A federal judge on Thursday temporarily barred the Department of Health and Human Services from terminating a variety of public health funds that had been allocated to states during the Covid-19 pandemic, finding that the move had left those states stranded and unable to provide critical health services.
Ruling from the bench during a hearing on Thursday, Judge Mary S. McElroy of the U.S. District Court for the District of Rhode Island said a coalition of Democratic states had easily demonstrated that the cuts had upended their public health infrastructure and jeopardized everything from childhood vaccination programs to opioid addiction treatment almost overnight.
On Tuesday, 23 states and the District of Columbia had filed a lawsuit pushing back against the Trump administration’s decision last week to cancel at least $11 billion in federal grants. The Trump administration had said that the funding was no longer necessary because the government’s pandemic emergency declaration had officially expired nearly two years ago.
Starting on March 24, state agencies began receiving notices from the health department, bluntly informing them that the grants they had relied on for years to fight infectious disease and provide treatment for mental health and addiction had been suspended.
“No additional activities can be conducted, and no additional costs may be incurred, as it relates to these funds,” the notices said.
But some of the funding at issue was not scheduled to expire until as late as June 2027, and the states suing said that the abrupt and seemingly arbitrary termination had left them scrambling to fill a deep hole in their budget.
During a hearing on Thursday, Sarah Rice, a lawyer from the Rhode Island attorney general’s office, ticked through what she described as a list of cascading crises thrust upon different states, which were documented in more than 4,000 pages of exhibits filed with the lawsuit on Tuesday.
In Minnesota, Ms. Rice said, 170 state employees including skilled epidemiologists and research scientists had been laid off this week as funding was halted, and about 12 percent of the state’s health care workers were expected to ultimately lose their jobs.
In Rhode Island, officials were preparing to shutter planned vaccination clinics, she said. And in California, because of its large population, public health officials were grappling with the loss of $2 billion in federal grant money that officials had counted on for childhood vaccine programs and rural health services in regions far from hospitals.
Ms. Rice said that state laboratories, which provide tests for serious diseases such as Zika or Ebola, were similarly reliant on federal grant money to acquire lab equipment and get test results back to patients.
“These, and actually many, many others that I’m going to omit for time, are some of the reasons that states are facing immediate, irreparable harm,” Ms. Rice said.
“States simply do not have the capacity to backfill these grants that they relied on when constructing their programs,” she added.
During the hearing, Judge McElroy zeroed in on grants from the Substance Abuse and Mental Health Services Administration, a branch of the health department that provides funding to states to help support treatment of alcohol use disorder and opioid addiction.
By law, she noted, S.A.M.H.S.A. grants and others like them cannot be summarily canceled without states being given adequate notice and the opportunity to appeal. Ms. Rice had argued earlier that the indiscriminate cancellation of those grants meant that people in addiction treatment who required immediate hospitalization or medication had been put at extreme risk.
The division is among those hard-hit by the mass layoffs that began rolling out at the health department on Tuesday, with entire offices hollowed out.
Leslie Kane, a lawyer for the government, said that the Justice Department had been unable to review the thousands of pages of exhibits the states had submitted in the two days since the lawsuit was filed. She asked Judge McElroy to hold off on an immediate order to allow the government time to craft its case.
But within 30 minutes, Judge McElroy decided to grant an emergency restraining order, citing the “voluminous” list of harms the states had recorded, and their “extremely strong” likelihood of success in the case. She ordered both sides to return to discuss next steps on April 16.
“I don’t see how I can deny the temporary restraining order on the record that’s before the court,” she said.
Zach Montague is a Times reporter covering the U.S. Department of Education, the White House and federal courts. More about Zach Montague
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