On Aug. 22, 2025, the U.S. District Court for the District of Maryland paused several key portions of a final rule imposing stricter enrollment and eligibility standards for the Affordable Care Act’s (ACA) Marketplaces (or Exchanges). Many of the new standards were scheduled to take effect on Aug. 25, 2025, although some provisions have a later effective date.
The U.S. Department of Health and Human Services (HHS) published the final rule on June 25, 2025, to reduce “widespread fraud” by strengthening the integrity of the Exchange’s eligibility and enrollment systems. Two nonprofit organizations and the cities of Baltimore, Chicago and Columbus, Ohio, brought a lawsuit against HHS, alleging that the final rule violates the Administrative Procedures Act (APA) and creates numerous barriers to affordable health coverage.
