Last week, the U.S. Supreme Court (SCOTUS) returned from their summer recess with a slew of cases which could directly and indirectly impact health care and public health. Most cases before the Court come from conservative groups aiming to reign in the power of the federal government. A case from Texas seeks to overturn a bill passed by Congress in 1994 prohibiting those under domestic violence restraining orders from possessing a firearm. A closely-watched case aims to overturn the Food and Drugs Administration’s approval of abortion drugs. Another case wants to rid the federal government of independent funding and require Congress to specifically fund agencies and programs – such as Social Security and Medicare – through the appropriations process. And a fishing case seeks to upend the nearly 40-year-old Chevron Doctrine, which allows Agencies to reasonably interpret vague statutes.

Domestic Violence and Guns

In 1994, Congress passed legislation barring individuals under domestic violence restraining orders from possessing firearms. The suit was filed by a Texas man who was charged with illegal possession of a firearm whilst under a domestic violence restraining order after assaulting his girlfriend and threatening to shoot her. He seeks to overturn the law, claiming that it violates the second amendment of the U.S. Constitution. A lower court ruled the law violates the Constitution because it is inconsistent with “our nation’s historical tradition of firearm regulation.” The Biden Administration has appealed the decision to the Supreme Court where hearings are scheduled for November 7th.

FDA Approval of Abortion Pills

The Food and Drug Administration (FDA) first approved Mifeprex (mifepristone) in September 2000 for medical terminations of pregnancy through seven weeks gestation. Years after, the FDA made the drug more accessible by allowing its use up to 10 weeks’ gestation and by approving a generic form. Following the overturning of Roe v. Wade, the anti-abortion group, Alliance for Hippocratic Medicine (AHM), filed a lawsuit to overturn the FDA’s approval of the drug entirely and any actions made by the government to increase access to it. The district court ruled in favor of the AHM, effectively banning the drug until the Fifth Circuit Court of Appeals reinstated the approval through 10-weeks’ gestation. The Supreme Court has not set a hearing date for this case, but it is expected to be some time in 2024.

Independent Agency Funding

This case is brought by the Community Financial Services Association (CFSA), which is seeking to block rules from the Consumer Financial Protection Bureau (CFPB). They argue that Congress violated the Constitution’s appropriations clause when it granted the CFPB a portion of the Federal Reserve’s operating budget. The conservative-leaning Fifth Circuit Court of Appeals ruled in favor of the CFSA stating that only funds appropriated through the annual Congressional process are legal. If SCOTUS upholds this precedent, many essential governmental agencies and programs – including Social Security and Medicare – would see their independent funding vulnerable to partisan challenges in Congress. SCOTUS heard arguments on this case on October 3rd.

The Chevron Doctrine

In 1984, the Supreme Court set a precedent that courts must defer to a federal agency’s interpretation of an ambiguous statute, within reason. A group of commercial fishing companies filed a case against the National Marine Fisheries Service over a rule that the fishing industry must pay for the costs of observers to monitor compliance with fishery management plans. In the case, the group asks the Court to revisit the Chevron Doctrine. Overturning the Chevron Doctrine could have far-reaching impacts on how health care in the U.S. is governed. The Centers for Medicare and Medicaid Services (CMS) relies heavily on this Doctrine to interpret major statutes such as the Medicare Act and the Affordable Care Act. This case and others challenging the Doctrine also reference SCOTUS’ unanimous decision last year rejecting the Department of Health and Human Services’ 2018 payment cuts to 340B covered hospitals. While these cases are being brought by conservative groups in an attempt to dismantle the “administrative state,” the Trump administration relied heavily on this doctrine to enforce conservative health care policies as well.