Judge Brendan Hurson blocks CMS marketplace rule

The Affordable Care Act of 2010 created federal health insurance marketplaces where Americans can shop for coverage. It also established advance premium tax credits that reduce monthly insurance costs for millions of low- and middle-income families.

Congress expanded ACA subsidies twice in recent years. The American Rescue Plan Act of 2021 increased subsidy amounts, and the Inflation Reduction Act of 2022 extended those enhanced credits through Dec. 31, 2025.

Without new legislation, the enhanced subsidies expired at the end of 2025. The Congressional Budget Office projected this would cause average premium increases of 114% for the 22 million Americans enrolled in marketplace plans for 2026.

The FDA approves drugs and medical devices at the federal level under statutory authority. However, states retain the power to license insurance companies, set market rules, and establish consumer protections within their borders.

On Aug. 22, 2025, U.S. District Judge Brendan Hurson issued a temporary injunction blocking portions of HHS's Marketplace Integrity and Affordability Rule. The rule aimed to tighten eligibility verification and crack down on enrollment fraud.

CMS estimated the Marketplace Integrity Rule would save taxpayers $12 billion over ten years. Critics argued the stricter requirements would create administrative barriers that would've blocked more than 2 million low-income Americans from accessing subsidized coverage.

State insurance commissioners warned that Congress's failure to extend subsidies would create chaos in 2026 enrollment periods. They predicted higher uninsured rates, especially among older adults and lower-income families who rely most heavily on federal assistance.