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Medscape
17 hours ago
- Health
- Medscape
Judge: Trump Must Restore Federal Health Websites
The Trump administration has begun restoring health-related websites and datasets that it removed in January in order to comply with an order from a federal judge, who said that agencies such as the CDC unlawfully deleted treatment guidelines and other critical data that impaired doctors' ability to care for patients. Federal agencies report that they now have restored 67 of the 212 webpages that plaintiffs included in their list, according to a court document filed on July 18. Those sites include pages about adolescent and school health, endometriosis, and health disparities among LGBTQ youth. The administration's initial purge of online health information prompted a lawsuit from the medical advocacy group Doctors for America and the city and county of San Francisco, which sought to force the government to restore the information. 'With this ruling, we can provide care for our patients and protect public health based on evidence, rather than ideology,' said Reshma Ramachandran, MD, MPP, MHS, a Doctors for America board member, in a statement. The legal battle began when President Trump issued an anti-transgender executive order on his first day in office. The order denies transgender people government recognition, stating, 'It is the policy of the US to recognize two sexes, male and female.' The Office of Personnel Management (OPM), the federal government's human resources agency, told federal agencies to comply with Trump's order. In a memo issued on January 29, the OPM gave agency heads until January 31 to 'take down all outward-facing media' that recognize or reference transgender identities. As part of a temporary restraining order issued in February, Judge John D. Bates of the US District Court for the District of Columbia ordered the federal agencies to restore missing websites on which the plaintiffs relied. Although the agencies said they followed the judge's order, plaintiffs reported that some webpages are still missing. Information Remains Missing Months later, some of the deleted webpages are still blank. A CDC webpage with information about HIV and transgender patients says 'the page you're looking for was not found,' for example. An FDA webpage about health equity in artificial intelligence contains no data. And an FDA webpage with guidance for increasing the number of minorities in clinical trials was found. 'In an order on July 2, Bates vacated the federal health agencies' directives calling for the removal of public information. In an accompanying legal opinion, Bates found that federal agencies did not follow federal law when they stripped medical information from government websites in January. He ordered the plaintiffs to compile a list of websites and datasets that they needed to treat patients by July 11 and for the federal agencies to file an update on their progress restoring the sites. In their legal response, the federal agencies said they will finish restoring the webpages that fall under the judge's order 'as soon as practically possible,' but that the pace of the restoration 'is limited by staffing and other resource constraints, as well as by agency safeguards that require multiple layers of approval in order to modify a website.' But the federal agencies also said they haven't been able to restore some webpages because the plaintiffs haven't given them a specific web link, according to court documents. In other cases, the agencies argue in court filings that certain missing websites are exempt from the judge's order because they were deleted for reasons other than now-vacated orders. In his opinion, Bates wrote that while presidents have the right to issue executive orders, the removal of 'hundreds or even thousands' of webpages and datasets upon which doctors, researchers, and policymakers rely failed to follow a federal law that regulates how agencies act. 'The decision serves as a reminder that the government must follow the law, just like the rest of us,' said Zach Shelley, a Public Citizen Litigation Group attorney and lead counsel for the plaintiffs, in a statement. But in a court document filed in March, the federal agencies defended the purge by saying the health websites and datasets were 'inconsistent with administration policy' both in terms of sex and gender, as well as Trump's executive order barring activities that promote diversity, equity, and inclusion. In the document, the agencies wrote, 'Forcing [US Department of Health and Human Services] HHS to host websites with information contrary to current policy would severely impinge the government's authority to choose what to say and not to say.' 'Arbitrary and Capricious' In their lawsuit, several physicians in Doctors for America described how the loss of professional medical guidelines on the CDC website harmed patient care. For example, Stephanie Liou, MD, FAAP, a member of the group's board, said the sudden loss of online resources for treating sexually transmitted infections stymied her efforts to combat an outbreak of chlamydia at 'one of the most underserved high schools in Chicago,' according to court documents. Ramachandran described how the abrupt disappearance of CDC resources delayed her care of a patient with a complex medical history. Without access to the CDC's professional guidelines, Ramachandran had to search elsewhere for specific instructions on prescribing medication to prevent HIV for this patient, according to court documents. In an article in The New England Journal of Medicine , a physician and two legal scholars noted that 13% of CDC datasets disappeared between January 21 and February 11, which left researchers and policymakers unable to assess key measures of American health, identify outbreaks of infectious disease, or spot trends in overdoses. The removals also impaired the ability of state and local agencies to monitor public health. 'Without access to accurate and timely, scientists' work will become more difficult, and we will understand less about the world,' the authors wrote. Bates questioned why government officials acted with such haste in January. Trump's executive order set a timetable of 120 days — not 48 hours — to rid federal websites of references to what the president calls 'gender ideology.' OPM's rushed directives were 'arbitrary and capricious,' Bates wrote in his opinion. 'This case involves government officials acting first and thinking later.' Federal officials didn't need to order the 'bulk removal of health care resources' to comply with the executive order, Bates wrote in the opinion. The judge noted in court documents that some agency officials took a measured approach by simply replacing terms to which Trump objects, such as 'gender' and 'pregnant people,' with alternatives such as 'sex' and 'pregnant women.' Other agency officials, Bates wrote in his opinion, took a 'slapdash approach' by 'fully removing any webpage with offending language, no matter how minimal, without any stated intent to modify and republish the webpage.' 'The government is free to say what it wants, including about 'gender ideology,'' Bates wrote in his opinion. 'But in taking action, it must abide by the bounds of authority and the procedures that Congress has prescribed.' Not the Last Word Bates noted in his opinion that federal agencies can head 'back to the drawing board' to 'craft a lawful policy with similar objectives.' And Janet Freilich, a professor at the Boston University School of Law, Boston, described the court decision as 'a partial win' for doctors and public health staff, noting that federal agencies are likely to appeal the decision. Bates' ruling 'does not entirely prevent these datasets and webpages from being taken down in the future,' Freilich said. 'The government could find a lawful way to modify and take down datasets.' Freilich also noted that the ruling won't necessarily resurrect all the data that have disappeared this year. That's because federal agencies are only obligated to restore the specific webpages on the plaintiffs' list. Yet Bates left the door open to recover additional webpages, Shelley said. For example, other doctors or public health leaders could potentially sue to force the Trump administration to restore webpages that are particularly important to them. 'The reasoning is that all of these removals are unlawful,' Shelley said in an interview. 'This administration has been incredibly careless. It's been, at times, just outright malicious. Carelessness and maliciousness don't hold up well in court.' Although many of the health webpages are back online, they now display a prominent yellow warning label noting that the health agencies were legally required to restore the pages and that their content may not be reliable. In his ruling, Bates wrote that federal agencies do not need to remove the disclaimers, which read, 'Any information on this page promoting gender ideology is extremely inaccurate and disconnected from the immutable biological reality that there are two sexes, male and female….This page does not reflect biological reality, and therefore the administration and this department reject it.' Critics of the Trump administration have filed more than 300 lawsuits to block his policies, according to Lawfare, a nonprofit multimedia publication. Two Harvard Medical School researchers sued the Trump administration in March after their research was removed from an online patient safety resource on the website of the Agency for Healthcare Research and Quality, part of HHS, because of the agency's attempt to comply with the anti-transgender executive order. One of the deleted articles, which focused on endometriosis, noted that physicians should be aware that the painful condition can occur in transgender and nonbinary patients. Another article noted that people who identify as LGBTQ have a higher risk for suicide. In May, federal judge Leo Sorokin ordered the administration to restore the articles while the case is litigated. In his order, Sorokin wrote that 'the plaintiffs are likely to succeed in proving that the removal of their articles was a textbook example of viewpoint discrimination by the defendants in violation of the First Amendment.' Although judges in lower courts have put many of Trump's policies on hold, the Supreme Court has reversed several of these decisions. The sudden disappearance of masses of public data has undermined faith in government health agencies, said Dorit Rubinstein Reiss, PhD, LLB, law professor at the University of California, San Francisco. 'If government needs a court decision to provide good science, we cannot trust that it will provide it in cases when people don't sue,' Reiss said.
The Hill
02-07-2025
- Health
- The Hill
Mayors sue over Trump administration rules restricting ObamaCare enrollment
A coalition of U.S. city mayors is suing the Trump administration over a recently finalized rule that limits enrollment in Affordable Care Act Marketplace plans. In June, the Trump administration finalized the 'Marketplace Integrity and Affordability' rule, which shortens the open enrollment period for ACA plans to Nov. 1 to Dec. 15. Customers normally have until Jan. 15 to enroll. The rule also increases the maximum annual cost-sharing limitation and enacts stricter income verifications. The changes take effect beginning in 2027. The cities of Chicago, Columbus and Baltimore have filed a lawsuit against the Department of Health and Human Services, challenging the rule. They are joined by the advocacy groups Doctors for America and Main Street Alliance. The group is being represented in the case by the legal organization Democracy Forward. In their suit, they claim that the physicians who are part of Doctors for America will be harmed by this rule as more of their patients will become uninsured, and they will receive less than full reimbursement for patients without coverage. They are alleging the rule is in violation of the Administrative Procedure Act. 'Defendants failed to provide adequate reasons for, and failed to adequately respond to comments about, the following provisions, such that they are arbitrary and capricious under the APA, and Defendants failed to observe required procedure in adopting these provisions,' the lawsuit states. The plaintiffs are asking that the rule be found in violation and the law be blocked from being implemented. 'This unlawful rule will force families off their health insurance and raise costs on millions of Americans. This does nothing to help people – and instead harms Americans' health and safety across our country,' Skye Perryman, Democracy Forward president and CEO said in a statement.
Axios
02-07-2025
- Health
- Axios
Cities sue Trump administration over ACA changes
The cities of Baltimore, Chicago and Columbus, Ohio, on Tuesday asked a federal court to overturn new regulations from Health Secretary Robert F. Kennedy Jr. that place tighter restrictions on Affordable Care Act enrollment. Why it matters: Shortening the enrollment period and other changes would increase the uninsured and underinsured population and place more financial pressure on city-funded public health programs, the cities argue in their complaint. They also argue that the loss of health insurance will make city residents less able to participate in civic life and have "cascading negative effects on city programs and communities." The Main Street Alliance — a small business advocacy group — and Doctors for America are also plaintiffs in the lawsuit, which was filed in the U.S. District Court for Maryland. State of play: Health and Human Services' regulation shortens the enrollment window for ACA plans on the federal insurance exchange and imposes a $5 monthly premium for consumers with fully subsidized coverage who are automatically reenrolled in ACA coverage, among other changes. HHS projects the policies will decrease ACA exchange plan enrollment by between 725,000 and 1.8 million people. The finalized rule "sets forth a wide range of changes that will render coverage on the Exchanges less affordable, less generous, and harder to obtain," the complaint reads. The complaint states that the Trump administration violated administrative law in finalizing the rule. But HHS maintains that its rule strengthens access to health insurance. "The rule closes loopholes, strengthens oversight, and ensures taxpayer subsidies go to those who are truly eligible — that's not controversial, it's common sense," HHS communications director Andrew Nixon said in an email. The agency has said the rule is necessary to improve program integrity in ACA markets and that it should lower enrollee premiums by 5% next year.
Boston Globe
01-07-2025
- Health
- Boston Globe
Mayors, doctor groups sue over Trump's efforts to restrict Obamacare enrollment
Advertisement The mayors of Baltimore, Chicago and Columbus, Ohio sued the federal health department on Tuesday over the rules, saying they will result in more uninsured residents and overburden city services. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up 'Cloaked in the pretense of government efficiency and fraud prevention, the 2025 Rule creates numerous barriers to affordable insurance coverage, negating the purpose of the ACA to extend affordable health coverage to all Americans, and instead increasing the population of underinsured and uninsured Americans,' the filing alleges. Two liberal advocacy groups — Doctors for America and Main Street Alliance — joined in on the complaint. The federal health department announced a series of changes late last month to the ACA. It will shorten the enrollment period for the federal marketplace by a month, limiting it to Nov. 1 to Dec. 15 in 2026. Income verification checks will become more stringent and a $5 fee will be tacked on for some people who automatically re-enroll in a free plan. Advertisement Insurers will also be able to deny coverage to people who have not paid their premiums on past plans. The rules also bar roughly 100,000 immigrants who were brought to the U.S. as children from signing up for the coverage. HHS said in a statement that the polices 'are temporary measures to immediately tamp down on improper enrollments and the improper flow of federal funds.' The mayors — all Democrats — argue that the polices were introduced without an adequate public comment period on the policies. 'This unlawful rule will force families off their health insurance and raise costs on millions of Americans. This does nothing to help people and instead harms Americans' health and safety across our country,' said Skye Perryman, the president of Democracy Forward, which is representing the coalition of plaintiffs in the lawsuit. The lawsuit does not challenge the Trump administration's restriction on immigrants signing up for the coverage. The Biden administration saw gains in Obamacare enrollment as a major success of the Democratic president's term, noting that a record 24 million people signed up for the coverage, thanks to generous tax breaks offered through the 2022 Inflation Reduction Act. But the program has been a target of Trump, who has said it is riddled with problems that make the coverage unaffordable for many without large subsidies. Enrollment in the program dipped during his first term in office.
Yahoo
30-05-2025
- General
- Yahoo
National medical org asks to join Tennessee lawsuit to advocate for abortion access
Doctors for America is trying to join a Tennessee lawsuit to ensure women can get abortions when their lives or health depend on the procedure. The organization is a national collection of more than 30,000 medical professionals that advocates for policies that expand access to affordable health care. Doctors for America on May 30 asked to intervene in a lawsuit brought by a different health care group, the Catholic Medical Association, which opposes abortion access. Catholic Medical Association sued the U.S. Department of Health and Human Services on Jan. 10 looking to overturn a 2022 directive that federal law requires hospitals provide abortions if doing so is necessary to stabilize a medical crisis. 'Doctors should not be forced to choose between following the law and saving a patient's life,' Dr. Christine Petrin, president of Doctors for America, said in a news release. Doctors for America is represented by the American Civil Liberties Union, the ACLU of Tennessee, the National Women's Law Center and Democracy Forward. Doctors for America explained in its May 30 filing it is intervening now because of the change in presidential administrations. "DFA cannot rely on the federal government to adequately defend (its) interests," the court filing states. More: What are abortion laws in Tennessee and where is the procedure legal? The law at question here is the Emergency Medical Treatment and Labor Act, a 1986 federal law often referred to as EMTALA. The law ensures the public can access emergency health care even if they cannot pay. In the wake of the overturning of Roe V. Wade in 2022, during President Joe Biden's administration, HHS issued guidance that EMTALA requires that emergency rooms that accept Medicaid provide abortions when they are medically necessary, even if doing so violates a state law prohibiting abortion. That guidance was challenged in court and appealed to the U.S. Supreme Court, but the justices declined to give a ruling on it. It seems likely the current iteration of the HHS under Secretary Robert F. Kennedy Jr. will reverse the previous administration's position. In a filing in this lawsuit in April, it wrote, "New leadership at the Department of Health and Human Services is actively considering how best to respond to the Complaint ... including to evaluate whether it may be possible to resolve this case without litigation" — meaning the Catholic Medical Association may get what it wants through a policy change. The Catholic Medical Association has argued that the 2022 guidance ensuring access to medically necessary abortion care runs afoul of the Supreme Court precedent set in Dobbs v. Jackson Women's Health Organization, the case that overturned Roe v. Wade and ruled there is not a constitutional right to abortion. The Catholic organization said it is urging the court to "allow doctors to perform their life-giving duties without fear of government officials forcing them to violate their beliefs.' More: Federal judge temporarily blocks part of TN's abortion travel ban on free speech grounds While most, if not all, state laws allow for abortions to be performed in very limited circumstances, Carrie Flaxman, senior legal advisor at Democracy Forward, said revoking EMTALA's guidance on abortion will "sow confusion for providers." 'Pregnant people have suffered needlessly, and some have died, because of the chaos and confusion that abortion bans have caused for patients and their doctors,' Flaxman said. Have questions about the justice system? Evan Mealins is the justice reporter for The Tennessean. Contact him with questions, tips or story ideas at emealins@ This article originally appeared on Nashville Tennessean: Medical org asks to join TN lawsuit to advocate for abortion access
