializing in the Affordable Care Act (ACA) and state health insurance marketplaces. Dr.Vance, welcome to Archyde News.
Dr.Vance: Thank you for having me. It’s a critical time to discuss these proposed rule changes.
Understanding the Proposed Rule’s Impact
Archyde News: The article details that five governors have raised serious concerns about the “Marketplace Integrity and Affordability Proposed Rule.” Can you,in simple terms,explain what this rule aims to do and why it’s causing such a stir?
Dr. Vance: Certainly. The proposed rule, if enacted, would primarily give the federal government more control over how states manage thier health insurance marketplaces established under the ACA. This means that states would have less flexibility in setting open enrollment periods, determining eligibility criteria, and offering special enrollment options. The concern is that this reduction in state control could lead to fewer enrollment options, higher costs for consumers, and overall instability within the markets, perhaps undermining the great progress made in covering millions of Americans, especially the vulnerable ones.
Key Concerns and Potential Consequences
Archyde News: The governors highlighted several specific concerns, including restrictions on open enrollment periods and the elimination of enrollment options for low-income families.What are the most critical impacts we should be aware of, and what do you see as potentially the most significant issues that could arise?
Dr. Vance: One of the key dangers is that it could restrict states’ abilities to respond effectively to the unique needs of their populations. For instance,if a state’s open enrollment must align strictly with federal standards,it can’t accommodate local circumstances,potentially leading to confusion or leaving some people without coverage when they need it most. Secondly removing enrollment options like those for families is more likely to leave people without health insurance. This will increase the financial burden on hospitals, as they provide care to those lacking coverage, and can reduce quality of care.
Archyde News: Governor Polis of Colorado pointed out the potential for higher premiums as well. How could this affect the broader economic and social well-being of the general public?
Dr. Vance: Higher premiums will undoubtedly strain families, particularly those with fixed or low incomes, who either face the challenge of choosing between health or other essential needs. This could lead to people delaying vital preventive treatments, going without prescription medication, and eventually, increased emergency room visits, considerably impacting financial standing and quality of life. And because healthcare impacts productivity and access to work, ther are potentially drastic economic consequences to further restrictions on consumers.
Legal and Political Landscape
Archyde News: The article mentions potential legal challenges and the influence of congressional debates.What are the key factors in determining the fate of this proposed rule?
Dr. Vance: The proposed rule could face legal obstacles if enacted. States concerned can reasonably argue that it crosses boundaries with a federal overreach. The Congressional debates focused on healthcare funding and subsidies would create a perfect storm if cuts where to be implemented concurrently with the proposed rule. This can be considered a crucial moment for the ACA, and everything depends on the government.
Looking Ahead
Archyde News: Dr. Vance, what advice would you give to Americans as they navigate this uncertain period?
dr. Vance: Stay informed.Follow the decisions and communications from your state’s healthcare officials and healthcare marketplaces. Be especially keen on any potential changes to your coverage. There will likely be some major changes in coverage that could catch many off guard.
Concluding Thoughts
Archyde News: Dr.Vance, thank you for your valuable insights. We hope this discussion will bring some awareness for the public. Is there anything else you’d like to add?
Dr. Vance: It’s important to remember that the ACA has always been a work in progress. Healthcare is constantly evolving. I want to remind all of you that states will continue to have a duty to ensure a healthier future for our communities, irrespective of what happens next.
Reader Engagement
Archyde News: We encourage readers to share any questions or thoughts in the comments section below. What impacts, if any, do you foresee this rule change having on you and your family?
