Author: Will Humble

Imagine waking up to a world where your local health department can’t track a measles outbreak, run immunization programs, or respond to foodborne illness outbreaks. That might not be a dream. It could shortly become a reality.

Shortly after Trump’s inauguration, his administration tried to cancel federal contracts and cooperative agreements with state and county health departments. A judge stepped in to block the move, but if that ruling is lifted—or if federal officials simply ignore it—it would be catastrophic for Arizona.

Why? Because more than 70% of county health department funding in Arizona comes from federal dollars.

Without it, the state would essentially have no functioning public health system. County health departments could still inspect restaurants (since that’s fee-based), but everything else—from infectious disease control to maternal health programs—would grind to a halt.

Infectious Disease Outbreaks: A Disaster Waiting to Happen

With no public health infrastructure, Arizona wouldn’t be able to track or respond to disease outbreaks like the recent measles cases in Texas and New Mexico. Surveillance for emerging threats like new COVID-19 variants? Gone. Efforts to contain tuberculosis? Over. Vector-borne diseases like West Nile virus and dengue? No one would be monitoring them.

Immunizations for Kids & Adults Would Collapse

Public health departments run vital immunization programs that protect children and adults from vaccine-preventable diseases. Slashing federal funds would mean fewer vaccines for low-income families, leading to outbreaks of diseases we thought were under control—like measles and whooping cough.

Foodborne & Vector-Borne Illnesses: Who’s Watching?

Public health officials investigate outbreaks of foodborne illnesses like salmonella and E. coli to keep the food supply safe. Without funding, those investigations stop, leaving the public (you) at risk. Similarly, Arizona’s fight against mosquito-borne diseases like West Nile virus would be gone, increasing the chances of widespread infections.

Maternal & Child Health Programs Would Disappear

Prenatal care programs, newborn screenings, and early childhood health initiatives rely heavily on federal funding. Without them, maternal and infant mortality rates could rise, reversing decades of progress.

No Emergency Preparedness for Pandemics, Heatwaves, or Bioterrorism

Public health emergencies—whether it’s a pandemic, extreme heat, or a bioterrorism threat—require coordinated responses. County health departments lead these efforts, ensuring Arizona can react quickly and effectively. If federal funds vanish, so does preparedness, putting millions at risk.

The Bottom Line

This isn’t an exaggeration—if these cuts happen, Arizona’s public health system would collapse. The consequences would be deadly. Public health funding isn’t just another budget line item—it’s what keeps our communities safe. Cutting it would be reckless, dangerous, and utterly disastrous.

Over the past several years, state attorneys general and nonprofit organizations have filed many lawsuits against Trump administration officials, challenging the legality and constitutionality of various agency and DOGE bro decisions and actions.

In many cases, federal judges have issued preliminary injunctions or temporary restraining orders to halt abrupt policy changes and actions, like cuts to research funding or the withholding of grants and contracts.

But what happens when Mr. Trump or his staff ignore or don’t follow these court orders? What legal remedies are available to plaintiffs, and who’s responsible for enforcing the judicial rulings if the administration blows them off?

The Role of U.S. Marshals in Enforcing Court Orders

Federal court orders are typically enforced by the U.S. Marshals Service, which is responsible for carrying out court directives, including serving subpoenas, making arrests, and ensuring compliance with judicial rulings.

In cases where a government official defies a court order, a judge can hold them in contempt of court, leading to potential fines or even jail time. The Marshals may be directed to act against those in defiance, ensuring that court mandates are upheld.

However, U.S. Marshals report to the President. If the Trump administration were to direct federal law enforcement to delay or refuse enforcement of a court order, plaintiffs could face significant hurdles in ensuring compliance.

Contempt of Court and Sanctions

If the Trump administration ignores judicial rulings, courts have another tool: contempt proceedings. Judges can impose escalating fines, sanctions, and even imprisonment for officials who refuse to comply.

Courts can also seek intervention from Congress or escalate matters to the Supreme Court to resolve constitutional crises.

At that point, it would be up to the 9 judges on the US Supreme Court to decide whether they care about the constitution and the republic or not.

Can State Law Enforcement Step In?

In cases where federal marshals fail to act to enforce court orders (or contempt of court findings), courts can turn to state and local law enforcement agencies.

Federal judges have the authority to deputize state law enforcement officers to carry out federal court orders, particularly in cases of contempt or defiance by federal officials. State attorneys general, governors, and local sheriffs can be called upon to enforce judicial rulings.

The use of state law enforcement to enforce federal court orders has happened before. In high-profile cases involving civil rights enforcement and desegregation orders, federal courts have relied on state and local law enforcement—sometimes even deploying the National Guard.

While the Trump administration could try to resist enforcement, state and local officials committed to the rule of law (in blue states) may still have tools at their disposal (and the will) to ensure compliance.

Bottom Line

When Trump administration officials (and the DOGE bros) ignore or fail to follow court orders, enforcement will depend on the willingness of law enforcement agencies—both federal and state—to uphold the rule of law.

While the U.S. Marshals Service is the primary enforcer, if (when) the administration obstructs enforcement, state law enforcement can be deputized to ensure compliance.

The rule of law and our republic are only as strong as our institutions’ ability to uphold it. If federal officials refuse to comply with judicial rulings, the courts need to be prepared to use every tool at their disposal to enforce their decisions and maintain the integrity of the judicial system (and the republic).

Legal Remedies when the Trump Administration Ignores Federal Court Orders

Attorney General Kris Mayes attended the Arizona Center for Rural Health Policy Forum last week and talked about how she and the other 22 democratic attorney generals are fighting the parts of the Project 2025 agenda now being implemented by the Trump Administration that they believe are unlawful or unconstitutional.

As policy decisions are made by the federal agencies or a DOGE bro – the staff at the state attorney general offices examine the decisions, prepare research, and build & file lawsuits to challenge those that conflict with existing federal law or that are unconstitutional.

That work has already bore some fruit. Several lawsuits have been filed about various policy decisions, with several judges issuing preliminary injunctions or temporary restraining orders halting those decisions – at least temporarily.

Here are a few examples:

• Challenge to Birthright Citizenship Executive Order: Multiple federal judges have issued preliminary injunctions blocking the enforcement of President Trump’s executive order aimed at ending birthright citizenship. These rulings assert that the order likely violates the Fourteenth Amendment.
• Lawsuit Against Federal Funding Freeze: A coalition of 23 states, filed motions resulting in a federal judge issuing a temporary restraining order against the Trump administration’s freeze on federal grants and loans. The court found the funding freeze to be potentially unlawful and issued a TRO.
• Legal Challenge to “Fork in the Road” Directive: A federal judge extended a temporary restraining order against the Trump administration’s “Buy Out, Fork in the Road Directive,” which aimed to alter government procurement processes. The extension prevents the directive’s implementation pending further legal review.
• Opposition to DEI and Gender-Related Executive Orders: Civil and human rights organizations filed a lawsuit challenging executive orders targeting Diversity, Equity, and Inclusion initiatives and gender identity policies. The plaintiffs argue these orders violate constitutional rights, leading to ongoing legal proceedings (no judge decision as of yet).
• Litigation Over USAID Funding Freeze: A federal judge has ordered the administration to release frozen USAID funds, but the Trump administration has been ignoring that Order leading to ongoing legal challenges and calls for enforcement of the court’s directive (more on this process in the next blog).
• Case Involving Special Counsel Dismissal: Hampton Dellinger, obtained a temporary restraining order preventing his firing by Trump. The case challenges the president’s authority to remove certain federal officials, and has already been escalated to the U.S. Supreme Court for resolution.

The judicial branch of government will be crucial in potentially mitigating some of the dangerous and harmful public health and healthcare decisions being implemented by the Trump Administration.

Some of those cases will ultimately be successful and some won’t – but until the mid-term elections the judicial branch is our most important tool for mitigating the damage.

But…  what if Mr. Trump, his secretaries or the DOGE bros ignore those court orders? What’s the remedy?

That’s the topic for my piece tomorrow: Legal Remedies when the Trump Administration Ignores Federal Court Orders