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A federal court has temporarily blocked the Trump administration from clawing back millions in public health funding from four Democrat-led municipalities in GOP-governed states.

It’s the second such federal ruling to reinstate public health funding for several states.

U.S. District Judge Christopher Cooper in Washington, D.C., issued a preliminary injunction Tuesday sought by district attorneys in Harris County, Texas, home to Houston, and three cities: Columbus, Ohio, Nashville, Tennessee, and Kansas City, Missouri. The decision means the federal government must reinstate funding to the four municipalities until the case is fully litigated.

Their lawsuit, filed in late April, alleged $11 billion in cuts to U.S. Centers for Disease Control and Prevention programs had already been approved by Congress and are being unconstitutionally withheld. They also argued that the administration鈥檚 actions violate Department of Health and Human Services regulations.

The cities and counties argued the cuts were 鈥渁 massive blow to U.S. public health at a time where state and local public health departments need to address burgeoning infectious diseases and chronic illnesses, like the measles, bird flu, and mpox.鈥� The cuts would lead to thousands of state and local public health employees being fired, the lawsuit argued.

The local governments, alongside the American Federation of State, County and Municipal Employees union, wanted the court to reinstate the grants nationwide. But Cooper said in his preliminary injunction that the funds can only be blocked to the four municipalities and in a May 21 hearing expressed skepticism about whether it could apply more widely.

The funding in question was granted during the COVID-19 pandemic but aimed at building up public health infrastructure overall, Harris County Attorney Christian Menefee said in a statement in April.

The four local governments were owed about $32.7 million in future grant payments, Cooper’s opinion notes.

The federal government’s lawyers said the grants were legally cut because, “Now that the pandemic is over, the grants and cooperative agreements are no longer necessary as their limited purpose has run out.鈥� They used the same argument in the case brought by 23 states and the District of Columbia over the HHS funding clawback.

Menefee said the cuts defunded programs in Harris County for wastewater disease surveillance, community health workers and clinics and call centers that helped people get vaccinated. Columbus City Attorney Zach Klein said the cuts forced the city to fire 11 of its 22 infectious disease staffers.

Nashville used some of its grant money to support programs, including a 鈥渟trike team鈥� that after the pandemic addressed gaps in health services that kept kids from being able to enroll in school, according to the lawsuit.

Kansas City used one of its grants to build out capabilities to test locally for COVID-19, influenza and measles rather than waiting for results from the county lab. The suit details that after four years of work to certify facilities and train staff, the city 鈥渨as at the final step” of buying lab equipment when the grant was canceled.

Representatives for HHS, the CDC, the cities and Harris County did not immediately respond to requests for comment Tuesday.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute鈥檚 Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.