A federal judge on Tuesday temporarily blocked the Trump administration from moving forward with a dramatic reorganization of the Department of Health and Human Services, finding that the mass firings and organizational changes were probably unlawful.
In an opinion accompanying the order, Judge Melissa R. DuBose of the U.S. District Court for the District of Rhode Island said that Health Secretary Robert F. Kennedy Jr.’s efforts to wipe out entire programs and reorient the agency’s priorities and work far exceeded his authority.
“The executive branch does not have the authority to order, organize or implement wholesale changes to the structure and function of the agencies created by Congress,” she wrote.
A coalition of 19 Democratic-led states and the District of Columbia had banded together in a lawsuit led by Letitia James, the New York attorney general, seeking to reverse Mr. Kennedy’s plan to cut 10,000 federal health workers after mass layoffs began in April. The lawsuit also challenged his reorganization of the sprawling department, which included paring down 28 federal divisions to 15.
The layoffs and restructuring effectively eliminated programs that assisted local officials with a variety of public health issues ranging from testing for sexually transmitted diseases to anti-smoking campaigns to lead-poisoning outbreaks, the states contended, resulting in the loss of critical services almost overnight.
In her order, Judge DuBose, an appointee of President Joseph R. Biden Jr., laid out a withering civics lesson, offering the government “a brief reminder about the bedrock doctrine of separation of powers that governs the relationship between the United States.” She added that the changes at the agency would have knock-on effects for the entire country, and that the Constitution expressly prevented someone in Mr. Kennedy’s position from attempting such a ”concentration of power in one part of the government.”
In recent testimony to Congress, Mr. Kennedy said that more than 700 staff members from the Centers for Disease Control and Prevention who had been let go had since been brought back. It is unclear how many of the public health gaps described by states in the litigation remain unaddressed.
Andrew Nixon, a spokesman for Mr. Kennedy, said on Tuesday that the agency stood by its “decision to realign this organization with its core mission and refocus a sprawling bureaucracy that, over time, had become wasteful, inefficient and resistant to change.”
He said the reorganization was meant to help the department reverse chronic disease and advance U.S. leadership in biomedical research. The agency is reviewing the court’s decision and considering next steps, he added.
Ms. James applauded the judge’s order as relief, however temporary, for “our most vulnerable communities.”
“H.H.S. is the backbone of our nation’s public health and social safety net — from cancer screenings and maternal health to early childhood education and domestic violence prevention,” she said in a statement. “Today’s order guarantees these programs and services will remain accessible and halts the administration’s attempt to sabotage our nation’s health care system.”
Shortly after taking office, President Trump ordered nearly every agency to undergo a drastic overhaul and present plans for large-scale layoffs.
During a court hearing in May, Molly Thomas-Jensen, an attorney with the New York Attorney General’s Office, outlined some of the services that were cut as a result of Mr. Kennedy’s efforts to follow that directive, including screening for hearing loss in newborns, tracking of maternal mortality and testing for sexually transmitted diseases.
“Secretary Kennedy has admitted that performing a careful review of job responsibilities before laying off 10,000 employees would have taken too long and would have resulted in a loss of political momentum,” Ms. Thomas-Jensen said. “He also conceded that he believed that 20 percent of these layoffs would be mistakes, and that that was always the plan.”
Elizabeth Hedges, a lawyer for the Justice Department, argued that the agency was working within its discretion to get rid of redundant functions.
“As an executive agency, it has to have some authority to order its affairs,” Ms. Hedges said.
She said many of the harms that states outlined were hypothetical and not imminent. She also argued that the changes to the department were not finalized, and therefore could not be challenged yet.
State and federal officials submitted declarations describing the effect of the cuts that were evident in May.
A Wisconsin official said that leaders of Milwaukee Public Schools discovered flaking lead paint and lead dust in school buildings — and children with elevated blood-lead levels. When they turned to the C.D.C. for help, the agency “declined the request due to the April 1 staff cuts,” the declaration said.
Other states also detailed the shuttering of the C.D.C.’s lead-exposure assistance unit, which has since been reinstated.
In Michigan, officials said they relied on specialists from the C.D.C. to inspect a renovated public health lab so that it could restart operations. It was still waiting for a response from the agency several weeks later, according to a declaration by Elizabeth Hertel, director of the Michigan Department of Health and Human Services.
Several states said they relied on the C.D.C. to fund help lines that people could call if they wanted support for quitting smoking, but that they got notice that their funding would end in the fall.
In Michigan, the grant covered 11 staff positions and their $1.3 million Quitlink program, which provides help to those seeking to stop smoking, a declaration said.
State officials in New York and Virginia said they already had to lay off about a dozen tobacco control workers each and pared back services, including support on the help lines. In West Virginia, high school students bemoaned the loss of a small anti-vaping program that gave them a chance to educate lawmakers in Charleston about policies that could help their school.
Christina Jewett covers the Food and Drug Administration, which means keeping a close eye on drugs, medical devices, food safety and tobacco policy.
Zach Montague is a Times reporter covering the federal courts, including the legal disputes over the Trump administration’s agenda.
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