Within a few weeks, the Supreme Court is likely to issue a ruling in two cases overturning or limiting the 40-year-old Chevron doctrine, which instructs courts to defer to “reasonable” federal agency statutory interpretations. Some commentators predict that such a ruling would result in disaster. Don’t believe them.

Health has historically been the province of state and local governments. Yet federal agencies now either spend money or issue regulations worth trillions of health dollars annually. The Centers for Medicare & Medicaid Services runs public insurance programs that cover more than a third of people insured in the U.S.; the Food and Drug Administration (FDA) regulates more than 20,000 drugs, 6,500 medical devices, and 100,000 tobacco products; and the Department of Veterans Affairs runs the Veterans Health Administration, the nation’s largest integrated health-care system, which operates 1,321 facilities and serves more than 9 million veterans.

The Chevron doctrine—set out in the 1984 ruling in Chevron U.S.A., Inc. v. NRDC—increased the level of deference accorded to federal agencies to interpret statutes and make regulations. The doctrine applies a two-step test. The first step asks whether Congress’s intent “is clear” and “unambiguously expressed.” If the statute is clear, then Congress’s unambiguous meaning controls. If the statute is ambiguous or silent, then the second step directs the court to defer to an agency’s reasonable interpretation (“permissible construction”) of the statute, even if the court would have chosen an alternative interpretation.

Subsequent decisions added “Chevron Step Zero”—a preliminary inquiry into whether the Chevron framework applies. It asks if Congress delegated authority to the agency to make rules carrying the force of law.

The Supreme Court rarely applies the Chevron doctrine to its cases (the last instance was in 2016). But lower courts continue to do so. That may soon change. The Court held oral arguments in January 2024 in two cases—Loper Bright Enterprises v. Raimondo and Relentless, Inc. v. Department of Commerce—in which it is expected to overturn or limit Chevron.

The lawsuits challenge a National Marine Fisheries Service regulation requiring fishing boat operators to pay on-board, private observers to conduct federally required compliance checks. The authorizing fishery-conservation statute was silent on who should pay for the monitoring. Lower appellate courts (the D.C. and First Circuits, respectively), citing Chevron, deferred to the agency’s “reasonable” interpretation of the statute.

Some commentators claim that health care is so complex that expert federal agencies need broad flexibility to issue regulations. Limiting Chevron deference would “disempower” federal agencies “from using their scientific expertise and real-world experience to interpret and administer public health statutes.”

Yet, during the Covid-19 pandemic, federal agencies’ purported scientific expertise was evidence-free, politically and personally motivated, dismissive of other points of view, and destructive of public trust. Some agency pronouncements, as Anthony Fauci admitted about the six-foot distancing rule, “sort of just appeared.” The Centers for Disease Control and Prevention (CDC) recommendations on masking and school reopening were more influenced by teachers’ unions than by randomized scientific trials.

Both before and during the pandemic, federal agencies repeatedly relied on Chevron to stretch the limits of their statutory authority in questionable ways. The Supreme Court has already relied on the major questions doctrine—a distinct doctrine that is related to Chevron steps zero and one—to strike regulations that have a significant economic and political impact absent clear authorization from Congress.

During the pandemic, the CDC issued a nationwide eviction moratorium under a provision of the Public Health Service Act, which authorizes federal officials to “make and enforce such regulations . . . necessary to prevent the introduction, transmission, or spread of communicable diseases.” The moratorium, which affected from 6 million to 17 million tenants, had dubious scientific basis. In Alabama Association of Realtors v. HHS (2021), the Supreme Court struck it down under the major questions doctrine because Congress had not explicitly authorized the CDC to make housing policy.

Similarly, in National Federation of Independent Business v. Department of Labor (2022), the Court held that an emergency temporary standard issued by the Occupational Safety and Health Administration (OSHA) that required employers to vaccinate or test 84 million employees nationwide was likely invalid. The Court held that Congress’s broad delegation to OSHA was “to set workplace safety standards, not broad public health measures.”

The sky did not fall after those two rulings, nor will it if Chevron gets reversed. Congress is capable of providing explicit authority for public health regulation.

In 1996, after years of expressly disavowing any such authority, the FDA claimed that the Food, Drug, and Cosmetic Act (FDCA) permitted regulation of nicotine as a drug and cigarettes and smokeless tobacco as drug delivery devices. The Supreme Court struck down the regulation in 2000. It held that Chevron deference “is premised on the theory that a statute’s ambiguity constitutes an implicit delegation from Congress to the agency to fill in the statutory gaps”—an unlikely presumption for major questions. The FDCA did not mention tobacco, while subsequent statutes did, suggesting that Congress had not intended the FDCA to give the FDA authority over tobacco products. Congress responded by adding explicit authority several years later.

Limiting Chevron may also enhance regulatory certainty. Currently, an agency’s reasonable interpretation of a statute can shift from one administration to another. Requiring Congress to be more explicit and shifting statutory interpretation from agencies back to the courts will alleviate that uncertainty.

Reversing or modifying Chevron will be key to restraining the ever-expanding administrative state. Even in health care, regulatory priorities should be set by Congress, not bureaucrats. And courts, not agencies, should be the ultimate interpreters of statutes.

Photo: Walter Bibikow / DigitalVision via Getty Images


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