By a 5-4 vote, the Court allowed the National Institutes of Health, the largest public funding source for biomedical research in the world, to terminate $783 million in grants previously awarded. National Institutes of Health v. American Public Health Association (August 21, 2025). 

In a strong dissent, Justice Ketanji Brown Jackson asserted that just when the Judiciary should be hunkering down to do all it can to preserve the law’s constraints, the Court opts instead to make preventing manifestly injurious government action “as difficult as possible.” 


The National Institutes of Health (NIH) is the world’s leading funder of biomedical and behavioral research and is, as such, responsible for the discovery of new ways to diagnose, prevent, and treat the most challenging diseases. 

By congressionally enacted statute, the NIH must make grants-in-aid to universities, hospitals, laboratories, and other public or private institutions to contribute to the effort to “diagnose, treat, and prevent physical and mental diseases.” 

Various statutory provisions shape the NIH’s discretion in allocating these funds, including ways that recognize the importance of science for the study, healing, and service of a diverse nation. For example, Congress requires the funding of programs designed to assist women who are members of “medically underserved populations, low-income populations, or minority groups.” And it instructs the NIH to make grants in biomedical and behavioral research training for individuals who are “members of minority health disparity populations.” 

Historically, the NIH has awarded multi-year grants pursuant to established statutory criteria and scientific objectives in recognition that disease research takes time. 

Also historically, the NIH’s grant selection process has been rigorously scientific. In the past, grant terminations have been extremely rare.

The NIH’s implementation of its grantmaking obligations changed dramatically in February 2025, after President Trump signed a trio of executive orders instructing the government to stop diversity, equity, and inclusion (DEI) initiatives, “gender ideology” promotion, and covid–19 research. 

In response, NIH leadership issued a series of directives ordering the termination, en masse, of existing grants that the agency perceived as in tension with the new administration’s policies. 

Thousands of grants were canceled, including those supporting research into suicide risk and prevention, HIV transmission, Alzheimer’s, and cardiovascular disease. 

A group of individual researchers, doctors, and unions who depend on NIH funding for their research and a coalition of 16 states on behalf of their public universities sued in federal district court in Massachusetts, arguing that the NIH had implemented the executive orders in a manner that violated, among others, the Administrative Procedures Act (APA) and the separation of powers under the Constitution. 

Following discovery and a bench trial, Judge William Young (a Reagan appointee) determined that both the underlying policy and the grant terminations were “breathtakingly arbitrary and capricious” in violation of the APA. American Public Health Association v. NIH (July 2, 2025). 

In fact, he found that there was “no reasoned decision-making” at all with respect to the NIH’s abrupt “robotic rollout” of these grant-termination actions. In place of science, the district court found “an unmistakable pattern of discrimination against women’s health issues” and “palpable” racial discrimination of a sort the judge had “never seen” in his 40 years on the bench. 

Following a decision by the First Circuit Court of Appeals not to intervene, the administration sought emergency relief from the Supreme Court. 

In another shadow docket ruling, four justices (Roberts, Sotomayor, Kagan, and Jackson) would have rejected the administration’s appeal in full. Four justices (Thomas, Alito, Gorsuch and Kavanaugh) would have granted the administration’s appeal in full. 

Justice Barrett, casting the deciding vote, split the difference. “My preliminary judgment is that the plaintiffs’ challenges to the grant terminations belong in the Court of Federal Claims, and their APA challenges to the guidance belong in district court.” 

As a result, the Court granted the government’s request to block that part of Judge Young’s ruling that required NIH to continue to fund the terminated grants.  

Justice Jackson dissented, asserting that by today’s order, an evenly divided Court neuters judicial review of grant terminations by sending plaintiffs on “a likely futile, multivenue quest for complete relief.” The Court evidently wishes to impose its “cumbersome, multistep judicial-review process” on any grantee that attempts to preserve its research advancements by filing a lawsuit. With potentially life-saving scientific advancements on the line, the Court turns a nearly century-old APA statute aimed at remedying unreasoned agency decision-making into a “gauntlet rather than a refuge.”  

Justice Jackson lamented the adverse impact on scientific research the Court’s decision will cause. The NIH grantees have detailed the devastating and irrevocable damage to the “symbiotic relationship” between the government and the nation’s research community that an abrupt cessation of funding would cause, not to mention the harm to the global primacy of American science. 

As Congress recognized when it made the NIH the world’s largest public scientific funder, scientific advancement lifts all boats. As Judge Jackson noted, “the harm is not just to researchers who will lose their livelihoods; vulnerable members of our society will also lose the benefits of their research.”