The Supreme Court's decision will impact patients receiving care through Medicare, Medicaid, and CHIP.
The United States Supreme Court recently overturned the long-standing Chevron deference doctrine, which held that courts should defer to agency interpretations of statutes that fall under the particular agency's purview, when the interpretation is reasonable, and the meaning of a statute is not made explicitly clear by Congress.
Hospitals and health systems will now potentially have to wait through legal challenges to regulations that were previously determined by the many federal agencies that influence healthcare.
The 6-3 decision was made on June 28 to reverse the original ruling made in the landmark case Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., in 1984. It is now up to the courts to determine their own interpretations of ambiguous regulatory standards.
There are many unknowns about how this decision will ultimately play out, but the impact on federal agencies such as the EPA, FDA, and OSHA and their ability to regulate environmental, health, and safety matters is undeniable.
This decision will also potentially impact the healthcare industry in two key ways.
Access to public healthcare
An amicus brief, published in September 2023, warned that "overruling Chevron would have enormous impact on the administration of federal programs, including Medicare, Medicaid, and CHIP, that are critical to public health."
According to the brief, approximately 65 million Americans receive healthcare coverage through Medicare, while Medicaid and CHIP cover 90 million low-income children and adults and seniors with disabilities.
The brief was signed by the American Academy of Pediatrics, American Cancer Society, American Cancer Society Cancer Action Network, ALS Association, American Heart Association, American Lung Association, American Public Health Association, American Thoracic Society, Bazelon Center for Mental Health Law, Campaign for Tobacco-Free Kids, Child Neurology Foundation, Epilepsy Foundation, Muscular Dystrophy Association, National Health Law Program, Physicians for Social Responsibility, The Leukemia & Lymphoma Society, and Truth Initiative.
When Chevron was still in effect, the brief stated, courts deferred to the Centers for Medicare & Medicaid Services (CMS) to make policies that the agency needed to make while "plugging the interstitial gaps that inevitable arise as it administers the health insurance statues in a myriad of every-changing real-world settings."
In a press release published the day of the ruling, the organizations said they were disappointed in the Supreme Court's decision, saying Chevron has helped those organizations ensure that healthcare laws are "interpreted and implemented appropriately."
"We anticipate that today's ruling will cause significant disruption to publicly funded health insurance programs," the contributors said, "to the stability of this country's healthcare and food and drug review systems, and to the health and well-being of the patients and consumers we serve."
Decline in public health
The Supreme Court decision will also impact organizations such as the U.S Department of Health and Human Services (HHS), Occupational Safety and Health Administration (OSHA), Food and Drug Administration (FDA), and Environmental Protection Agency (EPA). The FDA, EPA, HHS and OSHA are responsible for regulating different aspects of safety and health, and by proxy have an impact on the healthcare industry.
The brief’s signees argued in favor of the importance of having experts interpret standards that will have that impact.
"As our amicus brief noted, large health programs such as Medicaid and Medicare, as well as issues related to the Food, Drug and Cosmetic Act, are extremely complex," they said in the press release. "So it is key that decisions about how to interpret and implement relevant laws are made by experts at government agencies."
Healthcare leaders and workers will likely feel the effects of this decision through the impact it will have on public health.
"As leading organizations that work on behalf of people across the country who face serious, acute and chronic illnesses, as well as many people who lack access to quality and affordable healthcare," the signees said, "we will continue to work to ensure that healthcare laws are implemented in ways that benefit the public health."
G Hatfield is the nursing editor for HealthLeaders.
KEY TAKEAWAYS
The United States Supreme Court overturned the Chevron deference doctrine which will leave the interpretation of ambiguous regulatory standards up to the courts rather than dedicated federal agencies.
Several American medical associations are disappointed with this decision, warning that it will significantly disrupt publicly funded healthcare programs and impact patient health and wellbeing.