City of New York Leads Coalition of Local Governments to Protect Affordable Care Act Coverage for Millions of Americans

August 7, 2025

NEW YORK – New York City Mayor Eric Adams and New York City Corporation Counsel Muriel Goode-Trufant today announced that the City of New York is leading a coalition of local governments in filing an amicus brief supporting plaintiffs in California v. Kennedy et al., fighting to protect patient coverage under the Patient Protection and Affordable Care Act (ACA). The lawsuit — brought by a coalition of states, including New York — challenges a recently finalized federal rule that will create obstacles to enrollment in the ACA, result in millions more uninsured and underinsured people across the nation, and ban gender-affirming care as an essential health benefit. The coalition’s amicus details the harmful effects of the rule and supports the states’ effort to stop the U.S. Department of Health and Human Services (HHS) from implementing the rule on August 25.

“Access to health care is a human right codified into law by the historic passage of the Affordable Care Act, which has provided health coverage to millions of Americans. At a time when too many New Yorkers and people across the country are struggling with high costs, stripping away that coverage will only take us backwards,” said Mayor Adams. “Government should do everything in its power to provide and expand access to health care and other essential services, not restrict it, but this federal rule only serves to jeopardize health coverage for New Yorkers and Americans all across the nation. New York City is proud to lead this coalition of localities fighting to protect health coverage for the people we represent.”

“The sweeping regulatory changes to the Affordable Care Act adopted by the federal government are unlawful and a major step backwards for public health,” said Corporation Counsel Goode-Trufant. “As detailed in our brief, this misguided new federal rule will cause millions of people to lose their health insurance and force them to turn to severely strained public hospitals for care, exacting a tremendous human and financial cost on us all.”

The coalition’s brief argues that public hospitals will be rocked by the new rule at a time when steep staffing shortages, as well as soaring demand and costs, are already causing widespread hospital closures across the nation. The brief details how the new federal rule will undermine the ability of local officials to protect public health with devastating consequences across the board, including decreased trust in public hospitals as they are forced to stretch resources to deal with increased number of patients.

The brief further contends that when low-income individuals lose affordable coverage, their medical costs do not simply disappear, as the federal government assumes; they are shifted onto the backs to public health care systems and localities. For example, hundreds of thousands of the nearly 400,000 patients that New York City’s public health care system serves every year are uninsured, and most other patients are insured by public payers that reimburse at below-cost rates, resulting in more than $1 billion in uncompensated costs for the health systems seeing these patients.

If the new rule is allowed to take effect, some safety-net providers will surely buckle under the burden of caring for millions of newly uninsured people and billions of additional dollars in unpaid bills.

Filed in the U.S. District Court for the District of Massachusetts by 16 states, California v. Kennedy et al. alleges HHS Secretary Robert Kennedy’s actions violate federal laws such as the Administrative Procedure Act, the Separation of Powers doctrine, and the Spending Clause.

Joining the City of New York and NYC Health + Hospitals in filing this amicus are Santa Clara County, California and King County, Washington, as well as the city and county of San Francisco, California.

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