March 10 Federal Update: HHS Amends Rule Making Process     

The Department of Health and Human Services will no longer use notice-and-comment rulemaking procedures for matters relating to agency management or personnel or to public property, loans, grants, benefits, or contracts. The change in agency practice is expected to grant Secretary Robert F. Kennedy Jr. more discretion and reduce administrative hurdles while setting department policy.

Agencies typically publish proposed rules or notices in the Federal Register, open a time-limited comment period, and review and assess those comments before publishing a final version. The rule change empowers HHS agencies and offices with the discretion to apply notice and comment procedures to these matters but does not require them to do so unless otherwise required by law.

OCR Rescinds Prior Administration Guidance on Civil Rights and Health Information Privacy for Transgender Youth 

The Acting Director of HHS’ Office for Civil Rights rescinded the HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy. The guidance was issued in 2022 and outlined the application of federal civil rights and patient privacy laws to support transgender medical interventions. OCR Acting Director Anthony Archeval stated that the 2022 OCR Notice and Guidance no longer represents the views or policies of HHS OCR. 

The rescission was made to align with Executive Order 14187, “Protecting Children from Chemical and Surgical Mutilation.” Acting Director Archeval stressed that HHS will not promote, assist, or support “the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.” The rescission also aligns with Administration policy in Executive Order 14168, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.” 

Secretary of Agriculture Publishes Vision for the Department’s 16 Nutrition Programs 

Secretary Rollins released her guiding principles, encouraging states to partner as innovative collaborators. She stressed the importance of minimizing fraud, waste, and abuse, establishing clear expectations that SNAP recipients capable of working, do, and promoting healthy choices and outcomes.  

The Secretary affirmed her commitment to offering technical assistance and ongoing dialogue to state, tribal, territory, and local government partners. She pledged to work collaboratively to find bold and sustainable solutions that deliver effective programs to families. 

U.S. Senate Committee on Aging Hosts a Hearing to Discuss the Opioid Epidemic 

Chairman Scott (R-Fla.) and Ranking Member Gillibrand (D-NY) stressed the importance of urgent action to address the opioid crisis and increase access to preventative measures. The senators highlighted proposed legislation, including the Overcoming Prevalent Inadequacies in Overdose Information Data Sets Act and Supporting Families through Addiction Act of 2023. They also expressed gratitude for community-wide efforts led by law enforcement, community leaders, and governors.  

Alongside representatives, witnesses spoke to the need for a holistic approach that includes prevention, treatment, and support for grandfamilies. They highlighted the importance of Medicaid and Medicare, interdisciplinary care teams with addiction specialist physicians, and non-opioid options for chronic pain relief. Additionally, witnesses advocated for robust data collection and stressed the importance of financial stability, especially as many older adults live on fixed incomes.  

A Hearing with Sanctuary City Mayors 

The House Oversight and Government Reform Committee held a hearing with the mayors of Boston, Chicago, Denver, and New York City. The hearing follows an investigation created by Committee Chairman James Comer (R-Ky.) to examine the policies of sanctuary jurisdictions and their impact on public safety and federal immigration enforcement. 

While sanctuary cities do not have a single definition, they typically refer to a broad range of policies that limit cooperation with federal immigration enforcement actions. The mayors stressed that their city policies build trust between residents and police, in turn promoting safety and reducing crime. They highlighted the importance of investing in housing, nutrition, and healthcare and utilizing public safety resources wisely. The mayors additionally illustrated the legacy immigration has offered their cities and encouraged Congress to open additional pathways to immigration. However, several representatives expressed concern for public safety and maintained that the cities’ policies violate federal law by failing to cooperate with federal agents. 

Federal Budgetary Updates 

The Senate and House approved the Fiscal Year 2025 budget resolution along party lines. The Senate voted in favor 52 to 48 and the House, 217 to 216. The funding prioritizes border security, the military, and energy independence, but it does not address the expiring provisions of the 2017 Tax Cuts and Jobs Act (TCJA). 

The 2017 Tax Cuts and Jobs Act temporarily expanded the child tax credit, increased the adjusted gross income limit for cash donations made to public charities from 50% to 60%, and offered an employer credit for paid family and medical leave. Several critical provisions are set to expire on Dec. 31, which would jeopardize key funding streams, workforce stability, and service delivery for nonprofits. 

However, renewing the credits would require significant funding. Without the TCJA provisions, the House Budget is expected to increase the deficit by $4.8 trillion. Congress is expected to offset the costs through reductions to Medicaid and social services, including TANF, SNAP, and WIC. 

As the House and Senate work to find agreement on a proposed budget, they are expected to pass an additional continuing resolution as the current resolution will expire federal funding on March 14.  

President Trump Issues an Executive Order Surrounding Public Service Loan Forgiveness

On March 7, President Trump issued an executive order to prevent individuals employed by organizations with a substantial illegal purpose from becoming eligible for public service loan forgiveness. The order, Restoring Public Service Loan Forgiveness, tasks the secretaries of the Education Department and Treasury Department with ensuring that the definition of public service excludes organizations that support terrorism, violate immigration laws, and commit child abuse, including through providing gender-affirming care.

Sector Updates from the Judiciary  

Ongoing Legal Challenges to the Trump Administration’s Executive Orders  

Several executive orders issued by the Trump Administration have been granted preliminary injunctions. Previously, executive orders limiting access to gender-affirming care, pausing federal funding for nongovernmental organizations, and stopping the recognition of birthright citizenship were granted temporary restraining orders. Temporary restraining orders last up to fourteen days and are intended to provide short-term relief to prevent permanent injury, loss, or damage. Preliminary injunctions may remain in place for months or years while a lawsuit is pending. Most recently, preliminary injunctions were issued against executive orders freezing funding for refugee resettlement programs and federal financial assistance, allowing immigration raids in places of worship, stopping the recognition of birthright citizenship, and limiting access to gender-affirming care. 

By granting preliminary injunctions, executive orders will not go into effect until a judge issues their ruling. However, preliminary injunctions can be appealed. 

Trump Administration Prepares to Withdraw Emergency Abortion Lawsuit 

The US, Idaho, and the state lawmakers agreed to dismiss a lawsuit over whether Idaho can prohibit health-care providers from performing abortions when necessary to treat an emergency medical condition. 

The former secretary of the US Department of Health and Human Services sued Idaho in 2022 because of a provision that may have been interpreted as designating emergency abortion care illegal. Then-Secretary Xavier Becerra sued the state, arguing that the abortion law’s provision irreconcilably conflicted with hospitals’ obligations under the federal emergency care statute. 

The lawsuit raised the question of whether states are allowed to prosecute doctors for performing abortions to stabilize emergency medical conditions, despite the Federal Emergency Medical Treatment and Active Labor Act’s directive that Medicare hospitals provide emergency services regardless of patients’ ability to pay. 

The Trump administration’s decision to withdraw the lawsuit will allow emergency abortions to remain legal, although it does mark a departure from the Biden administration’s efforts to clarify that federal directives on emergency health care take precedence over state abortion bans. 

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