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

Published

1 year ago

July 2, 2024

admin

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.

This story also ran on ABC News. It can be republished for free.

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

Subscribe to KFF Health News' free Morning Briefing. Your Email Address Sign Up

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

Politics

Clampdown on social media ads for Channel crossings unveiled

Published

2 hours ago

August 3, 2025

admin

Clampdown on social media ads for Channel crossings unveiled

Anyone who advertises Channel crossings or fake passports on social media could face up to five years in prison under new government plans.

Research suggests about 80% of migrants arriving to the UK by small boat used internet platforms during their journey – including to contact agents linked to smuggling gangs.

While it is already illegal to assist illegal immigration, ministers hope the creation of a new offence will give police more powers and disrupt business models.

Home Secretary Yvette Cooper is also planning to introduce a fast-track scheme to tackle the asylum backlog, meaning decisions will be made within weeks.

It comes as official figures show more than 25,000 people have arrived on small boats so far in 2025 – a record for this point in the year.

Ms Cooper said it is “immoral” for smugglers to sell false promises online, adding: “These criminals have no issue with leading migrants to life-threatening situations using brazen tactics on social media.

“We are determined to do everything we can to stop them, wherever they operate.”

The new offence prohibiting the online promotion of Channel crossings is set to be included in the Border Security, Asylum and Immigration Bill already going through Parliament.

Officials from the National Crime Agency already work with tech giants to remove such posts – with more than 8,000 taken offline last year.

A Preston-based smuggler who was jailed for 17 years had posted videos of migrants thanking him for his help.

Meanwhile, Albanian smugglers have created promotions for £12,000 “package deals” which claim to offer accommodation and a job in the UK on arrival.

The Conservatives have described the measures as “too little, too late” – and say automatic deportations are the only way to tackle small boat crossings.

Shadow home secretary Chris Philp said: “Labour still has no clear plan to deter illegal entry, no effective enforcement and no strategy to speed up removals. This is a panicked attempt to look tough after months of doing nothing.”

It comes as protests outside hotels believed to be housing asylum seekers continue in towns and cities across the UK.

Several demonstrators were detained – with police breaking up brief clashes – outside the Thistle City Barbican Hotel in north London yesterday.

The government is legally required to provide accommodation and subsistence to destitute asylum seekers while their claims are being decided, most of whom are prohibited from working.

World

Just 36 aid trucks entered Gaza yesterday, Palestinian officials claim – short of 600 needed

Published

2 hours ago

August 3, 2025

admin

Just 36 aid trucks entered Gaza yesterday, Palestinian officials claim - short of 600 needed

Just 36 aid trucks entered Gaza on Saturday – despite the humanitarian situation in the enclave worsening, Palestinian officials have warned.

According to the Gazan government’s media office, most of the humanitarian supplies were looted and stolen – “as a result of the state of security chaos that the Israeli occupation systematically and deliberately perpetuates”.

Officials say at least 600 truckloads of aid are required on a daily basis, adding: “The needs of the population are worsening.”

A statement released late last night called for “the immediate opening of crossings, and the entry of aid and infant formula in sufficient quantities” – and “condemned in the strongest terms the continuation of the crime of starvation”.

Israel’s prime minister, Benjamin Netanyahu, refuted this – and accused Hamas of “stirring up a slanderous propaganda campaign against Israel”.

He said: “The cruelty of Hamas has no boundaries. While the State of Israel is allowing the entry of humanitarian aid to the residents of Gaza, the terrorists of Hamas are deliberately starving our hostages and document them in a cynical and evil manner.

“The terrorists of Hamas are deliberately starving the residents of the Strip as well, preventing them from receiving the aid.”

It comes as the Palestinian Red Crescent in Gaza said its headquarters in Khan Younis were hit by an Israeli strike, killing one staff member and injuring three others.

Footage posted on social media shows a fire broke out in the building.

Indirect negotiations between Hamas and Israel for a 60-day ceasefire, and a deal for the release of half the hostages still held in Gaza, ended in deadlock last week.

US President Donald Trump’s Middle East envoy told the families of the hostages yesterday that he was working with the Israeli government on a plan that would end the war.

Steve Witkoff claimed that Hamas was willing to disarm to stop the conflict, despite the group’s repeated statements that it would not do so.

In response, Hamas said it would not disarm unless an independent Palestinian state is established with Jerusalem as its capital.

After Mr Witkoff’s meeting with the families of the hostages, Hamas released two videos of an emaciated Israeli hostage, Evyatar David, who was abducted from the Nova music festival on 7 October 2023 and has been held in captivity in Gaza since.

The 24-year-old looked skeletal, with his shoulder blades protruding from his back. He was heard saying that he had not eaten for three days. The distressing videos show him digging his own grave, he said in the footage.

World

Videos of emaciated Israeli hostage Evyatar David released by Hamas

Published

2 hours ago

August 3, 2025

admin

Videos of emaciated Israeli hostage Evyatar David released by Hamas

Two videos of an emaciated Israeli hostage, Evyatar David, have been released by Hamas, after US special envoy Steve Witkoff this week met with the families of the hostages.

The now 24-year-old looks skeletal, with his shoulder blades protruding from his back, and says he has not eaten for three days.

The distressing videos show him apparently digging his own grave.

He worked in a restaurant, according to a video posted by Labour Friends of Israel, before he was abducted from the Nova music festival on 7 October 2023.

Since then, he has been held in captivity in Gaza, and the videos suggest he is being kept in dark tunnels and surviving on scarce portions of lentils and beans.

Gaza itself is suffering “man-made mass starvation” because of Israel’s blockade on aid to the enclave, the head of the World Health Organization (WHO) has previously said.

In the second video, released on Saturday, Mr David – according to the English subtitles – says: “I haven’t eaten for three days.”

The captions continue as he speaks while in an underground tunnel: “There’s no [sic] enough food. I barely get drinking water.”

The video shows him talking through what he ate in July, which has been recorded on a handmade calendar hung up on the side of an underground Gaza tunnel.

Speaking while under captivity and under duress, he adds: “They give me what they can get.”

At the end of the video, he is digging a hole. The subtitle reads: “This is the grave where I think I’m going to be buried in. Time is running out.”

He then appears to break down, crouching on the floor and leaning his head on his arm while still clinging to the shovel.

In a statement, his family said: “We are forced to witness our beloved son and brother, Evyatar David, deliberately and cynically starved in Hamas’s tunnels in Gaza – a living skeleton, buried alive.

“Our son has only a few days left to live in his current condition.”

They added: “Israel and the international community must oppose Hamas’s cruelty and ensure that our Evyatar immediately receives proper nutrition.

“The intentional starvation, torture, and abuse of Evyatar for propaganda purposes violate even the lowest standards of humanitarian law and basic human decency.”

‘Famine’ looms in Gaza

On Friday, US special envoy Steve Witkoff visited a site where the US and Israel-backed Gaza Humanitarian Foundation (GHF) has been distributing food in Gaza.

The controversial GHF scheme has been widely condemned, including by the UK government, after fatal shootings ever since it was set up earlier this year.

According to the United Nations’ human rights office, at least 859 people have been killed “in the vicinity” of GHF aid sites since late May.

The Israel Defence Forces has repeatedly said it “categorically rejects the claims of intentional harm to civilians” and has blamed Hamas militants for fomenting chaos and endangering civilians.

Meanwhile, the UN’s Integrated Food Security Phase Classification (IFSPC) this week said a “worst-case scenario of famine” was sinking in across the besieged enclave.

It has also said more than 20,000 children have been treated for acute malnutrition since April.

Families of the 50 hostages still in Gaza are concerned they are also starving, and blame Hamas.

On Saturday, Gaza’s health ministry said a further seven Palestinians had died of malnutrition-related causes in the past 24 hours, including a child.