Full Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA HENNEPIN COUNTY, MINNESOTA et al., Plaintiffs, Case No. 26-cv-2460 (CRC) v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES et al., Defendants. MEMORANDUM OPINION Millions of American teenagers have sex. Resulting unplanned pregnancies impose widespread costs on affected individuals and society generally. Alarmed by the country’s rising teenage birth rate, Congress funded grants through the Teen Pregnancy Prevention (“TPP”) Program to support local initiatives proven to reduce teen pregnancy, as well as promising approaches that might also prove effective after further observation and study. Congress intended for these programs to employ a range of strategies, from encouragement of abstinence and delayed sexual activity to education about contraceptives. The effort seems to be working: The teen pregnancy rate has plummeted since Congress began funding the grants in 2010.1 1 Recent surveys from the Centers for Disease Control and Prevention indicate that about one-third of the country’s roughly 17 million high school students have had sex at least once, and one-fifth are currently sexually active. These figures are down from approximately half and one- third of high schoolers, respectively, in 2013. See Jacob Fabina, Erik L. Hernandez & Kevin McElrath, School Enrollment in the United States: 2021, U.S. Census Bureau 2 tbl.1 (June 2023), https://www.census.gov/content/dam/Census/library/publications/2023/acs/acs-55.pdf [https://perma.cc/WFR4-U86J]; Youth Risk Behavior Surveillance Sys., Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023, CDC (2024), https://www.cdc.gov/yrbs/dstr/index.html [https://perma.cc/UZ2R-6UH2]. Under the current administration, the Department of Health and Human Services (“HHS”) has a different take on teen pregnancy. In its view, the money Congress has appropriated for teen pregnancy prevention should be used only for programs that promote abstinence and “body literacy,” a nebulous concept that appears to elevate fertility and marital procreation over well-tested forms of contraception and pregnancy prevention. The agency also seeks to bar grant recipients from encouraging or “normalizing” teen sexual activity, including through “sexually explicit” content and discussion. Despite prior judicial rebukes of components of this same policy, HHS has memorialized its new approach through official policy pronouncements, which have in turn been incorporated into recent grant solicitations known as “notices of funding opportunity” (“NOFOs”). HHS has also applied its reimagined teen pregnancy policy by terminating existing grants held by TPP Program providers across the country. Among these providers are the two local governments and one non-profit organization that filed this lawsuit, alongside a second non-profit that supports TPP programming but is not itself a grant recipient. These four Plaintiffs now seek to preliminarily enjoin the policy’s implementation through the issuance of new NOFOs and mass termination of existing grant awards. HHS is perfectly entitled to formulate its own views about how to stem teen pregnancy— or even whether it is worth preventing at all—and to pursue policy initiatives consistent with its viewpoint. But it is not at liberty, under the Administrative Procedure Act (“APA”), to impose conditions on grant recipients that Congress did not intend or that are unreasonable or unexplained. The preliminary record suggests that HHS has done just that. Through the TPP, Congress sought to fund a range of evidence-based teen pregnancy prevention strategies, not just abstinence. According to unrebutted record evidence, programs that teach abstinence to the 2 exclusion of all other approaches are ineffective in delaying sexual initiation and reducing adolescent pregnancy, at least as a general matter.2 The agency’s NOFOs themselves acknowledge a near-absence of evidence on “body literacy” approaches to pregnancy prevention. And an educational initiative that counsels teens on how to avoid pregnancy without discussing the realities of unprotected intercourse and its alternatives would seem to defy social reality, common sense, and scientific evidence alike. Yet HHS seeks to impose these and other unexplained criteria on all TPP grantees moving forward. As such, HHS’s new TPP policy is likely arbitrary and capricious. Having established the Court’s jurisdiction over this challenge and satisfied the other requirements for preliminary relief, the grant-recipient Plaintiffs are therefore entitled to a preliminary injunction preventing HHS from implementing its new policy, including through its recently-issued NOFOs, while this lawsuit is pending. The Court declines, however, to order the interim reinstatement of existing grants at this early stage, as it is less clear that this Court, as opposed to the Court of Federal Claims, may exercise jurisdiction over those portions of Plaintiffs’ APA claims that seek such relief. To be sure, that “agency guidance discusses” or memorializes “policies related to grants does not transform a challenge to that guidance into a claim ‘founded . . . upon’ contract that only the [Court of Federal Claims] can hear” under a channeling statute known as the Tucker Act. Nat’l Insts. of Health v. Am. Pub. Health Ass’n (“NIH”), 145 S. Ct. 2658, 2661 (2025) (Barrett, J., concurring) (quoting 28 U.S.C. § 1491(a)(1)). But there is a difference between vacating an unlawful agency policy and vacating an unlawfully terminated grant, “if the [Court of Federal Claims] has exclusive jurisdiction” over the latter 2 Whether that holds true for specific age groups, sub-populations, or communities is not evident on this early-stage record. 3 under the Act. Id. (emphasis added). Present uncertainty over that jurisdictional question counsels against enjoining enforcement of HHS’s grant terminations at this time. I. Background A. The TPP Program Teenage pregnancy is a critical public health issue in the United States, and unplanned adolescent childbearing has lasting and widely-felt health and economic consequences. Compl. ¶ 18. The federal government “has long recognized” the costs of teen pregnancy. Pol’y & Rsrch., LLC v. HHS, 313 F. Supp. 3d 62, 68 (D.D.C. 2018). Yet “its preferred method of addressing this societal concern has changed over time.” Id. at 69. In the late 1990s and early 2000s, Congress focused on “abstinence-only education as the primary tool” for reducing teen pregnancy. Id. (citation omitted). In the mid-2000s, teen birth rates began to tick up after years of decline. Compl. ¶ 20. Legislators were “deeply concerned” by this upward trend, H.R. Rep. No. 111-220, at 176 (2009), and especially “alarmed” given that “America’s teen birth rate” was “already high compared to other developed nations,” S. Rep. No. 111-66, at 160 (2009).3 To address this reemerging problem, Congress created the TPP Program by way of the Consolidated Appropriations Act of 2010. The “short” and “simple” statutory language that created the Program “has remained consistent since [its] inception.” Planned Parenthood of Greater Wash. & N. Idaho v. HHS (“PPGWNI”), 946 F.3d 1100, 1105 (9th Cir. 2020). Congress appropriated funds “for making competitive contracts and grants to public and private entities to fund medically accurate and age appropriate programs that reduce teen pregnancy.” 3 Despite recent improvements, the United States has one of the highest teen birth rates among industrialized countries. Its rate is over twice that of France and Canada and over five times that of Sweden. Alexandria K. Mickler and Jessica Tollestrup, Cong. Rsch. Serv., R45184, Teen Births in the United States: Overview and Recent Trends 11 (2025). 4 Consolidated Appropriations Act, 2010, Pub. L. No. 111-117, 123 Stat. 3034, 3253 (2009) (emphasis added). Aside from a portion of TPP funds set aside for “training and technical assistance, evaluation, outreach, and additional program support activities,” the remaining appropriation was to be split into two funding streams. Id. Tier 1 grants, which represent 75% of available funds, would “be for replicating programs that have been proven effective through rigorous evaluation to reduce teenage pregnancy, behavioral risk factors underlying teenage pregnancy, or other associated risk factors.” Id. (emphasis added). Tier 2 grants, which represent 25% of available funds, would “be available for research and demonstration grants to develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy.” Id. (emphasis added). In short, “Tier 2 lets grantees test new programs, and programs that prove effective then become eligible for Tier 1.” PPGWNI, 946 F.3d at 1106. Congress has appropriated TPP funding on a bipartisan basis since 2010, Compl. ¶ 25, supporting a variety of programs that had worked to reduce the prevalence of teen pregnancy since even before that inaugural year. If the drop in the teen birth rate—a roughly two-thirds reduction over the last two decades—is any indication, the Program has been a resounding success. Id.; see also Decl. of Ashley Johnson (“Johnson Decl.”) ¶ 22.4 Despite this seemingly impressive track record, the Trump Administration excluded the TPP Program from its proposed budget for Fiscal Year (“FY”) 2026. Compl. ¶ 26 n.8. Congress rejected that idea and once more appropriated a large sum for the initiative—$101 million, to be exact. Following the usual structure, 75% of non-administrative funds would support the “replicati[on]” of “programs that have been proven effective through rigorous evaluation to 4 All declarations cited in this Memorandum Opinion are appended to Plaintiffs’ Motion for Preliminary Injunction. 5 reduce teenage pregnancy,” while the remaining 25% of funds would be for developing, refining, and testing “additional models and innovative strategies for preventing teenage pregnancy.” Consolidated Appropriations Act, 2026, Pub. L. No. 119-75, 140 Stat. 173, 281 (2026). Separately, but in the very next sentence of the appropriations act, Congress allocated $35 million to fund abstinence-only sexual education. Id. at 281–82. That pot of funding would be for “making competitive grants which exclusively implement education in sexual risk avoidance (defined as voluntarily refraining from non-marital sexual activity),” so long as such programming relied on “medically accurate information referenced to peer-reviewed publications,” “implement[ed] an evidence-based approach,” and taught “benefits associated with self-regulation, success sequencing for poverty prevention,” and “healthy relationships,” among other social objectives. Id. Before addressing the policy changes at the heart of this suit, two brief notes on the mechanics of TPP grant disbursement. First, HHS allocates TPP funds through “cooperative agreements,” which—as defined under the Federal Grant and Cooperative Agreement Act (“FGCAA”)—are “legal instrument[s]” that the federal government uses when the “principal purpose of the relationship” between the government and the recipient “is to transfer a thing of value” to the recipient in order to “carry out a public purpose of support or stimulation authorized by a law of the United States instead of acquiring . . . property or services for the direct benefit or use of the United States Government.” 31 U.S.C. § 6305. Under a cooperative agreement, “substantial involvement is expected between the executive agency” and the recipient “when carrying out the activity contemplated in the agreement.” Id. § 6305(2). Second, HHS chooses TPP recipients “through a competitive process after issuing” a NOFO. Planned Parenthood of Greater N.Y. v. HHS (“PPGNY II”), No. 25-cv-2453 (BAH), 6 2025 WL 2840318, at *2 (D.D.C. Oct. 7, 2025). “The awards apply to a given ‘project period,’ during which HHS intends to keep funding the grant ‘without requiring the project to recompete for funds.’” Id. (citing 42 C.F.R. § 52.6(c)(1)). In practice, the agency funds the project for one year, and at the start of each subsequent year, the grantee submits an application (with a progress report, budget, and work plan) for a non-competing continuation (“NCC”) award. Id. HHS reviews that application and, if all is well, approves the project for its next year of funding. B. Recent Changes to the TPP Program 1. March 2025 Guidance Despite steadfast congressional commitment to reducing teen pregnancy, the TPP Program has experienced turmoil in the last year and a half. HHS issued the last round of TPP funding in 2023, with each cohort member’s five-year project period slated to run from 2023 to 2028. Grantees were required to submit their NCC applications at the start of each year of the project period. In March 2025, as the cohort prepared to enter its third year of the project period, HHS released guidance clarifying that recipients were expected to “review and be aware of current Presidential Executive Orders,” including those that, in the Administration’s words, rejected “gender ideology extremism,” “ended radical indoctrination in K-12 schooling,” and “ended radical and wasteful government DEI programs and preferencing.” Id. at *2–3 (cleaned up) (quoting March 2025 NCC guidance document). A handful of 2023 NOFO recipients challenged this guidance document in early 2025, arguing that the requirements associated with the Executive Orders were impossible for them to satisfy and violated their rights under the APA and the Constitution. See Planned Parenthood of Greater N.Y. v. HHS (“PPGNY I”), No. 25-cv- 1334 (TJK), 2025 WL 1768100 (D.D.C. June 26, 2025). Before the plaintiffs could get their 7 challenge off the ground, however, their NCC applications were approved, and they voluntarily dismissed the suit. See PPGNY II, 2025 WL 2840318 at *5. 2. July 2025 Policy Notice The legal tussle over the direction of the TPP Program was only just beginning. In July 2025, HHS issued a “Policy Notice” purporting to “clarify” to TPP Program grant recipients “when materials and activities are not ‘medically accurate,’ ‘age appropriate,’ do not ‘reduce teen pregnancy,’ or are otherwise outside the scope of the TPP Program.” See Compl., Ex. C (“July 2025 Policy Notice”) at 1. The Policy Notice emphasized that recipients were to “revise their projects, as necessary, to demonstrate that the NCC award application is aligned with current Executive Orders,” including those alluded to above. Id. at 1–2. It specifically highlighted President Trump’s Executive Order 14190, “Ending Radical Indoctrination in K-12 Schooling,” id. at 2–3, and underscored that “TPP Program-funded projects should not undermine the President’s clear policy directive to protect children from harmful ideologies or the constitutional rights of parents to direct the religious upbringing of their children,” id. at 3, citing the Supreme Court’s decision in Mahmoud v. Taylor, 606 U.S. 522 (2025). The Policy Notice went on to explain that “[p]rograms cannot be funded under the TPP Program if they include materials or activities . . . that are inconsistent with, or beyond the scope of, the statutory requirements for TPP programs,” which in HHS’s view included “teaching minors” about “gender ideology” or “discriminatory equity ideology,” including “the radical ideological claim that boys can identify as girls and vice versa.” July 2025 Policy Notice at 4–5. “Programs must be aimed at reducing teen pregnancy, not instructing in such ideological content,” the agency elaborated. Id. at 5. “By the same token,” the agency explained, material or instruction outside the scope of the TPP Program may include other content that is not related to, or counter to the aim of, reducing teen pregnancy, such as content that 8 encourages, normalizes, or promotes sexual activity for minors, including anal and oral sex, or masturbation, including through sexually themed roleplay. This also may include content on the eroticization of birth control methods, creating more pleasurable sexual experiences, or foreplay techniques. Id. at 4. The Policy Notice further clarified HHS’s understanding of the definition of key terms in the TPP Program’s authorizing statute. The phrase “medically accurate” excluded “inaccurate information about methods of contraception, including associated health risks, or information that denies the biological reality of sex or otherwise fails to distinguish appropriately between males and females, such as for the purpose of body literacy.” Id. at 6. “Age appropriate” programs for minors could not “contain material that depicts, describes, exposes or presents obscene, indecent, or sexually explicit content.” Id. And the agency’s previous references to terms like “health equity,” “inclusivity,” and “adolescent-friendly services” could “not be construed . . . to permit unlawful diversity, equity, or inclusion-related discrimination.” Id. Three 2023 NOFO recipients challenged the Policy Notice as constitutionally defective, contrary to the TPP’s authorizing statute, and arbitrary and capricious. See PPGNY II, 2025 WL 2840318, at *3, *5. Considering the matter on an expedited summary judgment schedule, Judge Howell concluded that the Notice’s “vagueness renders the new requirements imposed on TPP grant recipients largely incomprehensible and unworkable, putting in place an opaque ‘we-know- it-when-we-see-it’ standard for HHS to assess compliance with programming content restrictions that is susceptible to discriminatory application.” Id. at *22. She additionally found that the Notice “suffer[ed] from several of the other deficiencies plaintiffs identif[ied], including that it entirely lack[ed] reasoned explanation and justification, which independently require[d] the Policy Notice to be set aside.” Id. Granting summary judgment on the plaintiffs’ claim that the 9 Policy Notice was arbitrary and capricious, Judge Howell vacated the guidance document and barred HHS from implementing it. Id. at *30. 3. 2026 Policy Changes a. FY 2026 Tier 1 and Tier 2 NOFOs That brings us to the events at the core of this case. Undeterred by the vacatur of its guidance last fall, HHS waited out the 2025–26 school year. On June 23, 2026, the agency released FY 2026 NOFOs for Tier 1 and 2 funding, respectively, which set out the parameters for a new cycle of grant-making. The NOFOs reflect an array of substantial changes to the Program. First, HHS doubled down on several of the policy changes articulated in its now-vacated July 2025 Policy Notice, including the requirement that awardees “align” with agency policy priorities eschewing diversity, equity and inclusion (“DEI”), “gender ideology,” the denial of the sex binary, and the “normaliz[ation]” of sexual activity among minors. Compl. ¶ 41(b)–(d), (f). The agency did so both by incorporating the policy priorities it had articulated elsewhere and by reiterating multiple of those priorities directly in the body of the NOFO. See Compl., Ex. D (“FY 2026 Tier 1 NOFO”) at 4 (“The recipients of this award must . . . effectuate program goals and agency priorities in accordance with the Priorities of the Office of the Assistant Secretary for Health [“OASH”] (available at https://health.gov/priorities), and when authorized by law according to the TPP statute, regulations, legislative mandates, and additional program guidance.”); id. at 44 (“In carrying out any project funded under this NOFO, the recipient must adhere to the HHS priorities (available online at: https://hhs.gov/about/priorities/index.html)[.]”), id. at 45 (“[D]iscretionary awards shall not be used to fund . . . activities where race or intentional proxies for race will be used as a selection criterion for . . . program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable 10 characteristic . . . . If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.”); Compl., Ex. E (“FY 2026 Tier 2 NOFO”) at 4–5, 10, 22, 32, 55 (specifying the same requirements). In addition, the NOFOs echoed the July 2025 Policy Notice in mandating that grant recipients provide information about health risks associated with contraception and afford parents advance notice and the opportunity to opt out of pregnancy prevention programming on their children’s behalf. Compl. ¶¶ 41, 78. Second, HHS imposed new blanket requirements on TPP awardees that have not yet been judicially tested. For one thing, prospective awardees must incorporate “sexual risk avoidance” education in their programming, which the parties do not contest means an abstinence-only approach to teen pregnancy prevention. See FY 2026 Tier 1 NOFO at 12; FY 2026 Tier 2 NOFO at 9–10. For another, the NOFOs require awardees to promote “body literacy” education, which they defined as “the ability to understand how the body functions in a state of health.” FY 2026 Tier 1 NOFO at 55; FY 2026 Tier 2 NOFO at 66. The concept entails, among other things, “two distinct educational modules” focused on “female reproductive health and male reproductive health” that address topics like how “repeated or artificially stimulated arousal may affect neural development and behavior over time.” FY 2026 Tier 1 NOFO at 10. Under the “body literacy” heading, awardees must also provide instruction that includes “an overview of approaches to managing menstrual health concerns, including the advantages and disadvantages of ovarian suppression compared to approaches that address root causes.” Id. The FY 2026 Tier 1 NOFO further directs awardees to “affirm marriage and parenthood as meaningful and valued components of adult life,” id. at 11, and to provide “counseling that helps adolescents reflect on their goals related to relationships, childbearing, career, and future family formation,” id. at 6. 11 Zooming out, the Tier 1 notice instructs applicants to describe their “organization’s mission and how it aligns with the goals of th[e] NOFO, including advancing body literacy, informed consent, and optimal health.” Id. at 20. Prospective grantees are assessed on the degree to which they “demonstrate[] a strong alignment between the organization’s mission and the goals of the NOFO.” Id. at 38. In a marked shift from the FY 2023 NOFOs, see Compl., Ex. A (“FY 2023 Tier 1 NOFO”) at 6–7; Compl., Ex. B (“FY 2023 Tier 2 NOFO”) at 5–8, neither FY 2026 NOFO mentions a focus on populations disproportionately affected by teen pregnancy. HHS has additionally changed how award recipients are selected and truncated the project period length. The Tier 1 NOFO does not mention the agency’s “Teen Pregnancy Prevention Evidence Review” (“TPPER”), which is a review process akin to expert peer review that HHS previously used to identify programs eligible for “replication.” Compl. ¶¶ 23, 47. In fact, the new Tier 1 NOFO “awards bonus points to applicants who do not hold active TPP awards or have never received one,” suggesting that prior experience is now a disadvantage in competing for funding. Id. ¶ 47 (emphasis added); see also FY 2026 Tier 1 NOFO at 42; FY 2026 Tier 2 NOFO at 52. Lastly, the Tier 1 NOFO shortens the project period from five years to two years, with an “optional competitive third year” available. FY 2026 Tier 1 NOFO at 1. b. Mass Grant Terminations The 2026 NOFOs are forward-looking, setting forth a multifaceted rubric against which future TPP applicants are to be assessed. But HHS did not stop there. On June 26, 2026, three days after the publication of the FY 2026 NOFOs, the agency issued termination letters to nearly all members of the 2023–2028 funding cohort, including two local governments and one non- profit that are plaintiffs in this case. Compl. ¶ 52. 12 “The termination letters informed recipients that their cooperative agreements would be canceled immediately pursuant to 2 C.F.R. § 200.340(a)(4)” because, in the agency’s view, the projects “no longer effectuate[d] the program goals or agency priorities.” Id. ¶ 54. The letters did not suggest that the awardees had failed to satisfy the terms of their cooperative agreements or that they had engaged in any misconduct warranting termination. Id. ¶ 55. Instead, the agency explained with boilerplate language, “After a review of all curricular content, [the agency] believes that some curricula normalize adolescent sexual activity and are not age appropriate.” Id. ¶ 56. The letters invoked the understandings of “age appropriate” and “medically accurate” content articulated in both the 2026 NOFOs and vacated July 2025 Policy Notice. Id. ¶¶ 58–60. The letters concluded by explaining that the grantees’ awards would be terminated—and not merely suspended—in order to “better prioritize agency resources” because “[c]urrent program priorities . . . differ fundamentally from prior approaches.” Id. ¶ 61. The FY 2026 NOFOs and mass grant termination decision are related in two key ways. First, the NOFOs mandate “[a]lignment” with the “[p]riorities” of OASH (“available at https://health.gov.priorities”), a policy document which—as noted above—the NOFOs incorporate by reference. FY 2026 Tier 1 NOFO at 4; FY 2026 Tier 2 NOFO at 4. The grant termination letters, issued just three days after the publication of the new notices, likewise justified the cancellation of the majority of TPP grants on the basis that they were inconsistent with published OASH priorities. See Johnson Decl., Ex. 2 at 1; Decl. of Andrea Gerber (“Gerber Decl. I”), Ex. 2 at 1; Decl. of Virginia Miller (“Miller Decl.”), Ex. 2 at 1. Second, the grant terminations appear to be necessary to the issuance of the NOFOs, as HHS will fund new projects using “the same pot of appropriated funds that would have supported” the now- terminated programs “in years four and five of [their] awards.” Johnson Decl. ¶ 25. 13 C. Procedural History A few weeks after HHS released its 2026 NOFOs and terminated virtually all existing TPP awards, four plaintiffs—Hennepin County, Minnesota; King County, Washington; Planned Parenthood of the Heartland (“PPH”); and the Sexuality Information and Education Council of the United States (“SIECUS”)—filed this lawsuit. Their complaint takes aim at HHS’s “2026 Policy,” which they define as a pivot away from congressionally-mandated, evidence-based programming and toward abstinence-only programming that “aligns” with ideologically- inflected agency priorities and “restrict[s] discussion of teen sexual activity.” Compl. ¶ 5. Plaintiffs understand HHS to have “implemented the Policy through two related actions: the issuance of the 2026 NOFOs and the mass termination of ongoing cooperative agreements.” Id. ¶¶ 81, 88. They submit that both the Policy and (independently) the new NOFOs are contrary to law, in excess of HHS’s statutory authority, and arbitrary and capricious under the APA. See Compl. ¶¶ 79–85 (Count I), 86–95 (Count II), 96–102 (Count III), 103–07 (Count IV). Additionally, Plaintiffs allege that the Tier 1 NOFO constitutes unlawful viewpoint discrimination in violation of the First Amendment. See id. ¶¶ 108–10 (Count V). As of the filing of the complaint on July 14, 2026, no Plaintiff had applied for funding under the new NOFOs. On July 18, King County submitted a Tier 2 application. See Supp. Decl. of Andrea Gerber (“Gerber Decl. II”) ¶ 5. It proposed a new abstinence-only program for target populations who are not sexually active, id. ¶¶ 8–11, doing “the best [it] could to comply with the vague priorities set out in the NOFO” in launching this fledgling initiative, id. ¶ 12. One day after filing the complaint, Plaintiffs filed a motion for a preliminary injunction and a stay of agency action under 5 U.S.C. § 705, supported by a slate of declarations from staff members who implement TPP-related programming for Plaintiffs. See generally Johnson Decl.; 14 Gerber Decl. I; Miller Decl.; Decl. of Calleen Simon (“Simon Decl.”). HHS has opposed the motion. After an expedited briefing schedule and hearing, the motion is ripe for adjudication. II. Legal Standard “A preliminary injunction is an extraordinary remedy never awarded as of right.” Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 24 (2008). To secure such an injunction, a plaintiff “must establish that he is likely to succeed on the merits, that he is likely to suffer irreparable harm in the absence of preliminary relief, that the balance of equities tips in his favor, and that an injunction is in the public interest.” Id. at 20. “[T]he movant has the burden to show that all four factors, taken together, weigh in favor of the injunction.” Abdullah v. Obama, 753 F.3d 193, 197 (D.C. Cir. 2014) (citation omitted). Section 705 of the APA permits a court to “issue all necessary and appropriate process to postpone the effective date of an agency action or to preserve status or rights pending conclusion of the review proceedings” where “required and to the extent necessary to prevent irreparable injury.” 5 U.S.C. § 705. “[F]actors governing issuance of a preliminary injunction also govern issuance of a § 705 stay.” District of Columbia v. USDA, 444 F. Supp. 3d 1, 15 (D.D.C. 2020). III. Analysis As detailed above, Plaintiffs challenge a new set of policy priorities imposed by HHS on TPP grant recipients. In analyzing their request for preliminary relief, the Court first explains its working understanding of the object of this challenge—which Plaintiffs characterize as HHS’s singular “2026 Policy” and the government casts instead as two discrete agency actions. Next, the Court turns to Plaintiffs’ likelihood of success in this case, which encompasses their chance of (1) demonstrating Article III standing, (2) establishing that the Court has jurisdiction over its 15 claims, and (3) proving that the agency’s actions are unlawful under the APA.5 Finally, the Court evaluates the remaining preliminary injunction factors to determine whether status-quo- preserving relief is warranted. Before embarking on this journey, it is worth noting that “[t]entative conclusions” reached on this expedited briefing timeline and in the absence of a full administrative record “may not harden into settled judgments later.” Beatty v. Trump, 830 F. Supp. 3d 25, 48 (D.D.C. 2026) (Cooper, J.). Nevertheless, in light of the governing case law and the uncontroverted evidence available for review, “at least some [preliminary] relief is now in order.” Id. A. Scoping Plaintiffs’ Challenge Let’s begin by examining the object of this legal challenge. Plaintiffs contest HHS’s “2026 Policy,” which they say “rejects the [TPP] Program Congress created and replaces it with one divorced from the evidence-based programs funded by the statute.” Compl. ¶ 5. In Plaintiffs’ telling, the 2026 Policy mandates an abstinence-only approach to pregnancy prevention, promotes the amorphous concept of “body literacy,” and prohibits programming that could be understood to “normalize” sexual activity among adolescents, all while requiring TPP recipients to “align” with the agency’s repudiation of concepts like DEI and “gender ideology.” According to Plaintiffs, the agency has implemented its new Policy “through two related actions”: (1) the issuance of the FY 2026 NOFOs that condition TPP funding on these policy prescriptions and (2) the application of these prescriptions to existing TPP cooperative agreements, which led to the termination of the “vast majority” of awards. Id. 5 As will become evident below, the Court need not, and does not, evaluate the merits of Plaintiffs’ First Amendment challenge in this preliminary posture. 16 The APA subjects “[a]gency action” to judicial review. 5 U.S.C. § 704. Agency action, in turn, “includes the whole or a part of an agency rule, order, license, sanction, relief, or the equivalent or denial thereof, or failure to act.” Id. § 551(13). In ascertaining the contours of the agency action here, the Court is guided by two key principles. On one hand, agency action is not so broad as to encompass “continuing (and thus constantly changing) operations” of an agency that do not represent a discernible decision. Lujan v. Nat’l Wildlife Fed’n., 497 U.S. 871, 890 (1990). Rather, agency action must entail some type of “circumscribed, discrete” decision or occurrence. Norton v. S. Utah Wilderness All., 542 U.S. 55, 62 (2004). On the other hand, agency action “generally need not be committed to writing to be final and judicially reviewable,” Bhd. of Locomotive Eng’rs & Trainmen v. Fed. R.R. Admin., 972 F.3d 83, 100 (D.C. Cir. 2020), so long as there is a discernible course of agency conduct that reflects a discrete decision, cf. Venetian Casino Resort, LLC v. EEOC, 530 F.3d 925, 929 (D.C. Cir. 2008) (concluding that even though the “details” of the agency’s policy were hazy, “the record le[ft] no doubt” that it had a “policy of disclosing confidential information”); Her Majesty the Queen in Right of Ontario v. EPA, 912 F.2d 1525, 1531 (D.C. Cir. 1990) (“[T]he absence of a formal statement of the agency’s position, as here, is not dispositive[.]”). Otherwise, an agency could insulate its decisions from APA review by simply refusing to write them down. On the unrebutted record presently before the Court, HHS has made a discernible decision to reorient TPP criteria toward the goals of abstinence and “body literacy” and away from other forms of pregnancy prevention, as well as DEI, “gender ideology,” and the “normalization” of teen sexual activity. The agency’s decision is evidenced both by discrete statements of policy (i.e., the FY 2026 NOFOs and OASH policy priorities that the NOFOs 17 incorporate) and by its course of conduct (i.e., the termination of almost all existing TPP programs and reallocation of that funding to future grantees). The government, for its part, recognizes that HHS has decided to reallocate funding in this way. Although it asks the Court to treat the NOFOs and grant terminations distinctly for jurisdictional purposes (more on that in a moment), it does not contest that the agency has changed the TPP parameters in a decisive fashion. At the hearing on Plaintiffs’ motion, the government acknowledged that the new NOFOs “reflect the administration’s priorities” and “emerge” from the “same underlying considerations” as the grant termination decision. Prelim. Inj. Hr’g Rough Tr. 43:8–11. Counsel elaborated that “obviously the agency has made a shift . . . because of the incoming administration,” and the agency’s new funding conditions serve to “implement[] the program in a way consistent with the agency’s [stated] priorities.” Id. at 55:1–3, 10–12. To assess the merits of the agency’s policy shift, counsel also urged, the Court should look “not just at the termination letters themselves,” but also at the terms of the NOFOs, and, “of course, the HHS priority statement” released by OASH, which outlines the core “priorities that the NOFOs” and termination letters “refer to.” Id. at 50:11–22. The government thereby confirms that HHS has decided to impose a new set of programmatic requirements on TPP recipients, driven by policy priorities that the agency has set down on paper. Despite the government’s recognition that the FY 2026 NOFOs and mass grant termination decision stem from the same change in agency policy, the Court cannot wholly elide the distinction between these actions. Though they both implement the 2026 Policy, the FY 2026 NOFOs and grant terminations are unique in effect: One represents HHS’s forward- looking articulation of how grant funds will be allocated, while the other is a backward-looking decision to discontinue funding relationships with grant recipients based on non-compliance with 18 the agency’s new priorities. As Justice Barrett observed in her controlling concurrence in NIH, even if guidance and grant terminations “are linked, vacating the guidance does not necessarily void decisions made under it” or automatically entail the reinstatement of a terminated grant. 145 S. Ct. at 2661 (Barrett, J., concurring). That Plaintiffs have requested a preliminary order staying the implementation of the 2026 Policy, including both “the issuance of the 2026 NOFOs and the June 26, 2026[] terminations of [TPP] Program awards,” see Pls.’ Proposed Order for Prelim. Inj. Mot. at 1, reinforces that they seek two distinct forms of relief. The Court’s delineation of Plaintiffs’ challenge may evolve as the case develops. For purposes of resolving the present motion, however, the Court recognizes the existence of HHS’s overarching 2026 Policy, which mandates that TPP grantees operate abstinence-only, “body literacy”-focused pregnancy prevention programs that do not “normalize” teen sex or otherwise promote DEI or “gender ideology.” Yet it views the mass termination of existing TPP grants and issuance of the FY 2026 NOFOs as distinct, if interrelated, strategies for implementing that Policy. As we shall see, that distinction bears on the likely sweep of the Court’s jurisdiction. B. Likelihood of Success on the Merits 1. Jurisdictional Issues a. Article III Standing “For a lawsuit to constitute a case within the meaning of Article III, the plaintiff must have standing to sue,” and “[t]o demonstrate standing, plaintiffs must answer a basic question— What’s it to you?” Diamond Alt. Energy, LLC v. EPA, 606 U.S. 100, 110 (2025) (cleaned up). “In other words, plaintiffs must show that they possess a personal stake in the dispute and are not mere bystanders.” Id. at 110 (cleaned up). Standing, of course, has three elements: injury in fact, causation, and redressability. Lujan v. Defs. of Wildlife, 504 U.S. 555, 560–61 (1992). The 19 first element “requires the plaintiff to demonstrate an injury