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Public Health Funding
As we have reported previously, over the last several weeks, numerous lawsuits have been filed challenging Executive Orders and actions taken by the Trump Administration that may have an adverse effect on health. Most of these cases are still working their way through the courts, but in several instances, preliminary injunctions or temporary restraining orders have been issued. Most notable for public health, on April 3, 2025, a federal district judge in Rhode Island issued a temporary restraining order (TRO) in Colorado v. Department of Health and Human Services, in which 23 states challenged the abrupt termination on March 24 of $ 11 billion in funds used for infectious disease tracking, emergency preparedness, modernizing the public health infrastructure, and mental health and substance use treatments. According to the Department of Health and Human Services (DHHS), the funding was terminated because the funds were appropriated in COVID-relief bills and the pandemic is over.
In issuing the TRO, Judge Marcy S. McElroy found that the states were likely to win on the merits because DHHS failed to comply with statutory requirements for the termination of funds and because Congress did not limit the funds for COVID relief. The judge also found that the plaintiffs would suffer irreparable harm if the cuts went forward, noting that the terminations would likely cause a “significant threat to public health and safety.”
On April 7, as the judge ordered, DHHS’ affirmed its compliance with the court’s order. However, the case is far from over, as litigation continues.
SCOTUS Speaks
The ultimate fate of the Colorado v. DHHS lawsuit and many of the other cases challenging cutbacks imposed by the Trump Administration may depend on the Supreme Court. In the last week, the Supreme Court has issued several emergency decisions reversing lower court orders blocking the Trump Administration’s cuts to federal funding and the federal workforce. All of these decisions were issued from the Court’s so-called emergency, or “shadow” docket, and all were based on narrow jurisdictional grounds. None were on the merits. Nevertheless, the fact that the Court reached out to issue emergency orders overturning lower court rulings, may suggest that the Court is cautioning lower courts to proceed very carefully before blocking the Administration’s orders.
For public health, the most relevant decision is probably Department of Education v. California. In that case, a federal district court in Massachusetts issued a TRO temporarily halting the termination of certain education-related grants. Although TROs are not typically appealable, the Supreme Court by a 5-4 vote stated that “several factors counsel[ed]” in favor of treating the TRO as a preliminary injunction and subject to review. Among these reasons was that the government was likely to succeed in showing that the District Court lacked jurisdiction because claims to enforce contracts and claim money from the United States must usually be brought before the Federal Court of Claims, rather than the District Courts. The Supreme Court also stated that the plaintiffs had not shown irreparable harm, as they could keep their programs going while the litigation continued.
In her dissent, Justice Kagan argued that the plaintiffs had shown that the termination of funds would cause them irreparable harm. In another dissent, Justice Jackson, who was joined by Justice Sotomayor, argued that the Supreme Court itself lacked jurisdiction to rule on the matter and that there was no reason for the Court to grant the government the type of emergency relief it sought. Chief Justice Roberts also dissented, but did not sign any opinion.
The Court’s brief emergency ruling in Department of Education v. California, like the Court’s other recent emergency orders, is not precedential (because of its emergency nature). However, the majority’s conclusion that the lower court lacked jurisdiction may be applicable in other cases challenging cutbacks to federal grants and contracts. Even more worrisome for public health is the possibility that the Court’s conservative majority will continue to cast a skeptical eye on legal challenges to the Trump Administration’s broad assertions of executive authority.
** NOTE: Litigation relating to the Trump Administration’s orders and actions is rapidly developing. To follow updates, see Just Security’s litigation tracker.
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