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

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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 arent 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 Universitys ONeill Institute. One example could be challenges to the FDAs 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. Its going to open agencies up to attacks. Email Sign-Up

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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 Bidens 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 arent 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 courts 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 agencys scientific decisions.

The high courts ruling will be especially significant for the nations 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 dont go beyond the contours of the law.

The Supreme Courts 6-3 decision overturned Chevron U.S.A. v. Natural Resources Defense Council, which held that courts should generally back a federal agencys statutory interpretation as long as it was reasonable. Republicans have largely praised the new ruling as necessary for ensuring agencies dont overstep their authority, while Democrats said in the aftermath of the decision that it amounts to a judicial power grab.

Stephanie Armour: sarmour@kff.org Related Topics Courts Health Industry Medicaid Medicare Pharmaceuticals CDC CMS FDA Obamacare Plans Contact Us Submit a Story Tip

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Wes Streeting denies Labour has made ‘mistakes’ with ‘unpopular’ policies despite poor local election results

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Wes Streeting denies Labour has made 'mistakes' with 'unpopular' policies despite poor local election results

Health Secretary Wes Streeting has defended “unpopular” policies such as the cut to the winter fuel allowance despite Labour’s poor performance at the local elections.

Mr Streeting denied the government had made any mistakes when asked whether the policy was partly to blame for the party losing 189 council seats less than a year since the General Election.

Since coming into government last July, Labour has enacted a number of policies that were not in its manifesto.

These include means-testing winter fuel payments for pensioners, increasing employers’ national insurance contributions and slashing £5bn from the welfare bill.

Asked what mistakes his government had made so far that had led to its drubbing at the ballot box, Mr Streeting told Sunday Morning with Trevor Phillips: “Well, we will make plenty of mistakes.”

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Pressed again on whether he believed “mistakes” had been made, the health secretary replied: “No. When we made those choices, we knew they would be unpopular. And we knew that they would be opposed.

“The reason we made those choices is because we genuinely believe they’re the right choices to get the country out of the massive hole it was left in. And right across the board. Whether it’s the NHS, whether it’s schools, whether it’s prisons, whether it’s our defence and security, whether it’s crime and policing, there were enormous challenges facing this country when we came in.

“And we’ve had to make big and sometimes unpopular decisions so that we can face those challenges and deal with them. People might thank us if we just kind of go for the easy but we want to make the right choices.”

Some Labour MPs have urged the government to change direction, with one telling Sky News the cut to winter fuel was a “catastrophic error” that must be “remedied” if the party is to see any improvement in public opinion.

Others have warned that in courting Reform voters, the party risks fracturing its coalition of voters on the left who may be tempted by the Liberal Democrats and Green Party.

However, in the aftermath of the local elections, Sir Keir Starmer suggested the poor results meant he needed to go “further and faster” in delivering his existing agenda.

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Inside Reform’s election success

The real victor to emerge from Thursday’s local elections was Reform UK, which won control of 10 councils and picked up 677 council seats largely at the expense of the Conservatives in the south.

However, Reform also won the Runcorn by-election from Labour by just six votes, as well as control of Doncaster Council from Labour – the only local authority it had control of in this set of elections – in a significant win for Nigel Farage and his party.

The Reform UK leader declared that two-party politics was now “finished” and that his party was now the official “opposition” to Labour.

Asked whether the results meant that Labour would now treat Reform as “your most serious opposition”, Mr Streeting said: ” I certainly do treat them as a serious opposition force.”

“As I say, I don’t know whether it will be Reform or the Conservatives that emerge as the main threat,” he added.

“I don’t have a horse in that race, but like alien versus predator, I don’t really want either one to win.”

Read more:
Reform’s mission to ‘remoralise’ young people
Reform has put the two traditional parties on notice

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Reform UK are ‘fighting force’

Tory Party chairman Nigel Huddleston said Reform UK was not just a protest party and that Mr Farage was “a force in British politics”.

He told Trevor Phillips: “But the one thing about Nigel Farage is, and we’re seeing this again and again and again, he is a populist.

“He is increasingly saying everything that anybody wants to hear. He’s trying to be all things to all men.”

“We are establishing ourselves as a credible alternative government based on sound conservative principles and values and our values and our principles, and therefore our policies, will define the future of our party,” he added.

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It’s back: Hyundai IONIQ 5 qualifies for $7,500 tax credit – again!

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It's back: Hyundai IONIQ 5 qualifies for ,500 tax credit – again!

The Hyundai IONIQ 5 got a raft of upgrades and sporty, rally-focused XRT trim level for 2025 – but the biggest upgrade for the Made in America Hyundai might be this: the 5 has regained eligibility for the full $7,500 federal EV tax credit!

Despite being assembled at Hyundai’s Georgia meta plant for the last four month, the 2025 Hyundai IONIQ 5 was nowhere to be found on the EPA’s list of rebate-eligible vehicles. But that was then – with a fresh updated to the list coming online May 1st, Hyundai’s new-age electric hot hatch is back in the rebate game.

It’s worth noting that lease customers had been able to access the incentive under some circumstances, but this latest update to the EPA list makes it possible for cash and payment buyers to take advantage of the full Federal incentive, too – as long as they earn less than $300,000 as a married couple filing jointly, less than $225,000 as a head of household, or less than $150,000 as an individual.

With the $7,500 federal tax credit in the equation, you can get a new 2025 IONIQ 5 for somewhere in between $36,575 and $49,475, well under the $80,000 Federal MSRP cap.

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Victory lap

As if to celebrate, Hyundai announced that it was taking on the celebrate One Lap of America road rayy and race event in a factory collaboration with the track-focused enthusiasts at Grassroots Motorsports this week with One Lap veterans Andy Hollis and Tom Suddard campaigning a stock, 601 hp 2025 Hyundai IONIQ 5 N in the Alternative Fuels class.

“After winning our class in a gutted, caged race car last year, we wanted to compete in the best-of-all worlds this year: A vehicle that’s incredibly fast, incredibly comfortable on a road trip, and incredibly capable on a racetrack,” explains Suddard. “Electrification means it’s finally possible to have huge power without huge compromises in a street car, and the IONIQ 5 N promises to pair that huge power with the durability and capability to survive a week of racing.”

One Lap is widely regarded as one of the toughest street-legal motorsports events in the world, pitting amateur and professional drivers alike compete in stock and heavily modified vehicles of every description, battling it out in a series of scored challenges, including timed events at road courses, drag strips, skid pads, and autocross courses.

In between tracks, competitors safely travel thousands of miles around the country, proving the mettle and durability of the vehicles and the teams that drive them. This year, 86 teams from all over the country will compete in 17 scored events over the course of eight days at tracks like Virginia International Raceway and NCM Motorsports Park.

The Tire Rack One Lap of America is currently underway – you can track the Hyundai’s progress here, then let us know what you think of this new tax development in the comments.

SOURCES | IMAGES: Hyundai, One Lap of America; FuelEconomy.gov.


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It is ‘feasible’ Nigel Farage could be the next prime minister, says Kemi Badenoch

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It is 'feasible' Nigel Farage could be the next prime minister, says Kemi Badenoch

Kemi Badenoch has admitted it is “feasible” that Nigel Farage could become the next prime minister.

The Tory leader told the BBC’s Sunday With Laura Kuenssberg programme Mr Farage’s party was “expressing the feeling of frustration that a lot of people around the country are feeling” – but added it was her job to “come up with answers and solutions”.

Asked if it was feasible that Mr Farage could be the next prime minister, she cited how Australian Prime Minister Anthony Albanese had won re-election this weekend.

“As I said, anything is feasible,” she said. “Anthony Albanese: people were writing him off. He has just won a landslide, but my job is to make sure that he [Farage] does not become prime minister because he does not have the answers to the problems the country is facing.”

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Could Nigel Farage be prime minister?

Asked what Mr Farage was doing right, Ms Badenoch said: “He is expressing the feeling of frustration that a lot of people around the country are feeling.

“But he also doesn’t have a record in government like the two main parties do. Now he’s going to be running some councils. We’ll see how that goes.”

Mr Farage was the undoubted winner of Thursday’s local elections, in which 23 councils were up for grabs.

His party picked up 677 council seats and took control of 10 councils.

By contrast, the Conservatives lost 677 council seats as well as control of 18 councils in what was their worst local elections performance on record.

Mr Farage said the outcome spelt the end of two-party politics and that his party was now the official “opposition” to Labour – with the Tories having been rendered a “waste of space”.

Read more:
Reform has put the two traditional parties on notice

‘I get it’: Starmer responds after losing Runcorn by-election

Ms Badenoch said she believed the vote for Mr Farage on Thursday was partly down to “protest” but added: “That doesn’t mean we sit back. We are going to come out fighting.

“We are going to come out with the policies that people want to see, but what we are not going to do is rush out and tell the public things that are not true just so we can win votes.

“This is not about winning elections; this is about fixing our country. Yes, of course, you need to win elections to do that, but you also need a credible plan.”

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‘Farage is a force in British politics’

Conservative co-chairman Nigel Huddleston sought to play down the threat from Reform UK, telling Sky News: “When they’re in a position of delivering things, that’s when the shine comes off.”

He told Sunday Morning with Trevor Phillips: “The one thing about Nigel Farage is, and we’re seeing this again and again and again, he is a populist.

“He is increasingly saying everything that anybody wants to hear. He’s trying to be all things to all men.”

“We are establishing ourselves as a credible alternative government based on sound conservative principles and values and our values and our principles, and therefore our policies, will define the future of our party,” he added.

Asked whether the results meant that Labour would now treat Reform as “your most serious opposition”, Health Secretary Wes Streeting told Trevor Phillips: ” I certainly do treat them as a serious opposition force.”

“As I say, I don’t know whether it will be Reform or the Conservatives that emerge as the main threat,” he added.

“I don’t have a horse in that race, but like alien versus predator, I don’t really want either one to win.”

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