“Confirmed Judges, Confirmed Fears” is a blog series documenting the harmful impact of President Trump’s judges on Americans’ rights and liberties. It includes judges nominated in both his first and second terms.
Matthew Kacsmaryk, who was nominated by Donald Trump to the federal district court for the Northern District of Texas, issued a sweeping ruling that struck down nationwide a federal rule that protected private information on reproductive health care, including abortion, against disclosure to law enforcement and other authorities. The June 2025 decision in Purl v United States Department of Health and Human Services is the latest attack by Kacsmaryk on reproductive freedom.
What happened in this case?
After the Supreme Court overturned Roe v Wade in 2022, the Department of Health and Human Services (HHS) promulgated a new privacy protection rule that barred disclosure of reproductive health information to law enforcement or other authorities if the purpose was to “investigate patients who sought, or providers who offered,” such care. There was significant concern that after the demise of Roe, states that ban or limit abortion could seek to investigate and take action against those who seek abortion or other reproductive care out of state, and use patients’ own medical records to help do so.
Right-wing groups decided to challenge the rule. They filed a lawsuit before Kacsmaryk on behalf of a local doctor and her clinic who claimed the rule could prevent her from reporting incidents of child abuse to authorities. They sought summary judgment against HHS.
How did Kacsmaryk rule and why is the result harmful?
Kacsmaryk granted summary judgment against HHS and vacated the rule. His decision thus went beyond the doctor who brought the case, and had nationwide effects. He claimed that HHS had no authority to limit state public health or other laws allowing investigation of reproductive health matters.
Kacsmaryk’s ruling has already produced significant criticism. Maddy Gitomer, senior counsel at Democracy Forward, wrote that the “cruel” holding will eliminate the rule’s protection of the private medical records of healthcare providers and pregnant women against “invasive government intrusion,” and will “interfere with the ability of health care providers and patients to communicate confidentially and openly about a patient’s health care needs.”
Cases on this issue are pending elsewhere, but at least as of now, the Kacsmaryk decision will seriously harm reproductive privacy and health. In addition, the ruling illustrates the importance of our federal courts to health, welfare and justice and the significance of having fair-minded judges on the federal bench.