Federal Judge Brendan Hurson in Baltimore has temporarily blocked provisions of the Marketplace Integrity and Affordability Final Rule, which was set to take effect on August 25, 2025. The case was brought by the cities of Chicago and Baltimore, supported by public health advocacy groups. They argued that the new requirements, including higher fees and stricter verification measures, could result in the loss of health coverage for more than 2 million low-income Americans. The judge agreed that the plaintiffs had shown sufficient evidence of potential conflicts with the Affordable Care Act (ACA) and issued an injunction pending further review.
What the Rule Encompasses
The regulation, finalized in June 2025 by the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), was intended to strengthen marketplace integrity and reduce improper enrollments. Key elements included tougher income verification procedures, changes to automatic renewals, adjustments to premium delinquency handling, and revised eligibility standards for subsidies.
According to the court filings, the most contested elements involve new administrative fees and enhanced checks for low-income applicants.
Market and Industry Reaction
The decision had an immediate impact on the health insurance sector. Shares of major insurers such as Centene, Cigna, Elevance, Molina, and UnitedHealth rose following the ruling, as investors welcomed a pause in regulatory uncertainty ahead of the 2026 enrollment season.
What Comes Next
The case remains ongoing, with further arguments to be presented in the coming weeks. If the injunction is extended, insurers and brokers may push for transitional mechanisms to avoid disruptions during the open enrollment campaign. Should parts of the rule eventually be upheld, regulators will likely need to refine income-verification processes and fee structures to ensure compliance without triggering widespread coverage losses.
