Editorial: Passing it on

In her 58th lawsuit brought against the Trump administration in this second term, Vermont Attorney General Charity Clark last week joined a coalition of 19 other attorneys general in filing a lawsuit challenging a new federal rule that illegally undermines the Affordable Care Act and will make health insurance more expensive and harder to obtain.

The U.S. Department of Health and Human Services estimates the new rule will cause 2 million people to lose coverage in 2027 and a total of 5 million by 2030 if implemented, according to Clark's office.

Among other changes, the rule expands eligibility for health insurance plans that do not qualify for premium tax credits, offers limited coverage, and leaves consumers facing significantly higher out-of-pocket costs than standard ACA plans. The rule also attempts to reinstate several provisions that a federal court recently found unlawful.

Clark and fellow attorneys general called the rule change "harmful."

"Vermonters are already facing significant barriers to afford and access the healthcare they need, and the Trump administration's proposed rule will only make these challenges worse," said Clark in a statement. "Through this lawsuit, we are challenging this unlawful effort to weaken the Affordable Care Act and fighting to protect affordable health care for Vermonters and communities across the country."

The coalition argues that the rule unlawfully undermines the ACA's goal of expanding access to affordable health care by increasing costs, reducing enrollment, and shifting financial burdens onto consumers, states and health care providers, according to Clark.

Congress enacted the ACA to expand access to affordable health insurance, and more than 23 million Americans currently receive coverage through its marketplaces. The lawsuit follows the coalition's earlier challenge to the Trump administration's similar 2025 ACA Marketplace rule. A federal court last month vacated several provisions of the administration's 2025 rule — including provisions at issue in this case — after finding that they violated the Administrative Procedure Act. The administration's new rule setting standards for 2027 health plans, which is the subject of this lawsuit, brings back many of the same provisions and adds new changes that further undermine the ACA.

This all feels much more harmful. It feels negligent.

It is crazy to imagine a more perverse use of federal power than undermining a law designed to make health insurance more affordable and then asking Americans to pay the price.

The administration's effort to challenge the rule is precisely the wrong direction for American health care. Instead of strengthening the protections that help families afford comprehensive insurance, this approach risks steering people toward plans that can look cheaper on the surface while exposing them to substantially higher costs when they actually need medical care. That's irresponsible policy.

It's not making health insurance more affordable. It's shifting the costs from the monthly premium to the hospital bill, the specialist's office and the pharmacy counter.

Not only that, but it's no secret that the Affordable Care Act was built around a straightforward principle: insurance should provide meaningful protection when people get sick, not merely the appearance of coverage when they are healthy. Its premium tax credits help millions of Americans afford comprehensive plans. Its consumer protections establish standards for what qualifying insurance must cover. And its marketplace structure gives consumers a way to compare plans on something more meaningful than the size of the monthly payment. That is what was intended from the start.

Expanding plans that do not qualify for those tax credits and provide more limited coverage risks creating a two-tier system: comprehensive insurance for those who can afford it and skimpy coverage for everyone else.

That would be bad policy under any administration.

For us, it is particularly troubling when the government presents such a change as an expansion of consumer choice. Choice is not much of a choice when a cheaper option (especially when the options themselves are so limited) comes with substantially greater financial risk. A family that saves money on premiums but later faces thousands of dollars in uncovered or out-of-pocket expenses has not necessarily been helped. It has simply been handed a different bill.

But there's a basic fairness issue here. People do not buy health insurance because they expect never to use it. They buy it because illness and injury are unpredictable, and because a serious diagnosis can devastate a household financially. Insurance works only when it provides meaningful protection against that uncertainty.

Does this rule change make comprehensive health coverage more accessible and financially secure, or does it encourage people to trade adequate protection for a lower sticker price? We would say it is the latter and that the attorneys general are absolutely correct in being skeptical.