Shifting Tides: How the Demise of the Chevron Doctrine Could Reshape Children’s Health Care

The U.S. Supreme Court’s recent decision to overturn the Chevron doctrine in Loper Bright Enterprises v. Raimondo marks a significant shift in how federal regulations, including those governing children’s health programs like Medicaid and the Children’s Health Insurance Program (CHIP), will be interpreted and challenged in the future.

For over 40 years, the Chevron doctrine required courts to defer to federal agencies’ reasonable interpretations of ambiguous statutes. This deference allowed agencies like the Centers for Medicare & Medicaid Services (CMS) to fill in gaps and ambiguities in legislation, leveraging the expertise of policy experts within CMS to implement and enforce regulations effectively. Now, with the Chevron doctrine overturned, courts will have more authority to interpret these laws independently, potentially leading to significant changes in how these crucial programs operate.

The impact on Medicaid and CHIP could be far-reaching:

• Increased legal challenges: We may see a surge in lawsuits challenging existing regulations and interpretations related to Medicaid and CHIP. These challenges could create uncertainty and potentially disrupt the stability of these programs that serve millions of children.

• Regulatory Uncertainty: Agencies have historically relied on Chevron deference to navigate and clarify ambiguous statutory language. The removal of this deference means that courts will now have the final say on statutory interpretations, which could lead to inconsistent rulings and a lack of clear guidance for agencies. This uncertainty may hinder the effective implementation of Medicaid and CHIP, potentially affecting coverage and services for children.

• Potential coverage gaps: Medicaid and CHIP often involve complex regulations and require CMS to interpret ambiguous statutory terms for coverage decisions. If courts interpret statutes differently from the way CMS has been implementing them, it could potentially narrow the scope of covered services and impact children’s access to essential health care through Medicaid and CHIP.

• Slower policy implementation: Without the protection of Chevron deference, federal agencies may become more cautious in issuing new rules or guidance. This wariness could slow down the implementation of new policies or improvements to Medicaid and CHIP.

• Impact on innovation: The Chevron reversal might keep agencies from responding to emerging health care needs or deploying new medical technologies within Medicaid and CHIP, as they hesitate to interpret existing laws to cover new scenarios without explicit Congressional approval.

• Increased role of Congress: With courts now having more say in interpreting statutes, Congress may need to be more specific and detailed when drafting legislation related to children’s health programs. This change could lead to more comprehensive but potentially slower legislative processes, affecting the timely delivery of health care services to children.

The Supreme Court only recently overturned the Chevron doctrine, and the full impact of this decision will unfold over time as new cases make their way through the courts. Health care providers, policymakers, and advocates for children’s health must closely monitor the way this change affects the interpretation and implementation of Medicaid and CHIP regulations. Advocacy groups and health care organizations will likely play an important role in helping to navigate this new landscape and ensure that children’s health needs remain a priority in policy discussions and legal interpretations moving forward.