As the Trump administration continues its attempts to impose conditions on federal grants, a coalition of 60 local governments — including the counties of Santa Clara, Alameda and San Mateo — is asking a federal judge to block the U.S. Department of Health and Human Services from adding stipulations to grants that could put hundreds of millions of dollars at risk in the region.
Since taking office earlier this year, President Donald Trump has issued a slew of executive orders that require grant recipients to comply with his agenda — for example, prohibiting programs that support abortion, gender ideology and diversity, equity, and inclusion, and ensuring compliance with federal immigration enforcement.
An amended complaint filed on July 10 builds on an initial lawsuit from May that opposed conditions being placed on grants from the Department of Housing and Urban Development and the Department of Transportation. The lawsuit, led by King County, Washington, was filed in the U.S. District Court for the Western District of Washington.
On June 3, U.S. District Court Judge Barbara J. Rothstein granted a preliminary injunction in the initial case, preventing the Trump administration from imposing conditions on federal grants from HUD and the DOT.
Now, the coalition is looking to protect funding from HHS, which is the largest grant-making agency in the United States.
According to the amended lawsuit, the Trump administration’s “unlawful attempts to repurpose federal grant programs established by Congress harm Plaintiffs by threatening more than $12 billion in already-awarded and soon to be awarded funds” across HUD, DOT and HHS.
Kavita Narayan, the chief assistant county counsel for Santa Clara County, said federal law requires that any conditions placed on grants must be related to the purpose of the funding.
Trump’s limitations, she said in an interview, “in addition to being antithetical to our values, have absolutely no relationship to health care funding. Health care as a safety net provider of county services is something that we really care deeply about and view as one of our most fundamental responsibilities that the community counts on us for.”
Several other Bay Area jurisdictions that have joined in the lawsuit, including San Jose, Oakland and Pacifica. Santa Clara County and San Francisco, stand to see the biggest fiscal impacts if Trump is able to add conditions on HHS grants.
Santa Clara County receives more than $275 million in grant funding annually from HHS, with two-thirds of that going to the county’s social services agency to support child abuse prevention initiatives, foster young programs, adoption services and programs for seniors and those with disabilities. The remaining $68 million in HHS funding goes toward a variety of public health programs that aim to prevent infectious disease and support maternal and child health, among other programs.
Santa Clara Valley Healthcare — the county-run health and hospital system — is also facing an estimated $1 billion in lost revenue in the coming years due to cuts to Medicaid in what Trump dubbed his “big, beautiful bill.”
San Francisco receives roughly $325 million of HHS grants annual, including $90 million from the Centers for Disease Control and Prevention, $48 million from Health Resources and Services Administration, $19 million from Substance Abuse and Mental Health Services Administration and $148 million from the Administration for Children and Families.
“These grants provide billions in funding that help our city support early childhood development, health services, safe and effective transportation and housing to our most vulnerable,” San Francisco City Attorney David Chiu said in a news release. “These new grant conditions not only violate the Constitution, but they also have nothing to do with the purpose or performance of these grants. This is part of Trump’s strategy to push his extreme political agenda by threatening local programs and budgets.”
The latest complaint over HHS grants is part of a slew of lawsuits filed by Santa Clara County and San Francisco against the Trump administration this year. Local governments are increasingly becoming parties to these types of lawsuits as the Supreme Court recently limited federal judges’ power to grant nationwide injunctions.
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