State Attorneys General Blog

April 18, 2025 by Katherine D. Brodie

Focus on PBMs Garners Bipartisan Alliance

On April 14, 2025, a bipartisan group of 39 state attorneys general wrote to House and Senate leadership to express concerns about “the threat posed to the health and healthcare of the American people stemming from the increasingly consolidated healthcare market under the control of Pharmacy Benefit Managers (“PBMs”).” The next day, President Trump signed an Executive Order directing federal agency actions including scrutiny of the role of PBMs.

The state attorneys general urged Congress to legislate federally to prohibit PBMs, their parent companies, or affiliates from owning or operating pharmacies, with the goal of “foster[ing] fair competition and promot[ing] choice and transparency for the American people.”

PBMs, third-party administrators of prescription drug programs for health plans created to process claims for drug companies, were originally intended to assist in lowering costs for consumers. The state attorneys general express concern that PBMs are using manufacturer rebates to increase, rather than decrease, drug prices. They are also concerned that PBMs influence the market as middlemen, raising prices for consumers, including though the use of affiliated pharmacies owned by a PBM or PBM parent company.

Momentum appears to be gaining to address the issue. On April 15, 2025, President Trump published an Executive Order, “Lowering Drug Prices By Once Again Putting Americans First.”

Among other things, that Order directs that, within 90 days of the order, the Assistant to the President for Domestic Policy, in coordination with the HHS Secretary, the OMB Director and the Assistant to the President for Economic Policy, provide recommendations to the President on “ how best to promote a more competitive, efficient, transparent, and resilient pharmaceutical value chain that delivers lower drug prices for Americans.” The Order also directs improvements in PBM transparency by requiring, within 180 days of the date of the order, the Secretary of Labor to propose regulations pursuant to Section 408(b)(2)(B) of the Employee Retirement Income Security Act of 1974 to improve employer health plan fiduciary transparency into the direct and indirect compensation received by PBMs.

Attorneys general for the following states signed the letter: Arkansas, Alaska, American Samoa, Arizona, California, Delaware, the District of Columbia, Hawaii, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, U.S. Virgin Islands, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming.

April 14, 2025April 14, 2025 by Christopher H. Casey

Group of Attorneys General Sue Trump Administration to Allow Access to Funds to Address Long-Term Effects of Covid-19 on K-12 Children

On April 10, a group of Democratic state attorneys general, along with Pennsylvania Governor Josh Shapiro, sued the Trump Administration over access to previously-approved funding to address the long -term effects of Covid-19 on elementary and high school students. On March 28, the Department of Education sent a letter to the plaintiff states notifying them that they could no longer access the funds, totaling $1.1 billion, under programs enacted as part of the Biden Administration’s Covid relief plan.

The letter rescinding the funding had stated that “the COVID pandemic [has already] ended,” and therefore extending deadlines for COVID-related grants “is not consistent with the Department’s priorities and thus not a worthwhile exercise of its discretion.” But the Complaint alleges that many of the areas of focus for the funding “are not tied to the duration of the public health emergency, including evidence-based interventions (such as summer learning, extended day programs, and afterschool initiatives) intended to mitigate the long-term effects of learning disruptions caused by the pandemic; addressing academic, social, emotional, and mental health needs, especially for marginalized groups like low-income students; and providing educational technology to enhance learning environments.”

The Department of Education had previously said that the states could access the funds through March 2026. The Complaint seeks an order vacating and setting aside the Department of Education’s rescission letter, and an injunction precluding the Department from taking any action to prevent the states from accessing the funds through March 2026.

The plaintiffs include New York, Arizona, California, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Pennsylvania (through Governor Shapiro, acting in his official capacity), and the District of Columbia.

March 7, 2025March 7, 2025 by Christopher H. Casey

District Court Orders Trump Administration to Release Federal Funding to States and Enjoins Implementation of Federal Funding Freeze

On March 6, 2025, Judge John J. McConnell of the United States District Court for the District of Rhode Island granted the Motion for Preliminary Injunction sought by 22 state attorneys general and the Attorney General for the District of Columbia challenging the Trump Administration’s “pause” or “freeze” of grant funding payments. The Court, ordered the Trump Administration to “release and transmit any disbursements to the States on awarded grants, executed contracts or other executed financial obligations that were paused on the grounds of the OMB Directive” and other related Executive Orders. In his 45-page order, Judge McConnell held that the Trump Administration’s freeze on federal funding “fundamentally undermines” the separation of powers.

In support of their motion, the state attorneys general presented evidence of the widespread effects of the federal funding freeze, which they said has impacted “nearly all aspects of the States’ governmental operations” and has inhibited the States’ “ability to administer vital services to their residents.” These harms, they argued, are a direct result of the efforts taken by the Trump Administration to withhold federal funds and implement the federal funding freeze.

March 4, 2025 by Katherine D. Brodie

State Attorneys General Urge Congress to Finish the Job on Retail Theft Legislation

On February 25, 2025, a bipartisan group representing a majority of state attorneys general sent a Letter to Congress urging bipartisan congressional action to address organized retail theft. Citing gains made in the last Congress with the introduction of the Combating Organized Retail Crime Act of 2023 and the Organized Retail Crime Center Authorization Act of 2023, the Letter explains that the legislation is needed to provide necessary state and federal resources to curtail organized retail crime and the violence associated with it in communities across the country. Impacted retailers include Walgreens, Walmart and Target, which have had to close stores and ramp up security to protect employees and stem losses, with total financial losses from organized retail theft amounting to over $121 billion. The Letter notes that approximately 76% of store managers report impacts on their employees.

Federal legislation is needed, according to the authors, because the problem is larger than state resources available. The states seek greater cooperation with federal law enforcement through a proposed Organized Retail Crime Coordination Center at the Department of Homeland Security to address the complexity and scope of the organized retail crime problem, which also includes supply chain infiltration by organized crime. The states urge Congress to strengthen federal penalties for supply chain thefts and to appropriate additional funding to the states for law enforcement.

The letter is signed by attorneys general from Alabama, Alaska, Arizona, Arkansas, Delaware, Connecticut, Florida, Georgia, Hawaii, Illinois, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, U.S. Virgin Islands, Utah, Vermont, Virginia, Washington, Washington, D.C., and West Virginia.

February 25, 2025February 26, 2025 by Karen Lehmann Alexander

Multistate Coalition of Attorneys General Issue Guidance on DEI/DEIA Employment Initiatives Following Executive Order

On February 13, 2025, a coalition of 16 Attorneys General issued a document titled “Multi-State Guidance Concerning Diversity, Equity, Inclusion, and Accessibility Employment Initiatives” (“Guidance”). The stated purpose of the Guidance is “to help businesses, nonprofits, and other organizations operating in our respective states understand the continued viability and important role of diversity, equity, inclusion, and accessibility efforts” after private sector participants raised concerns about the continued viability of such policies and programming following an Executive Order that purports to target “illegal DEI and DEIA policies” across a wide range of organizations.

The Guidance reports that “diversity, equity, inclusion, and accessibility best practices are not illegal,” and that “the federal government does not have the legal authority to issue an executive order that prohibits otherwise lawful activities in the private sector or mandates the wholesale removal of these policies and practices within private organizations[.]” The Guidance contends that diversity, equity, inclusion, and accessibility initiatives help businesses prevent workplace discrimination and are consistent with federal and state law. The Guidance concludes with a list of best practices for diversity, equity, inclusion, and accessibility in the areas of recruitment and hiring, professional development and retention, and assessment and integration.

The Attorneys General for the states of Massachusetts, Illinois, Arizona, California, Connecticut, Delaware, Hawaii, Maine, Maryland, Minnesota, Nevada, New Jersey, New York, Oregon, Rhode Island, and Vermont joined in the Guidance. The full text can be found here.

Meanwhile, on February 21, 2025, in Nat’l Assoc. of Diversity Officers in Higher Ed. v. Trump, D. Md, the United States District Court for the District of Maryland issued a preliminary injunction that blocks, at least for now, some of the more salient provisions of the executive order that affect federal contractors and other private sector employers. In particular, the court took issue with the constitutionality of the certification and enforcement threat provisions (anchored in the False Claims Act). An analysis of the implications of the injunction for employers and others may be found here.

February 24, 2025February 24, 2025 by Daniel R. Walworth

Court Extends TROs Enjoining Enforcement of NIH Rate Change within 22 Plaintiff States

By Dan Walworth, Rolando Sanchez, Frederick Ball, Geoffrey Goodale and Sara Smith

Since taking office, the Trump Administration has taken steps to reshape the United States’ federal funding infrastructure. One such action relates to the National Institutes of Health’s (“NIH”) rate change, imposing a 15% cap for indirect costs, for new grants and for existing grants awarded to institutions of higher education (“IHEs”). This rate change, which represents a drastic reduction from historical rates normally negotiated by grant recipients, will impact ongoing research programs and clinical trials, and will have a long-term impact on the United States’ research infrastructure and abilities.

On February 10, 2025, the day the rate change was intended to go into effect, three lawsuits were filed in the U.S. District Court for the District of Massachusetts challenging the rate change. The lawsuits were filed by a group of stakeholders, including twenty-two states, thirteen universities, three university associations and five associations. Also on February 10, 2025, a district court judge granted two temporary restraining orders (“TROs”), enjoining enforcement of the rate change within the 22 Plaintiff states, and enjoining enforcement nationwide with respect to institutions. On February 21, 2025, following a hearing on the Plaintiffs’ motions for injunctive relief, the district court ordered that the TROs entered on February 10, 2025, are extended and will remain in effect until further order of the Court.

February 11, 2025February 11, 2025 by Daniel R. Walworth

Court Rules Trump Administration Violated TRO Enjoining Administration’s Funding Freeze

On February 10, 2025, Judge John McConnell of the United States District Court for the District of Rhode Island granted the motion of the state attorneys general for enforcement of the January 31, 2025, temporary restraining order (TRO) relating to the Trump Administration’s proposed “pause” or “freeze” of federal grant funding payments.

The January 31, 2025, TRO prohibits all pauses or freezes on federal funding based on the OMB Directive. Judge McConnell found the Trump administration in violation of this TRO. His February 10, 2025, order provides that “[t]he States have presented evidence in th[eir] motion that the Defendants in some cases have continued to improperly freeze federal funds and refused to resume disbursement of appropriated federal funds.” Such pauses in funding violate the express terms of the TRO, the Court said.

The February 10, 2025, order requires the Trump administration, during the pendency of the TRO, to restore frozen funding, to end any federal funding pause, to take every step necessary to effectuate and comply with the TRO, to immediately restore withheld federal funds, and to resume the funding of institutes and agencies, such as the National Institute for Health.

February 6, 2025February 6, 2025 by Christopher H. Casey

State Attorneys General Diverge on Birthright Citizenship Executive Order

On January 23, 2025, Judge John C. Coughenour of the United States District Court for the Western District of Washington granted a TRO in one of two cases (in Massachusetts and Washington federal courts) brought by attorneys general of 22 states and the District of Columbia to enjoin implementation of a Trump Administration Executive Order concerning “automatic” birthright citizenship. The Order, set to take effect on February 19, 2025, absent an injunction, directed federal agencies not to issue citizenship documents to those born in the United States to a mother who is unlawfully present or lawfully present on a temporary basis and a father who is neither a U.S. citizen nor a lawful permanent resident. The 14th Amendment of the U.S. Constitution states: “All persons born or naturalized in the United States and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.”

In advance of preliminary injunction hearings in the Western District of Washington scheduled for February 6, 2025, a second group of 18 state attorneys general have filed an amici curiae brief in that district, opposing the preliminary injunction being sought by the other AGs. The amici AGs opposing the injunction includes the Attorneys General of Iowa, Alabama, Arkansas, Florida, Idaho, Indiana, Kansas, Louisiana, Missouri, Mississippi, Montana, Nebraska, North Dakota, Oklahoma, South Carolina, Utah and Wyoming.

On February 5, 2025, Judge Deborah Boardman of the United States District Court for the District of Maryland granted a nationwide injunction halting the Executive Order in a separate suit brought by immigration advocacy groups. The preliminary injunction hearings in the two cases brought by the state AGs are still scheduled to go forward.

February 3, 2025February 3, 2025 by Daniel R. Walworth

Court Grants State Attorneys General TRO Enjoining Administration’s Funding “Freeze”

On January 31, 2025, Judge John McConnell of the United States District Court for the District of Rhode Island granted the TRO sought by 22 state attorneys general and the Attorney General for the District of Columbia challenging the Trump Administration’s “pause” or “freeze” of grant funding payments.

The Court found that the attorneys general had a likelihood of success on the merits on their claims that the pause violated the Administrative Procedure Act, is arbitrary and capricious; violates separation of powers; and violates the Constitution’s Spending, Presentment, and Take Care clauses. The Court reached its determination “[b]ecause of the breadth and ambiguity of the ‘pause,’” and therefore anchored its reasoning “based on the effect it will have on many—but perhaps not all—grants and programs it is intended to cover.”

In rejecting the Administration’s argument that the Rescission Memo from OMB mooted the case, the Court relied upon a tweet by the White House Press Secretary –and an email from the EPA sent after the Rescission Memo stating that money would not be disbursed while the EPA determined how to implement the funding “freeze” memo from OMB. The Court found that “the OMB Directive that the States challenge here [is] still in full force and effect.”

To address the Administration’s statements that the “freeze” or “pause” would continue notwithstanding the Rescission Memo, the scope of the TRO prohibits the Trump Administration Defendants from “reissuing, adopting, implementing, or otherwise giving effect to the OMB Directive under any other name or title or through any other Defendants (or agency supervised, administered, or controlled by any Defendant), such as the continued implementation identified by the White House Press Secretary’s statement of January 29, 2025.”

January 30, 2025February 11, 2025 by Daniel R. Walworth

Federal Judge in State AG Suit Signals Intention to Enjoin Funding Freeze, Despite Second OMB Memo Rescinding Prior Memo Directing Freeze

In the suit brought in federal district court in Rhode Island by a group of 23 state attorneys general to challenge the Trump Administration’s cessation of federal funding payments, District Court Judge John McConnell Jr. indicated on Wednesday, January 29, 2025, the Court’s intention to grant the TRO sought by the State AGs. An injunction in the State AGs’ suit would follow an injunction granted by a D.C. District Court on Tuesday, January 28, 2025, in a suit challenging the funding freeze brought by a group of not-for-profit entities.

Despite a two-sentence memo issued by the White House Office of Management and Budget stating that the prior funding freeze memo was “rescinded,” the Court reportedly described the OMB’s memoranda as “hugely ambiguous,” and relied upon statements of White House Press Secretary, Karoline Leavitt, in indicating the Court’s intention to grant the injunction.

Press Secretary Leavitt tweeted that the memo rescinding the funding freeze memo did not, in fact, lift the freeze, but only rescinded “the OMB memo.” Leavitt made clear on behalf of the administration that the freeze remained in effect, but only “the memo” was rescinded to “end any confusion created by” the D.C. District Court’s injunction.