How litigation against the HHS and government agencies works

Litigation against the U.S. Department of Health and Human Services (HHS) and its subagencies is a persistent feature of the American legal landscape, reflecting clashes over regulatory authority, civil liberties, and public health priorities. These cases often involve high-stakes disputes between federal agencies, state governments, healthcare providers, and advocacy groups, with outcomes that shape national policy. 

In 2012, a New Hampshire hospital attempted to block the state health department from accessing medical records during an investigation into a hepatitis C outbreak linked to a hospital employee. More recently, in 2025, a coalition of 19 states led by New York Attorney General Letitia James sued HHS over mass layoffs and restructuring under Secretary Robert F. Kennedy Jr., alleging unconstitutional dismantling of programs like Medicaid eligibility determination and infectious disease testing.

While HHS often prevails in cases involving public health emergencies, its vulnerability to challenges increases when actions appear politically motivated or procedurally irregular. The agency’s legal battles are further complicated by the evolving interpretation of laws like the Affordable Care Act and the Public Health Service Act, which grant broad discretion but require adherence to due process and anti-discrimination safeguards.

Why government agencies get sued 

• A primary driver of litigation is disputes over data access and privacy, exemplified by cases where hospitals or individuals resist sharing medical records during disease outbreaks. For instance, during the 2012 hepatitis C investigation, HHS’s demand for unfiltered patient records faced pushback, though courts ultimately prioritized public health needs over privacy concerns. (Public Health Rep.2015 May-Jun; 130(3):278–283)
• Funding and program cuts also spark lawsuits, particularly when states or providers argue that reductions violate federal statutes. The 2025 multi-state lawsuit against HHS hinges on claims that abrupt layoffs and program terminations breached congressional funding agreements, leaving states unable to administer Medicaid or monitor disease outbreaks. (WHYY PBS, 2025)
• Civil rights violations are another common trigger, with advocacy groups challenging policies that disproportionately harm marginalized communities. In 2023, organizations like Justice in Aging sued HHS for rolling back language access protections for seniors with limited English proficiency, arguing the move violated Title VI of the Civil Rights Act. (Center for Medicare Advocacy, 2021)
• Partisan policy shifts-such as the 2025 restructuring-invite litigation when perceived as undermining statutory missions.

Who can sue?

State governments are frequent plaintiffs, as they have standing because they administer federal programs like Medicaid and rely on HHS grants, making them uniquely affected by funding cuts or regulatory changes. Healthcare institutions, including hospitals and clinics, may sue over enforcement actions, such as penalties for noncompliance with Medicare rules or demands for patient data during investigations. 

Advocacy organizations like the American Civil Liberties Union (ACLU) or Justice in Aging often litigate on behalf of vulnerable populations, asserting representational standing. The case reference in the previously mentioned Centers for Medicare Advocacy article noted, “The lawsuit alleges that Health & Human Services failed to follow the Administrative Procedure Act when it rolled back language access protections that were put in place as part of the Health Care Rights Law (or Section 1557) of the Affordable Care Act (ACA). The protections are meant to target health disparities by requiring health plans and other entities to inform patients both of their right to interpretation”

Individuals rarely sue HHS directly due to stringent standing requirements, though exceptions exist. In Heckler v. Chaney (1985), the Supreme Court limited individual suits by granting agencies broad discretion over enforcement decisions, but patients harmed by specific policies, such as denial of disability benefits, may challenge rulings in administrative courts.

Unpacking the legal action brought against the HHS by AG Leticia James 

The 2025 lawsuit against HHS, spearheaded by New York AG Letitia James and joined by 19 states, centers on allegations that Secretary Robert F. Kennedy Jr.’s restructuring of the agency violated constitutional and statutory safeguards. The plaintiffs argue that the layoffs of 20,000 employees, including personnel necessary to disease surveillance, Medicaid processing, and grant administration, were enacted without congressional approval, circumventing the Appropriations Clause, which reserves spending decisions to legislators. 

The  Make America Healthy Again initiative, which Kennedy framed as a cost-cutting measure, abruptly terminated programs like the CDC’s antibiotic resistance lab network and slashed staffing for the Administration for Community Living, which supports elderly and disabled populations. AG James contends these actions disproportionately harmed low-income and minority communities, citing a 40% increase in Medicaid application denials in New York due to understaffing. 

The lawsuit seeks to reverse the layoffs and restore funding, but its immediate impact has been chaotic: measles outbreaks in Ohio and Arizona worsened as state health departments lost federal technical support, and nonprofit clinics report delays in HIV/AIDS grant disbursements. Secretary Kennedy made the admission that 20% of the layoffs were erroneous, including firing personnel he later called essential.

The litigation process against federal agencies

The process typically begins with exhausting administrative remedies, where plaintiffs must first challenge the agency’s decision through internal appeals, as required by the APA. A hospital fined by HHS for HIPAA violations must petition the Departmental Appeals Board before filing a lawsuit. 

If unresolved, the case proceeds to federal district court, where plaintiffs argue the agency acted unlawfully. In emergencies, plaintiffs may seek preliminary injunctions to halt policies pending trial, as seen in the 2023 language access case, where a judge temporarily blocked HHS’s rollback of translation rules. 

Discovery is limited in administrative law cases, with courts primarily reviewing the agency’s administrative record rather than new evidence. If the district court rules against the agency, HHS may appeal to circuit courts and, ultimately, the Supreme Court. However, many cases settle before trial, as agencies seek to avoid precedent-setting losses. In line with this, the HHS reinstated LGBTQ+ nondiscrimination protections in 2021 after lawsuits threatened to overturn its narrower interpretation of Section 1557 of the Affordable Care Act. 

Sovereign immunity shields federal agencies from some claims, but the Federal Tort Claims Act allows lawsuits for certain torts, and the APA waives immunity for unconstitutional actions. Despite these avenues, the process is slow. The 2025 multi-state lawsuit is expected to take 18–24 months to resolve.

Barriers to citizen lawsuits and circumvention strategies

Ordinary citizens face barriers when suing HHS, including strict standing requirements, which demand proof of direct, particularized harm. A Medicaid recipient denied coverage might sue, but a taxpayer opposing HHS policies generally cannot claim standing. Financial constraints also deter individuals, as litigation against federal agencies requires specialized legal expertise and prolonged commitment. 

The complexity of administrative law, including navigating the APA and agency-specific statutes, further disadvantages laypersons. Sovereign immunity principles limit suits unless explicitly waived, as seen in the Federal Tort Claims Act’s narrow exceptions. 

A Chapter from Hazards: Technology and Fairness titled The Bhopalization of Maerican Tort Law provides these expections as, “To cover cases where the exposure to the risk caused present damage to land values and so on, or where the defendant's conduct created such acute and broadly shared fears in the community that the courts felt it appropriate to intervene. But these exceptions were narrow. A tuberculosis hospital, for example, located in a proper place, was not an actionable nuisance.” To circumvent these barriers, individuals often rely on advocacy organizations like the Center for Medicare Advocacy, which pool resources and expertise to challenge systemic issues. 

Related: HIPAA Compliant Email: The Definitive Guide (2025 Update)

FAQs

What is the HHS’s function? 

The HHS’s function is to enhance and protect the health and well-being of all Americans by providing effective health and human services, advancing medical research, and supporting programs like Medicare, Medicaid, and public health initiatives.

What is the HHS’s structure?

The HHS’s structure consists of 13 operating divisions, including major agencies such as the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Food and Drug Administration (FDA), and Centers for Medicare & Medicaid Services (CMS), all overseen by the Secretary of Health and Human Services, a cabinet-level official.

What are the powers of the HHS and its subagencies? 

The powers of the HHS and its subagencies include regulating food and drug safety, administering health insurance programs, conducting health research, enforcing public health laws, responding to health emergencies, and protecting civil rights in healthcare settings.

What legislation supports the HHS functions? 

Legislation supporting HHS functions includes the Social Security Act, Public Health Service Act, Health Insurance Portability and Accountability Act (HIPAA), Affordable Care Act, and other federal statutes that define its authority and responsibilities.