Rule of Law

PFLAG v. Trump

In PFLAG v. Trump, the United States Court of Appeals for the Fourth Circuit is considering whether President Trump can legally cut off federal funding for institutions that provide gender-affirming medical care for people under age nineteen.

Case Summary

This case is about whether our Constitution, which grants the power of the purse to the people’s representatives in Congress, allows the President to unilaterally impose conditions on federal funding not found in any law.  The answer is no.

Yet shortly after taking office, President Trump issued an executive order commanding federal agencies to “immediately take appropriate steps to ensure that institutions receiving Federal research or education grants end” gender-affirming medical care for people under the age of nineteen. That order built upon another, which proclaimed that “[f]ederal funds shall not be used to promote gender ideology.” Together, these orders resulted in a sudden and devastating shutdown of medically necessary care for children and teenagers across the country experiencing gender dysphoria.

Advocates for LGBTQ families, health care professionals, and parents of young people receiving gender-affirming care challenged the administration’s actions in the United States District Court for the District of Maryland, which granted a preliminary injunction blocking the unlawful conditions. The government appealed to the United States Court of Appeals for the Fourth Circuit. In September 2025, CAC filed an amicus brief in the Fourth Circuit in support of the plaintiffs. Our brief made three principal points.

First, the Framers gave Congress control of appropriations and spending to guard against the risk of a tyrannical president. They took pains to deny the President the sweeping powers that the King of England had historically enjoyed, such as the power to spend without Parliament’s approval. By the time of the Constitutional Convention, there was a clear consensus that the legislative branch would have the power of the purse. In the Taxing and Spending Clause, the Framers granted Congress the affirmative power to raise revenue and to spend funds, while the Appropriations Clause limits the executive, stating that “[n]o Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.” The text of the Constitution is clear that the executive branch cannot make an end-run around the legislative process, including in the realm of spending and appropriations.

Second, for hundreds of years, Congress has passed federal legislation guarding its control of the purse. Since the earliest days of the Republic, when the Tenth Congress passed the Purpose Statue requiring appropriations to be “solely applied to the objects for which they are respectively appropriated,” Congress has made clear that the President cannot disobey its spending decisions. The Anti-Deficiency Act reiterates that the executive branch cannot make spending decisions outside of what is authorized by law. And after President Richard Nixon unlawfully refused to spend billions of dollars in federal appropriations, Congress passed the Impoundment Control Act of 1974 (ICA) to create special procedures the President must follow to seek congressional approval for delays or cancellations of federal funding. Recently, in response to the first Trump administration’s efforts to withhold foreign aid, Congress strengthened the ICA with new transparency requirements.

Third, the challenged executive orders violate the separation of powers by usurping Congress’s authority over spending and appropriations. Though Congress has the exclusive power to attach conditions to federal funding, it may delegate that authority to the executive branch through a statute. In this case, however, there is no statutory delegation, so the executive orders are lawful only if authorized by the Constitution itself. And, as discussed above, the Constitution requires that appropriations be “made by Law,” which is to say, through the constitutionally prescribe process of bicameralism and presentment. The President may not use an executive order to make an end-run around that process. To the contrary, the Constitution requires that the President “take Care that the Laws be faithfully executed,” even when he disagrees with those laws or thinks they should say something that they simply do not say.

The Fourth Circuit should reject President Trump’s attempt to seize Congress’s power of the purse.

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