Jan 17, 2024 - Health

How a SCOTUS challenge over federal power could affect health care

Illustration of the supreme court with an asterisk made of the ambulance symbol.

Illustration: Shoshana Gordon/Axios

A Supreme Court hearing on a case that could significantly curtail the federal government's regulatory power has big implications for America's health care system.

Why it matters: The justices on Wednesday are considering whether to overturn the 40-year-old legal doctrine known as the "Chevron deference," in which the courts have given leeway to federal agencies to reasonably interpret ambiguous laws or ones subject to multiple interpretations.

  • Chevron has long been targeted by the conservative legal movement that's supported deregulatory efforts.
  • If the doctrine is overturned — which Axios senior editor Sam Baker writes is likely — more federal rules will face closer scrutiny from the courts and are less likely to survive.

Details: The case itself involves a challenge to federal oversight of herring fishing, but health experts say a rollback of authority could ultimately hinder the administration of government insurance programs like Medicare and Medicaid that cover tens of millions of people, public health protections and scientific advancement.

  • Essentially, they argue that federal health agencies have the subject matter expertise and the ability to deal with a range of complex issues in a timely way that Congress simply does not.
  • "The prospect of overruling Chevron is especially concerning in health care policy, where agencies must leverage their expertise to address emergencies, adapt to ever-changing technology, and improve health outcomes," Suhasini Ravi of Georgetown's O'Neill Institute for National and Global Health Law writes in a roundup of what health experts have told the Supreme Court.

What they're saying: Overturning Chevron would unleash a wave of litigation against federal rules governing payments to health care providers that depend on the Chevron doctrine, the American Cancer Society wrote with consumer advocates, medical associations and legal experts.

  • "The resulting uncertainty would be extraordinarily destabilizing, not just to the Medicare and Medicaid programs but also — given the size of these programs — to the operational and financial stability of the country's health care system as a whole," they wrote.
Go deeper