Governors Issue Joint Letter Against Harmful Proposal to Disrupt State Marketplaces & Limit Access to Health Insurance

CHICAGO—Illinois Governor JB Pritzker, Colorado Governor Jared Polis, Maryland Governor Wes Moore, New Mexico Governor Michelle Lujan Grisham, and Oregon Governor Tina Kotek issued a joint letter to Peter Nelson, Director of the Centers for Medicare & Medicaid Services (CMS). The letter is in response to the Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P “Proposed Rule”), which would restrict states’ ability to regulate their health insurance marketplaces, causing confusion among customers, limiting enrollment options for low-income families, and ultimately disrupting local healthcare landscapes and making coverage less accessible to residents. The Governors urged Director Nelson to withdraw the Proposed Rule and ensure states retain flexibility in the health insurance marketplace.

The proposed rule comes as a record number of Americans (24.2 million) accessed healthcare through marketplaces in 2024, including nearly 4 million new customers.

“Once again, it is clear that the Trump Administration will stop at nothing to restrict access to health insurance for Americans,” said Governor JB Pritzker. “This proposed rule will cause confusion, make it harder to enroll, and limit healthcare access for the most vulnerable Illinoisans.”

Governors are advocating for withdrawal of the harmful portions of the Proposed Rule; key concerns include:

1. Restrictions on states’ ability to set open enrollment periods and determine eligibility: States intimately know local healthcare landscapes, and inconsistency in eligibility, benefits, and open enrollment periods will create confusion among consumers. The markets, which rely on risk calculation, will suffer destabilization and uncertainty if individuals and families are left without coverage.
2. Eliminating Enrollment Options for Low-Income Families: Eliminating options for special enrollment will increase the likelihood that large numbers of our residents will return to being uninsured and will leave hospitals and providers to foot the bill for their medical care.
3. Increased Consumer Costs and Special Enrollment Limitations: Changing premium adjustment calculations will significantly increase the cost burden on consumers and contribute to overall price inflation. Additionally, low-income families who rely on special enrollment will return to being uninsured, creating imbalance in the amount hospitals and providers pay for medical care.

“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 important coverage for millions of Americans,” said Colorado Governor Jared Polis. “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.”

“When the Affordable Care Act took effect, roughly three-quarters of a million Marylanders lacked health coverage–since 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 unnecessary 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

The full letter can be accessed here.