After 40 years on the road, the so-called Chevron doctrine has been hit with a big, fat Uno Reverse card.

The Supreme Court made a historic ruling on June 28 when it overturned Chevron, which had been cited in 18,000+ court decisions over the years, including a 2019 case involving short-term health insurance plans.

The reversal of the doctrine has already come into play in at least one healthcare-related case this month, too. A federal judge in Mississippi ruled that the US Department of Health and Human Services (HHS) can’t enforce a rule banning healthcare providers from discriminating against patients based on gender identity and sexual orientation, citing Chevron’s overturning in his decision.

If you’re not sure what the ruling means or how it could affect the healthcare industry, never fear: Healthcare Brew has put together a handy explainer for you.

What’s the Chevron doctrine?

First, let’s start with a quick background on what the Chevron doctrine is (or was).

The Chevron deference doctrine came out of the 1984 Chevron v. Natural Resources Defense Council case, which questioned whether the Environmental Protection Agency had legally created regulations for pollution-emitting devices. At the time, the Supreme Court decided that if Congress passed a law that would be administered by a government agency, US federal courts must defer to the agency’s interpretation of the law, so long as that interpretation was “reasonable.”

The reasoning was that agencies had more expertise on complicated subjects, like health insurance, that may be included in some legislation. Plus, the court held that deferring to the agencies was appropriate because they’re part of the executive branch, which is accountable to voters, unlike federal courts that have appointed judges, according to Morgan Nighan, a partner in Nixon Peabody’s Complex Disputes practice, where she leads the law firm’s healthcare dispute resolution team.

Nighan told Healthcare Brew that Chevron was “fundamental to how policy gets made” in the US, and the doctrine has been the “gold standard” in how legal teams look at laws passed by Congress.

Keep reading here.—MA, CM

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The Supreme Court’s historic decision to overturn the 40-year-old Chevron doctrine may have ripple effects for virtually everyone in the US and disproportionately affect LGBTQ+ people, experts say.

Many regulations that protect queer people come in the form of federal agency rules, such as Section 1557 of the Affordable Care Act, which prohibits healthcare providers from discriminating against patients based on their sexual orientation or gender identity. In Chevron’s absence, however, agencies may have a harder time enforcing those rules if litigants attempt to challenge them in court.

The overruling opens the door for judges to decide that agencies don’t know best, experts say. “It’s this judge’s singular interpretation that matters [without Chevron], which can obviously be very problematic for LGBTQ folks and other marginalized communities that have really benefited from some of these regulations,” Timothy Wang, director of policy and advocacy at Chicago-based Howard Brown Health, an LGBTQ+-focused healthcare provider, told Healthcare Brew. Essentially, conservative judges and organizations that oppose transgender rights may have an easier time overturning healthcare protections in Chevron’s absence.

Keep reading here.—MA