It was deja vu from 2025: The Centers for Disease Control and Prevention this week announced more than $600 million in cuts to public health grants in California, Illinois, Colorado and Minnesota — four Democratic-led states.
Right away, attorneys general in the affected states filed their lawsuit late Wednesday in a federal district court in Illinois asking for the temporary restraining order.
And the next day, a federal judge blocked the Trump administration's action with a temporary restraining order released late Thursday.
In an opinion accompanying the order, U.S. District Judge Manish S. Shah wrote that even though the stated reason for the cancellations was that the grants did not align with the priorities of the CDC, "recent statements plausibly suggest that the reason for the direction [to cut the funds] is hostility to what the federal government calls 'sanctuary jurisdictions' or 'sanctuary cities.'"
The whole process aligns with the way the federal government has been operating since President Trump's second inauguration last year. But the context is new. These grants were not all put in place by a previous, Democratic administration. The $600 million is included in the funding bill that passed with bipartisan support in Congress and was signed into law by Trump himself just weeks ago.
"Integral to keeping people safe"
In Santa Clara County, Calif., the official notice of grant terminations came Thursday morning. "Two large grants that we rely on for core functions in public health to keep people safe and healthy have now been canceled," says Dr. Sarah Rudman, director of the county's public health department. "The way these grants are applied throughout our department, they're integrated with a huge range of activities we sometimes have to do by law and are absolutely integral to keeping people safe."
As an example, she says, one of the grants pays for a staffer in their public health laboratory. "That staff member is key to our overall capacity to test for things most other labs can't test for, like Ebola and anthrax and measles," she says. "We're not going to stop testing for those diseases today, but our ability to do it as well and as fast as we always do is immediately at risk."
Santa Clara is just one of dozens of local health departments targeted in the grant cancellations. A joint statement from other affected public health departments said the cuts could affect everything from HIV prevention in Chicago, firearm injury reduction in Denver, and access to affordable, healthy foods in Minneapolis.
Rudman says the feeling is "whiplash" when federal grants can be canceled suddenly with little explanation, although she says she's relieved the judge stepped in quickly to temporarily block the cuts.
"It's absolutely imperative that we have stability and predictability in our funding," she says. "We need to plan ahead and know we have the resources to do so."
New budget, same sudden cuts
These latest grant cancellations follow a pattern that began last year when the second Trump administration began. Sometimes those decisions have been reversed after public pressure or successfully overturned in court.
In this case, the attorneys general argue, the cancellations fit in with President Trump's recent threats to stop all federal payments to certain Democratic-led cities and states in retaliation for having policies the president doesn't like.
"The Office of Management and Budget ('OMB') then spent the last two weeks of January developing a hit list of funds for potential targeting in disfavored States," reads the complaint. "In early February, OMB issued a directive (the 'Targeting Directive') commanding agencies to cut funding to Plaintiff States, starting with more than $600 million in CDC public-health funding."
OMB did not respond to NPR's request for comment. OMB Director Russell Vought is the lead defendant in the state AGs' lawsuit, which also sues the Department of Health and Human Services and the CDC.
When it comes to public health department funding, "all of the cancellations that we have seen over the past 12 months or so do seem to have been directed from the Office of Management and Budget," says Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials. "It is outside the norm of how federal public health funding has gone for decades before."
While the cancellations of grants in 2025 were explained by HHS as necessary to align the agency's work with the new administration's priorities, Health Secretary Robert F. Kennedy Jr. and other Trump officials have now been in power for a full year. All of the grants awarded since Trump's inauguration have been approved by his own administration's political appointees, Casalotti notes.
Some of the grants canceled this week were even included in President Trump's 2026 budget and in the bipartisan HHS budget that was passed into law this month and signed by Trump on Feb. 3.
"When we look at the public health infrastructure grants that have been canceled in these states, Congress actually gave it a $10 million increase in their final law — it was supported in the House [budget] bill and the Senate bill," says Casalotti. "These funds have a ton of support across the board."
Three days' notice
There was something different about the grant cancellation process this time, notes Rep. Rosa DeLauro, D-Conn., ranking member of the House Appropriations Committee.
"We included a provision in the 2026 Labor-HHS [budget] bill of notification, to kind of deal with the Congress's power of the purse," she says. Because of that provision, the appropriations committees in the House and Senate received an emailed list of the CDC grant cancellations earlier this week. The emails, obtained by NPR, include a long list of grant numbers, and the reason for each reads: "Inconsistent with Agency Priorities" with a link to an "About CDC" webpage.
"Look, if you have notification, you've got public outrage," DeLauro says. She credits the three days of notice with giving targeted states time to file a lawsuit so quickly. "You know, diseases don't care who you voted for — Republicans, Democrats, Independents — Americans are going to be hurt by these actions," she says.
NPR reached out to Sen. Bill Cassidy, R-Louisiana., who chairs the HELP Committee which has oversight of HHS, and did not hear back by press time.
California Attorney General Robert Bonta predicted that the temporary restraining order would be followed by a victory for the states in the case.
"I've said it before, and I'll say it again: If President Trump and those who work for him want to stop losing in court, they should stop breaking the law," Bonta said in a press release.
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