“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.
Trump Supreme Court Justices Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett cast deciding votes in a 5-4 shadow docket ruling that cancelled a lower court stay and let the Trump Administration go forward with terminating almost $800 million in crucial medical grants from the National Institutes of Health (NIH). Chief Justice Roberts joined Justice Elena Kagan, Sonia Sotomayor, and Ketanji Brown Jackson in dissenting from the August 2025 ruling in National Institutes of Health v American Public Health Association.
What happened in this case?
In a series of executive orders early in his second term this year, President Trump claimed he was directing the end of government medical and health grants “related to DEI objectives, gender identity, or Covid 19” or “based on race.” As a result, NIH cut off funding for more than 1,700 grants for almost $800 million “focused on heart disease, HIV/AIDS, Alzheimer’ disease, alcohol and substance abuse and mental health issues.”
Medical and health groups filed a federal lawsuit that was heard by Reagan nominee William Young. Judge Young conducted a comprehensive trial-type hearing and ruled that the grants must be restored. Young noted that many of the terminated grants were studying the impact of particular diseases on specific minority groups, and that he would be “blind” not to “call out” that this “represents racial discrimination and discrimination against America’s LGBTQ community.”
The First Circuit rejected an effort to stay Judge Young’s ruling. The Trump Administration thus took the case to the Supreme Court on its shadow docket, seeking a stay.
How did Trump justices Gorsuch, Kavanaugh, and Barrett plus the rest of the Supreme Court majority rule and why is the result harmful?
The three Trump justices plus Justices Alito and Thomas voted 5-4 to stay Judge Young’s decision and allow the termination of the NIH grants to go forward. In a short explanation, they claimed that the lower court should have followed the earlier shadow docket decision allowing the termination of Department of Education grants to continue.
Chief Justice Roberts’ lead dissent explained what was wrong with that theory, even if the validity of that earlier shadow docket decision was accepted. He pointed out that in this case, in addition to stopping the cutoff of grants funds, the district court had vacated more general NIH directives that applied the discriminatory criteria of Trump’s executive orders to future grants. This meant the decision was not just about whether particular grants should be suspended, but instead also about criteria for grantmaking and related subjects that more traditionally have been subject to court review if a legal violation is shown. Because the directive implicated prospective issues beyond the reinstatement of specific grants, Roberts concluded, the case was not controlled by the Education Department case and the district court did have jurisdiction under the Administrative Procedure Act to vacate both the prospective directives as well as the grant terminations. Therefore, he said the district court’s decision should have been upheld by the Supreme Court.
Justice Jackson wrote a broader and much more critical dissent. She echoed previous criticisms of the majority for resolving questions like this via the shadow docket without full explanation, in this case relying on the previous “unprincipled and unfortunate” Education Department shadow docket ruling to justify the “abrupt cancellation of hundreds of millions of dollars allocated to support life-saving biomedical research.” She carefully explained why this edict was “of a piece” with the majority’s “recent tendencies” in shadow docket rulings to “make vindicating the rule of law and preventing manifestly injurious Government action as difficult as possible.” She sarcastically noted that in this series of holdings, one of the few “fixed rules” is that “this Administration always wins.” Jackson concluded by detailing some of the “devastating and irrevocable damage” that the ruling will do to crucial medical research.
As Justice Jackson pointed out, this is fortunately not the final ruling concerning the validity of the Trump administration’s actions. But this shadow docket decision will severely harm both critical medical research and the rule of law. 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.