In this April 12, 2013 file photo, Health and Human Services (HHS) Secretary Kathleen Sebelius testifies on Capitol Hill in Washington. State officials say thousands of people with medical problems are in danger of losing coverage as the Obama administration winds down one of the earliest programs in the federal health care overhaul. At risk is the Pre-Existing Condition Insurance Plan, a transition program that has turned into a lifeline for the so-called "uninsurables" _ people with serious medical conditions who can't get coverage elsewhere. The health care law capped spending on the program, and now money is running out.National Journal

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On Tuesday, Health and Human Services Secretary Kathleen Sebelius told a congressional panel she would not interfere in the lung-transplant decision of a 10-year-old girl dying of cystic fibrosis. Wednesday, a federal judge ordered her to do just that.

The order provides an exception to what is known as the "under-12 rule" of the Organ Procurement and Transplantation Network, which says that children under 12 should be deferred on waiting lists for adult organs. But here's the thing: As rare as intact adult organs are to come by for transplantation, the chances of finding a child-sized body part are even slimmer. Sarah Murnaghan, the girl at the center of this legal battle, has been on the waiting list for a child's lungs since 2011.

"I'm begging you."¦ She has three to five weeks to live. Please suspend the rules," Rep. Lou Barletta, R-Pa., urged Sebelius at the ruling. While the secretary has said she wants the policy to be reviewed, in this case, she deferred the transplant decisions to the medical community. "The worst of all worlds, in my mind, is to pick and choose who lives and who dies," she said.

So the parents sued early Wednesday morning, and the judge issued the order before the close of business the same day. Here's an excerpt, with none-too-kind words for the secretary:

The Plaintiffs contend "¦ the Secretary's refusal to set aside the Under 12 Rule to protect the very few children nationally who are subject to it, despite evidence showing that the Rule discriminates against children and serves no purpose, is arbitrary, capricious, and an abuse of discretion.

Read the entire court order here. Sarah Murnaghan still may not get a lung, but now she will be considered the same as an adult waiting for one. The order lasts for 10 days; a hearing for a continued injunction will be held June 14.

This article is from the archive of our partner National Journal.

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