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American Dental Education Association


Volume 3, No. 49, July 3, 2024

Supreme Court Overturns Chevron Case, Limits Powers of Federal Agencies
 
In a landmark decision on June 28, the U.S. Supreme Court issued a 6-3 opinion [ [link removed] ] in Loper Bright Enterprises et al. v. Raimondo (Loper Bright), overturning the deference doctrine established in Chevron USA Inc. v. Natural Resources Defense Council. It marks a significant shift in the balance of power among executive agencies, Congress and the courts. The implications of this ruling could have substantial ramifications for how preventive health care services are mandated and covered under federal law in the future.
 
Chevron had long stood as a cornerstone of administrative law, requiring courts to defer to agencies' interpretations of ambiguous statutes if they were deemed reasonable. This principle, applied in countless regulatory decisions over decades, allowed agencies substantial leeway in implementing laws related to such areas as environmental protection, health care and consumer safety. The 6-3 decision—split along ideological lines—now mandates that courts must independently evaluate whether agencies have stayed within their statutory authority, effectively reducing agency discretion and potentially exposing existing regulations to legal challenges. The decision will not be applied retroactively.
 
Chief Justice John G. Roberts Jr., writing for the majority, argued that Chevron had become impractical and led to undue judicial deference. He asserted that courts should exercise more scrutiny over agency actions to ensure they align closely with legislative intent.
 
The implications of the decision are far-reaching. It is expected to lead to challenges to a wide array of federal regulations that were previously shielded by Chevron deference. This includes regulations crucial for maintaining environmental standards, public health measures and consumer protections. The dissenting justices, notably Justice Elena Kagan, warned that the ruling could destabilize settled legal interpretations and create a volatile environment where previously accepted regulatory practices could be subject to abrupt legal challenges, potentially disrupting industries and public policy implementation.
 
To quell concerns of possible retroactive impact, Chief Justice Roberts wrote that the retroactive impact of Friday’s decision will be limited, saying that regulations upheld by courts under Chevron cannot be challenged based solely on the overturning of the Chevron case.
 
Overall, the Supreme Court's decision could have profound implications for how regulations are crafted, implemented and enforced in the future. The ruling underscores a shift towards stricter judicial scrutiny of agency actions, marking a significant departure from previous deferential norms and setting the stage for continued legal battles over the interpretation and application of federal regulations across various sectors.

Appeals Court Upholds ACA’s Preventative Care Mandate for Most Americans, but Leaves Opening for Future Legal Challenges
 
The 5th U.S. Circuit Court of Appeals has ruled [ [link removed] ] that the United States Preventive Services Task Force (USPSTF), created under the 2010 health care law, is unconstitutional. However, the Court's decision does not immediately affect access to preventive care for most Americans. The ruling specifically addresses a group of Texas businesses who objected to the law's requirement that insurers cover certain preventive care services without cost-sharing, such as the HIV preventative drug PrEP, lung cancer screenings and breast cancer medications.
 
The Court's decision acknowledged the plaintiffs’ objections that the USPSTF lacks congressional confirmation and, therefore, should not be binding. The Court concluded that the USPSTF's authority to make unreviewable recommendations effectively makes its members principal officers under the Constitution, a status that requires Senate confirmation.
 
Despite the ruling, access to preventive care remains, at least for now, protected for the vast majority of Americans. The Court's decision only allows the plaintiffs, the Texas businesses involved in the case, to avoid providing coverage without cost-sharing. For everyone else, the coverage mandate remains unchanged.
 
Further litigation is likely. The plaintiffs in this case did not bring a challenge under the Administrative Procedures Act (APA). However, the 5th Circuit said a nationwide injunction could be allowed under such a challenge.
 
The Court also directed Judge Reed O'Connor of the U.S. District Court for the Northern District of Texas to consider challenges against the constitutionality of mandatory preventative care coverage recommendations from the Advisory Committee on Immunization Practices (ACIP) and the Health Resources and Services Administration (HRSA), which recommends vaccines, contraceptives and other preventive services. O'Connor had originally rejected the plaintiffs' challenges to ACIP and HRSA, but the Appeals Court said, "if [these challenges] were left unconsidered, [it] could lead to an incorrect result with respect to the plaintiffs' unconstitutional challenges."

Canada’s Federal Dental Plan Opens to All Children Under 18 and Adults with Disabilities
 
On June 27, Canadian Dental Care Plan [ [link removed] ] opened to all children under the age of 18 and adults with a disability tax credit certificate. The plan covers a range of specified diagnostic and preventative services, basic services, major services, anesthesia, sedation and orthodontic services.
 
The program, which opened to children under age 12 whose families earn less than $90,000 CAD in 2023, completed a gradual rollout [ [link removed] ] that granted coverage to income-eligible individuals over the age of 65 and income eligible children under the age of 18. By 2025, the program will expand eligibility to anyone who makes less than $90,000 CAD.
 
Although the plan is currently being implemented across the country, officials from Alberta have indicated plans to withdraw [ [link removed] ] by 2026. According to those officials, the federal program duplicates coverage that is already available to many in the province, and “it would be more effective to expand existing provincial programs than to introduce a new federal plan.”

Colorado Moves Toward Adopting “Food as Medicine” Policy for Medicaid Enrollees
 
In early June, Colorado Gov. Jared Polis (D) signed a bill [ [link removed] ] that requires the state’s Department of Health Care Policy & Financing to conduct a feasibility study that explores seeking a federal waiver to provide nutrition, housing and tenant supportive services that address Medicaid enrollee’s health-related social needs. The Department is required to submit the study's findings to the Colorado General Assembly’s joint Budget Committee on or before Nov. 10, 2024.
 
The nutrition-related services aspects of the study are required to consider costs and implementation factors related to:
 • Providing up to three medically tailored meals per day, for up to six months with the possibility of continuing the meals delivered to the home of a Medicaid enrollee who has an eligible health-related medical or health-related social need;
 • Pantry stocking or providing up to three meals per day that are delivered to an enrollee’s home or other private residence for a child or youth under 21 years of age or a pregnant person for up to six months;
 • Providing for up to six months of nutrition prescriptions targeted to medically vulnerable populations and tailored to an enrollee’s health and social risk or nutrition-sensitive health conditions or the nutrition prescriptions have a demonstrated outcome improvement, including fruit and vegetable prescriptions and protein boxes; and
 • Coordinating with state agencies and county departments to connect members experiencing food insecurity to other state and federal nutrition programs, including the federal Special Supplemental Food Program for Women, Infants, and Children (WIC), the Supplemental Nutrition Assistance Program (SNAP) and the Temporary Assistance for Needy Families (TANF) program.

“Food as medicine” and nutrition service policies have gained traction [ [link removed] ] in state legislatures this year as five other states are actively considering policies.

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ADEA Advocacy in Action
This appears weekly in the ADEA Advocate to summarize and provide direct links to recent advocacy actions taken by ADEA. Please let us know what you think and how we might improve its usefulness.
 
Issues and Resources
 • ADEA report [ [link removed] ] on teledentistry
 • ADEA report [ [link removed] ] on the Impact of the COVID-19 Pandemic on U.S. Dental Schools
 • ADEA policy brief [ [link removed] ] regarding overprescription of antibiotics
 • For a full list of ADEA memos, briefs and letters click here [ [link removed] ] .

Key Federal Issues [ [link removed] ]

ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ]

Key State Issues [ [link removed] ]

The ADEA Advocate [ [link removed] ] is published weekly. Its purpose is to keep ADEA members abreast of federal and state issues and events of interest to the academic dentistry and the dental and research communities.
 
©2024
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
Tel: 202-289-7201
Website: www.adea.org [ [link removed] ]

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B. Timothy Leeth, CPA
ADEA Chief Advocacy Officer
 
Bridgette DeHart, J.D.
ADEA Director of Federal Relations and Advocacy
 
Phillip Mauller, M.P.S.
ADEA Senior Director of State Relations and Advocacy
 
Contact Us:
[email protected] [ mailto:[email protected] ]

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