Kaiser Health News

The Supreme Court Just Limited Federal Power. Health Care Is Feeling the Shockwaves.

Published

1 week ago

July 1, 2024

Stephanie Armour
Mon, 01 Jul 2024 15:30:00 +0000

A landmark Supreme Court decision that reins in federal agencies' authority is expected to hold dramatic consequences for the nation's health care system, calling into question government rules on anything from consumer protections for patients to drug safety to nursing home care.

The June 28 decision overturns a 1984 precedent that said courts should give deference to federal agencies in legal challenges over their regulatory or scientific decisions. Instead of giving priority to agencies, courts will now exercise their own independent judgment about what Congress intended when drafting a particular law.

The ruling will likely have seismic ramifications for health policy. A flood of litigation — with plaintiffs like small businesses, drugmakers, and hospitals challenging regulations they say aren't specified in the law — could leave the country with a patchwork of disparate health regulations varying by location.

Agencies such as the FDA are likely to be far more cautious in drafting regulations, Congress is expected to take more time fleshing out legislation to avoid legal challenges, and judges will be more apt to overrule current and future regulations.

Health policy leaders say patients, providers, and health systems should brace for more uncertainty and less stability in the health care system. Even routine government functions such as deciding the rate to pay doctors for treating Medicare beneficiaries could become embroiled in long legal battles that disrupt patient care or strain providers to adapt.

Groups that oppose a regulation could search for and secure partisan judges to roll back agency decision-making, said Andrew Twinamatsiko, director of the Health Policy and the Law Initiative at Georgetown University's O'Neill Institute. One example could be challenges to the FDA's approval of a medication used in abortions, which survived a Supreme Court challenge this term on a technicality.

“Judges will be more emboldened to second-guess agencies,” he said. “It's going to open agencies up to attacks.”

Regulations are effectively the technical instructions for laws written by Congress. Federal agency staffers with knowledge related to a law — say, in drugs that treat rare diseases or health care for seniors — decide how to translate Congress' words into action with input from industry, advocates, and the public.

Up until now, when agencies issued a regulation, a single rule typically applied nationwide. Following the high court ruling, however, lawsuits filed in more than one jurisdiction could result in contradictory rulings and regulatory requirements — meaning health care policies for patients, providers, or insurers could differ greatly from one area to another.

One circuit may uphold a regulation from the Centers for Disease Control and Prevention, for example, while other circuits may take different views.

“You could have eight or nine of 11 different views of the courts,” said William Buzbee, a professor at Georgetown Law.

A court in one circuit could issue a nationwide injunction to enforce its interpretation while another circuit disagrees, said Maura Monaghan, a partner at Debevoise & Plimpton. Few cases are taken up by the U.S. Supreme Court, which could leave clashing directives in place for many years.

In the immediate future, health policy leaders say agencies should brace for more litigation over controversial initiatives. A requirement that most Affordable Care Act health plans cover preventive services, for example, is already being litigated. Multiple challenges to the mandate could mean different coverage requirements for preventive care depending on where a consumer lives.

Drugmakers have sued to try to stop the Biden administration from implementing a federal law that forces makers of the most expensive drugs to negotiate prices with Medicare — a key cog in President Joe Biden's effort to lower drug prices and control health care costs.

Parts of the health care industry may take on reimbursement rates for doctors that are set by the Centers for Medicare & Medicaid Services because those specific rates aren't written into law. The agency issues rules updating payment rates in Medicare, a health insurance program for people 65 or older and younger people with disabilities. Groups representing doctors and hospitals regularly flock to Washington, D.C., to lobby against trims to their payment rates.

And providers, including those backed by deep-pocketed investors, have sued to block federal surprise-billing legislation. The No Surprises Act, which passed in 2020 and took effect for most people in 2022, aims to protect patients from unexpected, out-of-network medical bills, especially in emergencies. The high court's ruling is expected to spur more litigation over its implementation.

“This really is going to create a tectonic change in the administrative regulatory landscape,” Twinamatsiko said. “The approach since 1984 has created stability. When the FDA or CDC adopt regulations, they know those regulations will be respected. That has been taken back.”

Industry groups, including the American Hospital Association and AHIP, an insurers' trade group, declined to comment.

Agencies such as the FDA that take advantage of their regulatory authority to make specific decisions, such as the granting of exclusive marketing rights upon approval of a drug, will be vulnerable. The reason: Many of their decisions require discretion as opposed to being explicitly defined by federal law, said Joseph Ross, a professor of medicine and public health at Yale School of Medicine.

“The legislation that guides much of the work in the health space, such as FDA and CMS, is not prescriptive,” he said.

In fact, FDA Commissioner Robert Califf said in an episode of the “Healthcare Unfiltered” podcast last year that he was “very worried” about the disruption from judges overruling his agency's scientific decisions.

The high court's ruling will be especially significant for the nation's federal health agencies because their regulations are often complex, creating the opportunity for more pitched legal battles.

Challenges that may not have succeeded in courts because of the deference to agencies could now find more favorable outcomes.

“A whole host of existing regulations could be vulnerable,” said Larry Levitt, executive vice president for health policy at KFF.

Other consequences are possible. Congress may attempt to flesh out more details when drafting legislation to avoid challenges — an approach that may increase partisan standoffs and slow down an already glacial pace in passing legislation, Levitt said.

Agencies are expected to be far more cautious in writing regulations to be sure they don't go beyond the contours of the law.

The Supreme Court's 6-3 decision overturned Chevron U.S.A. v. Natural Resources Defense Council, which held that courts should generally back a federal agency's statutory interpretation as long as it was reasonable. Republicans have largely praised the new ruling as necessary for ensuring agencies don't overstep their authority, while Democrats said in the aftermath of the decision that it amounts to a judicial power grab.

——————————
By: Stephanie Armour
Title: The Supreme Court Just Limited Federal Power. Health Care Is Feeling the Shockwaves.
Sourced From: kffhealthnews.org/news/article/supreme-court-chevron-deference-doctrine-health-care-policy-shockwaves/
Published Date: Mon, 01 Jul 2024 15:30:00 +0000

Post Views: 40

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Kaiser Health News

Planned Parenthood to Blitz GOP Seats, Betting Abortion Fears Can Sway Voters

Published

8 hours ago

July 8, 2024

Staff Editor

Molly Castle Work
Mon, 08 Jul 2024 09:00:00 +0000

Planned Parenthood is preparing a seven-figure campaign blitz to oust GOP incumbents from California congressional seats, part of a larger national effort by the reproductive rights group to prevent a Republican majority from passing abortion restrictions, including a national ban.

Planned Parenthood Affiliates of California is targeting eight districts where voters largely backed Republicans in 2022 even as they endorsed a constitutional amendment enshrining access to abortion and contraceptives. The advertising plan goes negative by focusing on each incumbent's record of voting against access to abortion and contraceptives. In the past, the group riffed on the “Burn Book” from the 2004 comedy “Mean Girls.”

GOP party officials said they were confident voters in those districts would look at the bigger picture and return Republicans to office. And one incumbent dismissed the notion that there's a threat to reproductive care in the Golden State.

“Access to abortion and other reproductive care aren't going anywhere in California,” said Calvin Moore, a spokesperson for Rep. Ken Calvert of Riverside County. “Congressman Calvert believes this is a deeply personal issue that should be left up to the states and opposes a national abortion ban.”

With 52 seats, liberal California could tip the scales for control of the U.S. House this fall. But Planned Parenthood has its work cut out for it since seven of the seats it is targeting are currently held by Republicans and only one — to be vacated by Democrat Katie Porter after an unsuccessful bid for U.S. Senate — is open.

According to The Cook Political Report, four are toss-up races; Rep. Michelle Steel's district, mostly in Orange County, leans Republican; and Reps. Kevin Kiley, who represents a district along California's eastern border, and Young Kim, who represents a district east of Anaheim, are likely to win.

Abortion has proved to be a bigger issue for many voters than political analysts may have anticipated. “In many of these seats, I think voters care about their reproductive freedoms and they resonate with our message, so we think we're going to win,” said Jodi Hicks, CEO and president of Planned Parenthood Affiliates of California.

While Planned Parenthood is focused on House races, Hicks said it is also monitoring neighboring states. One California branch, Planned Parenthood Mar Monte, stretches into Reno, Nevada, and its advocacy arm has been actively supporting a Nevada ballot initiative that would constitutionally protect Nevadans' right to abortion.

Nationally, the group plans to spend $40 million in at least eight states: Arizona, Georgia, Montana, New Hampshire, New York, North Carolina, Pennsylvania, and Wisconsin.

In California, Planned Parenthood aims to highlight the record of members of Congress like Kiley, who voted to potentially impose prison sentences on doctors who provide abortions. Calvert, Kim, Steel, and Reps. Mike Garcia, of northern Los Angeles County, and David Valadao, of the Central Valley, voted against access to birth control. And Garcia, Valadao, and Steel co-sponsored a bill to effectively ban abortions nationwide.

Assembly Republican leader James Gallagher, who is on the California Republican Party board, said many Californians don't trust Democrats to protect their health care rights even if political leaders support abortion being legal, pointing out that under Democrats maternity wards have closed and hospitals have filed for bankruptcy.

“Democrats don't really have a great record in California right now on women's health care issues,” Gallagher said. “So I think it just rings a little bit hollow.”

According to a February KFF poll on abortion as a 2024 election issue, about half of Republican voters who support it being legal trust their own party more on the issue, while 8% trust the Democratic Party more. One in three said they don't trust either political party on the issue.

Ivy Cargile, an associate professor of political science at California State University-Bakersfield, said it may be tricky to galvanize voters on the issue since many Californians are confident their reproductive rights are protected in the deep-blue state. “Voters might be thinking that California is so progressive, so reproductive rights are safe,” Cargile said. “But federal law does trump state law.”

Planned Parenthood will impress upon Central Valley and Southern California voters that remaining loyal to Republicans risks a national abortion ban. A large part of its advertising campaign will focus on connecting the dots for voters, arguing support for reproductive rights requires voting for Democratic candidates.

“California is so pivotal to ensure that we're winning at the national level,” Hicks said.

Gallagher said the GOP's focus on inflation and public safety will resonate with voters in California's more conservative districts. He and Calvert predict the races will mirror what happened in 2022: Though voters backed the constitutional amendment for reproductive rights, they supported incumbent Republicans, even those who were anti-abortion.

California Healthline spoke to six voters in Garcia's district who say they support access to abortion but typically vote for Republican candidates. All six planned to vote for Garcia's reelection.

Rose Large of Santa Clarita said that while she supports abortion rights, she has deeper concerns with Democratic Party leadership on issues such as the economy and border control. Others mentioned fears of rising crime and wanting to protect Second Amendment rights.

Asked if she believed Planned Parenthood's campaign would sway her or voters in her neighborhood, Large replied, “Personally, I don't. No.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

——————————
By: Molly Castle Work
Title: Planned Parenthood to Blitz GOP Seats, Betting Abortion Fears Can Sway Voters
Sourced From: kffhealthnews.org/news/article/planned-parenthood-ad-blitz-us-house-of-representatives-races-california/
Published Date: Mon, 08 Jul 2024 09:00:00 +0000

Post Views: 14

Kaiser Health News

Abortion and the 2024 Election: A Video Primer

Published

10 hours ago

July 8, 2024

Staff Editor

Julie Rovner, KFF Health News and Rachana Pradhan
Mon, 08 Jul 2024 09:00:00 +0000

More than a dozen states are weighing abortion-related ballot measures to be decided this fall, most of which would protect abortion rights if passed. KFF Health News' Julie Rovner and Rachana Pradhan explain what's at stake in the 2024 election, both at the national and state levels.

Find more of our abortion coverage here.

Credits

Hannah Norman
Video producer & animator

Oona Tempest
Art director & illustrator

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By: Julie Rovner, KFF Health News and Rachana Pradhan
Title: Abortion and the 2024 Election: A Video Primer
Sourced From: kffhealthnews.org/news/article/abortion-2024-election-video-primer/
Published Date: Mon, 08 Jul 2024 09:00:00 +0000

Post Views: 11

Kaiser Health News

KFF Health News’ ‘What the Health?’: SCOTUS Term Wraps With a Bang

Published

5 days ago

July 3, 2024

Staff Editor

Wed, 03 Jul 2024 14:30:00 +0000

The Host

Julie Rovner
KFF Health News

@jrovner

Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

It was a busy year for health-related cases at the Supreme Court. Among other issues, the justices grappled with two abortion cases, a separate case touching on the opioid epidemic, and a case challenging whether localities can bar homeless people from sleeping in public spaces. Also, the court struck down a decades-old precedent that could dramatically change how the federal government oversees health care and other types of policy.

In this special episode of “What the Health?”, Sarah Somers, legal director of the National Health Law Program, joins KFF Health News' chief Washington correspondent, Julie Rovner, to discuss how the justices disposed of the term's health-related cases and what those decisions could mean going forward.

A Summary of the Cases

On the functioning of government:

Loper Bright Enterprises v. Raimondo, challenging the “Chevron doctrine” that required courts to defer in most cases to the expertise of federal agencies in interpreting laws passed by Congress.

Corner Post Inc. v. Board of Governors of the Federal Reserve System, challenging the statute of limitations for bringing a case against a federal agency's actions.

On abortion:

Food and Drug Administration v. Alliance for Hippocratic Medicine, challenging the FDA's approval of the abortion pill mifepristone.

Moyle v. United States and Idaho v. United States, about whether the federal Emergency Medical Treatment and Active Labor Act requirement that hospitals participating in Medicare provide the care needed to stabilize a patient's condition overrides Idaho's near-complete abortion ban when a pregnant patient experiences a medical emergency.

On other health issues:

Harrington v. Purdue Pharma, about whether federal bankruptcy law can shield an entity from future claims without the consent of all claimants.

City of Grants Pass v. Johnson, about whether banning sleeping in public subjects those with no other place to sleep to “cruel and unusual punishment” under the U.S. Constitution.

Previous “What the Health?” Coverage of These Cases:

“SCOTUS Ruling Strips Power From Federal Health Agencies,” June 28

“SCOTUS Rejects Abortion Pill Challenge — For Now,” June 13

“Waiting for SCOTUS,” May 30

“Abortion — Again — At the Supreme Court,” April 25

“The Supreme Court and the Abortion Pill,” March 28

“Health Enters the Presidential Race,” Jan. 25

“The Supreme Court vs. the Bureaucracy,” Jan. 18

Credits

Francis Ying
Audio producer

Emmarie Huetteman
Editor

To hear all our podcasts, click here.

And subscribe to KFF Health News' “What the Health?” on Spotify, Apple Podcasts, Pocket Casts, or wherever you listen to podcasts.

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Title: KFF Health News' ‘What the Health?': SCOTUS Term Wraps With a Bang
Sourced From: kffhealthnews.org/news/podcast/what-the-health-354-supreme-court-term-wrap-july-3-2024/
Published Date: Wed, 03 Jul 2024 14:30:00 +0000

Post Views: 86