President Donald Trump’s official portrait, via the White House
President Donald Trump’s official portrait, via the White House

Baltimore is again suing the White House over its health care policies, this time due to the president’s alleged undermining of the Affordable Care Act.

The complaint, filed in the U.S. District Court of Maryland this morning, accuses the Trump administration of violating a constitutional clause to “take care that the laws be faithfully executed” through the president’s very vocal push to repeal the eight-year-old Patient Protection and Affordable Care Act, most of which took effect in 2014. The law mandated sweeping health insurance reforms in an attempt to expand coverage to millions of Americans, though many Republicans have opposed it, arguing it disrupts the existing private insurance scheme and is unaffordable for many Americans.

Trump’s administration has been undercutting the law, the suit says, by attempting to suppress enrollment, shifting away funds meant to support the law’s reforms, reducing oversight of insurance rate increases and generally disrupting insurance markets, among other actions.

The filing of the lawsuit comes the morning after the U.S. Department of Health and Human Services (HHS) finalized regulations to let people keep expensive and less comprehensive short-term insurance plans for up to three years, up from the three-month cap imposed by the Obama administration. Doing so pushes more people to leave the Affordable Care Act market, which drives up costs for those who are participating, critics argue.

Baltimore and other cities–Columbus, Cincinnati, Chicago and Charlottesville are also plaintiffs in the suit—argue the Trump administration’s subversion of the law is overburdening their budgets as they expand services. A release from the Baltimore City Health Department says it has been forced to “devote additional funding, personnel, and other resources to subsidize and provide uncompensated care to residents lacking adequate health insurance.”

“By intentionally sabotaging the ACA, the Trump Administration is directly increasing the number of uninsured and underinsured Baltimoreans,” Health Commissioner Dr. Leana Wen said in a statement. “This will increase demand for our services, without additional resources.”

The suit names President Donald Trump, HHS, Centers for Medicare and Medicaid Services, (CMS), HHS Secretary Alex Azar and CMS Secretary Seema Vera as defendants. It asks the court to nullify or halt various rule changes to insurance markets, require the White House to implement the ACA and cover plaintiffs’ legal fees.

Baltimore sued the Trump administration over its funding cuts for programs helping to reduce teen pregnancy rates, a case the city won in April.

Similarly, Maryland last week joined other states in suing the Trump administration over a new U.S. Department of Labor rule allotting more freedom for formation of controversial association health plans, which allow small businesses to band together to buy insurance. Maryland Attorney General Brian Frosh said expanding footprint for such plans “is yet another attempt to undermine the Affordable Care Act at the expense of consumers.”

Ethan McLeod is a freelance reporter in Baltimore. He previously worked as an editor for the Baltimore Business Journal and Baltimore Fishbowl. His work has appeared in Bloomberg CityLab, Next City and...