How overturning Chevron deference could affect healthcare

The Supreme Court's conservative supermajority expressed willingness to roll back Chevron deference during hearings on two cases, CNN reported Jan. 17. 

Chevron deference stipulates that when disputes arise over regulation of an ambiguous law, judges should defer to federal agency interpretations so long as those interpretations are reasonable, according to the report. Chevron deference emerged from a 1984 court case. 

Justice Neil Gorusch argued that Chevron "is exploited against the individual in favor of the government," according to the report. The court's three liberal justices, on the other hand, argued that overturning the 1984 rulings would force courts to make policy decisions that are better left for experts at federal agencies. 

A rollback of Chevron deference could have "an enormous impact on the administration of federal programs — including Medicare, Medicaid and CHIP — that are crucial to public health," a coalition of healthcare organizations argued in a friend-of-the-court brief. Organizations signing the brief included the American Cancer Society, the National Health Law Program and the American Heart Association. 

The groups argued that the "competent and stable administration of these programs depends on the deep expertise of the agencies to which Congress has assigned the responsibility of promulgating rules and rendering interpretive decisions in connection with the implementation of these complex statutes, which serve nearly half the U.S. population, in every geographic region, of every income level, and with every kind of medical and care need.

"The disruption to the healthcare system that would occur during the transition to such a post-Chevron world — as litigants seek to reopen disputes involving dozens of programs and billions of dollars that were previously resolved through application of the Chevron doctrine —  would be enormous." 

Suhasini Ravi, an associate at Washington, D.C.-based Georgetown University's O'Neill Institute for National and Global Health Law, wrote in an October article that the "prospect of overruling Chevron is especially concerning in healthcare policy, where agencies must leverage their expertise to address emergencies, adapt to ever-changing technology and improve health outcomes."

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