Another Court Rules CASA Does Not Limit Universal Relief Available Under the APA

In Trump v. CASA, the Supreme Court significantly constrained the equitable authority of federal district courts to grant universal or nationwide injunctive relief, clarifying that, with specific exceptions, a federal court’s power to grant relief is limited to the parties before it. When it was issued, many bemoaned CASA’s implications for preventing government overreach.

And yet, as we wrote then, that reaction seemed premature. Plaintiffs filing cases against federal agencies typically do not need to rely on a court’s equitable authority to obtain relief: under the Administrative Procedure Act (APA), federal courts are authorized by statute to “set aside” unlawful or arbitrary agency action, which historically has been construed to mean the power to “vacate.” Given the remedy of vacatur, the practical effect of CASA was never as severe as the early punditry presaged. And, sure enough, post-CASA, courts around the country have consistently exercised their authority under the APA to both vacate unlawful or arbitrary agency action nationwide, and, pending a final decision, enjoin such action universally, preventing its application or implementation in all instances, not just for the plaintiffs bringing the lawsuit.

Healthcare organizations face constant regulatory changes from HHS, CMS, and other federal agencies affecting reimbursement, quality reporting, drug pricing, and operational requirements. The ability to challenge these regulations and obtain relief that applies industry-wide—not just to individual plaintiffs—is critical for ensuring regulatory certainty and avoiding costly, piecemeal litigation. A recent decision from Maine confirms that this powerful litigation tool remains available despite CASA's limitations. On December 29, 2025, Chief Judge Walker of the U.S. District Court for the District of Maine emphatically embraced the broad relief available under the APA notwithstanding the limitations of CASA. Am. Hosp. Ass’n, et al. v. Kennedy, et al., Civ. No. 2:25-cv-00600, Docket No. 90 (D. Me. Dec. 29, 2025). At issue was the lawfulness of a federal drug reimbursement program implemented by the U.S. Department of Health and Human Services (HHS). Bringing suit under the APA, the plaintiffs asked the court to “set aside” the program as arbitrary and capricious. Moreover, pending a final decision on the merits, the plaintiffs asked the court to preliminarily “stay” the program’s implementation.

HHS pushed back, defending the merits of its program but also arguing that even if preliminary relief were appropriate, CASA prevented the “universal” relief plaintiffs sought. The government’s argument, however, failed to account for the power granted federal courts under the APA, which authorizes them to “hold unlawful and set aside agency action” if the agency action is arbitrary, capricious, or unlawful. 5 U.S.C. § 706(2). And in aid of that ultimate relief, courts may “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.” Id. § 705. Preliminary relief under § 705 is subject to the same four-factor test as preliminary injunctions sought under Rule 65 of the Federal Rules of Civil Procedure, providing a statutory avenue for universal preliminary relief that makes universal injunctions under Rule 65 largely unnecessary in APA litigation.

Sure enough, in enjoining HHS’s implementation of the program, the district court emphasized that CASA “declined to resolve the distinct question whether the [APA] authorizes federal courts to vacate federal agency action.” Notably, the court referenced language from CASA itself, including Justice Kavanaugh’s concurrence acknowledging that district courts may still “grant or deny the functional equivalent of a universal injunction—for example, by . . . preliminarily setting aside or declining to set aside an agency rule under the APA.”

The court also cited both Supreme Court and circuit court authority recognizing that this “set aside” power is not restricted to the parties before the court, noting that the First Circuit had already declined to limit APA relief to identified association members. See Doe v. Trump, 157 F.4th 36, 80 (1st Cir. 2025). Accordingly, and relying on the APA’s text, the court concluded that CASA does not limit the APA’s traditional remedies and that preliminary or permanent vacatur need not be confined to the plaintiffs alone. Rather, the APA empowers federal courts to “hold unlawful and set aside agency action,” which includes the authority to vacate agency rules on a universal basis. 

This decision provides further confirmation that CASA does not curtail the broad remedial powers available to district courts under the APA unless and until the Supreme Court says otherwise.^[1]For organizations challenging federal regulations, this decision reaffirms the continued availability of universal vacatur and preliminary injunctions in APA cases. Entities affected by agency action should continue to consider APA litigation as an effective means of securing broad relief, and they should closely monitor further developments as courts and agencies respond to this evolving legal landscape.