In a move that mixes pure politics with flawed congressional procedures, Senate Democrats are seeking to force a vote to repeal a Trump administration rule that they say will make it harder to enroll in Affordable Care Act health plans and sharply increase out-of-pocket costs for those who remain covered.
The measure is unlikely to pass the Republican-controlled Congress, but Democrats could use the vote against their opponents on the campaign trail.
When the ACA rule was released in May, the Trump administration touted it as a means to combat enrollment fraud, reduce premiums for some people and offer a broader range of insurance plans, including those without an established network of doctors or hospitals.
But many Democrats warned that the changes would hurt consumers already suffering from high health care costs, as well as higher prices for gasoline, groceries and other household needs. Administration estimates found that the regulation, called the payment and benefit parameters notice, could cause up to 2 million people to lose ACA coverage.
Senate Minority Leader Chuck Schumer and fellow Democratic Sens. Tammy Baldwin of Wisconsin and Ron Wyden of Oregon plan to introduce a Congressional Review Act resolution Wednesday to block the rule.
Baldwin told KFF Health News in a statement that the rule is “wrong” and said she was “committed to doing everything I can” to stop Republicans from “throwing Americans out of their health care.”
The directive from the Centers for Medicare and Medicaid Services is an annual exercise that sets standards for ACA coverage over the next year. Some of the changes in the finalized 2027 rule are technical, but many would directly affect consumers.
They include stricter income verification requirements. The rule also provides for more eligibility checks for people who apply outside the normal annual enrollment period for reasons such as marriage, divorce or loss of employment coverage.
The ACA's own plans would also be different. Insurers could offer some plans with 30% higher out-of-pocket limits (the amount consumers may have to pay each year in cost-sharing such as copays and deductibles), with a new limit of up to $15,600 for individual coverage or $31,200 for a family plan.
Democrats' effort to repeal the rule is a risky bet; would need a majority vote in both the House and Senate. But simply forcing a floor vote will likely be seen as a victory by the minority party.
“What Democrats are trying to do is get Republicans to vote on policies that would be unpopular if they reached the level of public consciousness,” said Adrianna McIntyre, an assistant professor in the Department of Health Policy and Management at the Harvard TH Chan School of Public Health. “Democrats want to show that they want to change these policies, even if they don't have the votes to do it.”
Under the review law, enacted as part of a broader law in 1996, Congress has the authority to revoke rules issued by federal agencies. While more than 40 such resolutions of disapproval have been passed, hundreds have been introduced, often primarily to draw attention to an issue.
It is one of the few levers a minority party has to force action in the Senate.
That's because if just 30 senators sign a discharge petition to send the measure to the floor, Democrats get a vote, without needing to go through a Republican-controlled committee or hold a hearing. A companion resolution is expected to be introduced in the House on June 17.
And there is no doubt that Democrats will try to use any congressional vote on health care costs as a litmus test for Republicans in the November elections.
“Time and again Democrats have used Republican efforts to undermine the ACA for the political gain of their campaigns, and this year will be no different,” said Larry Levitt, executive vice president of health policy at KFF, a nonprofit health information organization that includes KFF Health News.
Polls show the Republican Party could be vulnerable if Democrats can convince voters that their party would do better on health care costs, which are a top concern among voters.
A recent Pew survey, for example, found that 73% of adults see health care costs as a very big problem for the country, leading both inflation and the federal budget deficit. KFF tracking polls have found that health care costs are a top concern, even among Make America Healthy Again supporters allied with President Donald Trump.
At least half of people who identify as MAHA voters say those health costs will have a “significant impact” on their decision to vote and which party they support.
Medical costs generally tend to rise faster than inflation, driven by rising hospital and medical bills and the use of medications, devices and other healthcare services. That leads to higher costs for employers who offer health plans to their workers and for taxpayer-supported programs like Medicare and Medicaid, as well as higher premiums for insurance plans sold under the ACA. Consulting firm PwC projects that the cost of treating patients will increase by 9% this year, the highest in almost two decades.
Higher premiums and lower subsidies also hit many ACA enrollees this year, with about 1.2 million fewer enrollments than for 2025 in January.
The costs “are a good Democratic talking point,” said Joseph Antos, a former government health official who is now a fellow emeritus at the right-wing American Enterprise Institute. “Trump was going to solve inflation and instead, what do we have?”
