A federal judge in the Northern District of Texas has vacated the Biden administration’s 2024 amendments to the HIPAA Privacy Rule that sought to strengthen privacy protections for reproductive health care information. The ruling, issued in the case Purl v. United States Department of Health and Human Services, found that the Department of Health and Human Services (HHS) overstepped its statutory authority and unlawfully limited state powers to regulate and investigate matters such as child abuse and public health.

Judge’s opinion held that the 2024 Rule was “contrary to law” on several grounds:

• Limiting State Public Health Laws: The court found that the rule unlawfully restricted state laws governing public health, child abuse reporting, and investigations. Under federal law, specifically 42 U.S.C. § 1320d-7(b), HIPAA cannot be construed to “invalidate or limit” state authority in these areas. The judge determined that the 2024 Rule imposed new burdens and procedural hurdles on health care providers, such as requiring legal determinations about the lawfulness of care and demanding detailed attestations before releasing information, which amounted to impermissible limits on state powers.
• Redefinition of Statutory Terms: The rule’s redefinition of key terms like “person” (excluding unborn children) and “public health” was found to be inconsistent with federal statutes and the Dictionary Act. The court held that HHS’s attempt to exclude unborn children from the definition of “person” denied legal status or rights recognized under state law, particularly in states that treat substance abuse during pregnancy as child abuse.
• Major-Questions Doctrine: Citing recent Supreme Court precedent, the judge ruled that HHS lacked clear congressional authorization to create special privacy protections for reproductive health information, a matter of “great political significance” now primarily regulated by the states. The court found that the agency’s reliance on general grants of regulatory authority was insufficient to justify such a significant policy change.

The case was brought by Dr. Carmen Purl and supported by the conservative Alliance Defending Freedom.