A federal judge ordered federal health agencies Tuesday to restore pages they removed from their websites last month to comply with President Donald Trump’s executive order on “gender ideology and extremism,” saying the decision to pull them down could be detrimental to public health.
Restoring Critical Information for Public Health
The decision by U.S. District Judge John Bates, a George W. Bush appointee, came after a testy Monday afternoon hearing in which he sharply questioned the administration about doctors’ claims that the removal of the pages damaged their ability to care for patients.
Bates said Tuesday that the pages’ removal appeared to harm some doctors’ ability to treat patients and was done without any public rationale, recourse or ability to challenge the decisions, despite laws and regulations that typically require them.
“No backend remedy could ameliorate the inability to provide all required care during an appointment time to a patient who cannot return in the future,” Bates wrote. Bates’ decision requires federal health agencies — including the Department of Health and Human Services, Centers for Disease Control and Prevention and Food and Drug Administration — to restore by midnight websites identified by Doctors for America, the left-leaning advocacy group that initiated the lawsuit.
Court Orders Restoration of Vital Data
The order followed a 90-minute hearing Monday on Doctors for America’s bid to win a temporary restraining order restoring the pages and blocking the agencies “from removing or substantially modifying” other datasets to implement the executive order.
The group sued the Office of Personnel Management, the CDC, the FDA and HHS last week, claiming the missing information “deprives” doctors and researchers of ready access to data that’s critical to treating patients and addressing public health emergencies.
Implications on Federal Bureaucracy
Bates’ order is the latest in a growing list of court decisions to slow or stop Trump’s early blitz of executive orders that are remaking the federal bureaucracy.
Zachary Shelley, an attorney with consumer advocacy group Public Citizen representing the doctors, argued the removal of datasets and guidance — including guidelines on HIV and contraception drugs and information on student health — has hampered their ability to timely treat patients based on federally vetted information.
“There’s nothing that can be done to un-delay research, un-delay progress,” he said. “Every day that’s lost now can’t be given back if pages eventually go up.”
Legal Battle Over Information Accessibility
DOJ attorney James Harlow argued that agencies are free to stop sharing information or to remove it for review, even if that data was once routinely disclosed.
“An agency’s maintenance of a website is not the functional equivalent of an agency’s formulation of an order,” he said. But Bates challenged Harlow’s “maintenance” assertion, arguing the agencies could have announced their intent to review the webpages in question while leaving them up in the interim.
“It’s termination,” Bates said of the pages’ removal. “That’s different than … ‘ordinary maintenance.’”
Ensuring Patient Care and Timely Treatment
In his opinion, Bates said the agencies’ decisions to take down certain webpages “likely” constitute an “order” that’s reviewable under federal administrative law. “The decision to remove myriad public-facing webpages, some of which had been active for decades, is certainly a ‘form of agency power’ or ‘action’ that the [Administrative Procedures Act] reaches,” he wrote.
Dr. Reshma Ramachandran, a Yale School of Medicine professor who provides primary care at a clinic that serves low-income people, said in a declaration to the court that the webpages’ removal has impacted her work. Ramachandran said the disappearance of CDC guidelines on prescribing HIV preventive medication added time and confusion to a recent patient visit.
Patients visiting federally qualified health centers like where she practices tend to use public or scheduled transportation options that leave them with tight timelines to receive care and medications, Ramachandran said. Reducing the risk of HIV transmission requires timely care, she said. “The delays imposed by CDC’s removal of information is extremely harmful,” Ramachandran added.
Protecting Access to Healthcare Information
Harlow’s argument that patients weren’t losing access to health care “because CDC pulled down a couple pages” prompted Bates to loudly reprimand him for “questioning” the judge. “‘Adequacy of treatment’ — that’s a pretty clear term,” Bates said.
In his opinion, Bates signaled those impacts on patient care convinced him the doctors had a case.
“These doctors’ time and effort are valuable, scarce resources, and being forced to spend them elsewhere makes their jobs harder and their treatment less effective,” he wrote.
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