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Recent court decisions impacting the Marketplace

These recent court decisions may impact eligibility and coverage.

Court decision on Deferred Action for Childhood Arrivals

On December 9, 2024, the United States District Court for the District of North Dakota issued a preliminary injunction in Kansas v. United States of America (Case No. 1:24-cv-00150) partially blocking implementation of a final rule. This final rule allowed Deferred Action for Childhood Arrivals (DACA) recipients and individuals in certain other noncitizen groups to enroll in a qualified health plan (QHP) through the Health Insurance Marketplace® (if otherwise eligible) for plan years 2024 and 2025, effective on November 1, 2024.  As a result of the preliminary injunction, Marketplace enrollment has been placed on hold for these groups in the 19 states that are involved in the lawsuit. These states are: Alabama, Arkansas, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, South Carolina, South Dakota, Tennessee, Texas, and Virginia. All of those states except Idaho, Kentucky, and Virginia are served by the Federal Marketplace platform on HealthCare.gov.
To comply with this court order, DACA recipients and other noncitizens covered by the rule who reside in the above 19 plaintiff states shouldn't attest to having eligible immigration status in applications for Marketplace coverage. 
To further comply with the Court’s order, on December 26, 2024 the Marketplace will make a technical change so that DACA recipients and those other noncitizens covered by the rule who attest to lawful presence aren’t eligible for Marketplace coverage in the 16 states above served by HealthCare.gov. Following that technical change, the Marketplace will cancel any enrollments for 2025 Marketplace coverage selected by DACA recipients and other noncitizens covered by the rule in the 16 states. The insurance company will refund any premiums paid for that 2025 coverage. DACA recipients and those other noncitizens covered by the rule who enrolled in 2024 Marketplace coverage will have their Marketplace enrollment terminated at the end of the month and won’t have Marketplace coverage starting in 2025. The Marketplace will send a letter about ineligibility for coverage to DACA recipients and those other noncitizens covered by the rule in the 16 states.
We encourage impacted consumers who had a change in their immigration status since they applied for Marketplace coverage to update their Marketplace application with their new immigration status.

Court decisions on nondiscrimination

Pursuant to decisions by various district courts regarding the 2024 Final Rule implementing Section 1557, entitled Nondiscrimination in Health Programs and Activities, 89 Fed. Reg. 37,522 (May 6, 2024) (“2024 Final Rule”), provisions are stayed or enjoined as indicated below:  
  1. In Florida v. Department of Health and Human Services, No. 8:24-cv-1080-WFJ-TGW (M.D. Fla.), the court stayed 45 C.F.R. 92.101(a)(2)(iv), 92.206(b), 92.207(b)(3)-(5), and 42 C.F.R. 438.3(d)(4), in Florida. OCR also may not enforce the interpretation of discrimination “on the basis of sex” in 45 C.F.R. 92.101(a)(2)(iv), 92.206(b), or 92.207(b)(3)-(5) in Florida.
  2. In Tennessee v. Becerra, No. 1:24cv161-LG-BWR (S.D. Miss.), the court stayed nationwide the following regulations to the extent they “extend discrimination on the basis of sex to include discrimination on the basis of gender identity”: 42 C.F.R. 438.3, 438.206, 440.262, 460.98, 460.112; 45 C.F.R. 92.5, 92.6, 92.7, 92.8, 92.9, 92.10, 92.101, 92.206-211, 92.301, 92.303, 92.304; and enjoined HHS from enforcing the 2024 Final Rule “to the extent that the final rule provides that ‘sex’ discrimination encompasses gender identity.”
  3. In Texas v. Becerra, No. 6:24-cv-211-JDK (E.D. Tex.), the court stayed nationwide the following regulations: 42 C.F.R. 438.3(d)(4), 438.206(c)(2), 440.262, 460.98(b)(3), 460.112(a); 45 C.F.R. 92.101(a)(2) (and all references to this subsection), 92.206(b), 92.207(b)(3)–(5).
Notices of appeal have been filed in all three cases.
Review our accessibility and nondiscrimination notice.
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