“Coffee shop” doesn’t quite have the same ring to it. Regardless, the trio found they had a lot to talk about. Last week, the U.S. Supreme Court heard oral arguments on the judicial precedent known as the “Chevron Doctrine,” which dictates that courts facing ambiguous legislative language should defer to the interpretations of the administrative agencies, as long as that interpretation is reasonable. When a statute is unclear, a federal Agency will often rely on internal knowledge and on input from subject matter experts to help develop the regulations defining and implementing the statute. Now, the once Republican-championed doctrine has become the target of some conservatives aiming to dismantle what they call the “administrative state.” Supporters of the Chevron Doctrine disagree; they argue that the Chevron Doctrine is critical to maintaining “competent, stable, and consistent administration” of Medicare, Medicaid and the Children’s Health Insurance Program (CHIP). Today, the Court is poised to decide two separate cases asking the Court to overturn Chevron.

What does this mean for health care?

In a friends-of-the-court brief, patient advocates argue that the stability and competency of programs such as Medicare, Medicaid and CHIP relies 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.”

The brief stresses the regulatory burden that would be shifted to Congress if the doctrine is reversed, potentially delaying action on important issues impacting health care, and that it would be impractical and unrealistic to rely on Congress to regularly draft and update health insurance statutes with the “speed, technical granularity, and prescience needed to anticipate and plug every conceivable statutory hole” which may appear when implemented. Apart from destabilizing the administration of U.S. health care, reversing Chevron could reopen countless disputes previously resolved through its framework.

How did we get here in the first place?

Since its inception, the Chevron Doctrine has become of the most influential judicial precedents with well over 18,000 citations in federal courts – possibly the most cited case in U.S. administrative law. In 1981, the Environmental Protection Agency (EPA), under the Reagan Administration, changed its interpretation of the word “source” in the Clean Air Act of 1963, which the act did not define. This change significantly narrowed the scope of the definition, allowing companies to bypass EPA regulations when building new projects. When the issue was brought before the Supreme Court, it ruled 6-0 in favor of the Reagan Administration; a ruling hailed by Republicans in the deregulation movement and believed to prevent liberal justices from interpreting statutes according to their own ideologies. In his opinion, then-Associate Justice John Paul Stevens wrote:

“When a challenge to an agency construction of a statutory provision, fairly conceptualized, really centers on the wisdom of the agency’s policy, rather than whether it is a reasonable choice within a gap left open by Congress, the challenge must fail. In such a case, federal judges—who have no constituency—have a duty to respect legitimate policy choices made by those who do.”

Since then, the Chevron doctrine has been used by both republican and democratic administrations to achieve policy goals through regulatory action and to sometimes bypass an increasingly dysfunctional Congress. Cases were brought to the Court by conservative advocacy groups representing commercial fishing groups. The groups contest federal regulations requiring fishing vessel operators to pay for having observers on the boats to enforce fishing quota rules. They argue that since Congress didn’t explicitly authorize the federal agency to make them pay for the cost of federal observers, the agency therefore cannot require them to pay. They also state that Chevron shifts constitutional powers allocated to Congress over to the Executive branch and disallows the judiciary from exercising its own judgment in individual cases.

What should we expect?

During the hearings last week, the Court’s conservative super-majority seemed agreeable to reversing the Chevron doctrine, or at least, trimming it back. Some of the justices noted that the doctrine has not been employed by the Court since 2016; and that it leaves legislative interpretations vulnerable to the political whimsy of the administration of the day.