The Supreme Court (SCOTUS) concluded its most recent term in July 2024, issuing numerous decisions that impact physicians and their patients. ACP advocacy staff are consistently monitoring the courts to provide timely analysis and updates to the latest cases affecting the practice of medicine.
Abortion Under Emergency Medical Treatment and Active Labor Act (EMTALA)
Moyle v. United States (6/27/24)
Facts: Under EMTALA, hospitals receiving Medicare funding must provide “necessary stabilizing treatment” to all patients who present themselves to an emergency room. In Idaho, state law criminalizes the provision of abortion care, with limited exceptions.
Ruling: SCOTUS dismissed the case, finding the decision to hear the case was improvidently granted, and vacated its stay of the district court’s preliminary injunction.
Takeaway: The U.S. District Court of Idaho had earlier issued a preliminary injunction prohibiting enforcement of Idaho’s abortion ban, which was reinstated. As a result, pregnant people in Idaho are able to obtain emergency abortion care. SCOTUS did not rule on the facts of the case, but rather found that it shouldn’t have accepted the case. The case will go back to the lower courts to continue to be litigated, where it is possible that it ends up back before SCOTUS in the future. This case is far from settled and provides only a temporary reprieve for pregnant patients in Idaho.
Read ACP’s amicus brief submitted in this case and statement in response to the ruling.
Approval of and Access to Mifepristone
Food and Drug Administration v. Alliance for Hippocratic Medicine (6/13/24)
Facts: Mifepristone, a drug used in medication abortion, has been approved by the Food and Drug Administration (FDA) since 2000. Defendants challenged subsequent 2016 and 2021 FDA updates to the drug’s Risk Evaluation and Mitigation Strategies (REMS) that substantially reduced restrictions and increased access to the drug.
Ruling: SCOTUS ruled that the defendants in this case lacked standing to bring the case.
Takeaway: While FDA’s existing approval and REMS prevail for now, states are still able to impose their own restrictions and prohibitions on abortion, including medication abortion. As SCOTUS did not rule on the facts of the case, but rather issued a procedural opinion, the door remains open for future defendants with standing to challenge the FDA’s approval of mifepristone. Physicians should familiarize themselves with their state’s abortion laws.
Read ACP’s amicus brief submitted in this case and statement in response to the ruling.
Regulatory Power of Federal Agencies (Chevron Deference)
Loper Bright Enterprises v. Raimondo; Relentless v. Department of Commerce (6/28/24)
Facts: For decades, U.S. courts have relied on a legal framework known as Chevron deference, under which courts defer to federal agencies when issuing regulations that address ambiguously written law so long as the regulation is a “reasonable interpretation” of law.
Ruling: SCOTUS overturned the case law that established Chevron deference.
Takeaway: Historically, federal agencies have provided the technical expertise of career civil servants who specialize in specific aspects of government programs and functions. Congress simply lacks the resources and staff expertise to be able to legislate the specifics of the wide spectrum of government functions. In the context of health care, things such as physician payment, out-of-pocket limits, environmental toxicant standards, food safety systems and prescription drug affordability efforts are delegated to federal agencies to figure out how to best implement them. This ruling creates a lot of uncertainty, and its implications are unclear. In the immediate term, this decision has already been cited by federal judges to overturn protections for transgender patients in federal health programs. Much of the impacts are unknown until specific federal regulations are challenged and litigated under the revised legal framework.
ACP will continue to monitor the judicial landscape and assess the impact of the overturning of Chevron deference on physicians and their patients.
Resources:
Social Media Misinformation
Murthy v. Missouri (6/26/24)
Facts: During the COVID-19 pandemic, officials at the White House and federal agencies engaged in outreach with social media companies to inquire about content moderation policies pertaining to misinformation, especially around COVID-19 treatment, vaccine, and masking efficacy, as well as flag specific content for removal they felt violated the companies' policies. States and social media users challenged these efforts, alleging they constituted state action that violated First Amendment free speech rights.
Ruling: SCOTUS ruled the defendants did not suffer direct injury and lacked standing to bring the case.
Takeaway: In rejecting the case, lower court restrictions imposed on federal officials abilities to communicate with private social media companies around content moderation were dispensed with. However, SCOTUS did not rule on the facts of the case, but rather issued a procedural decision. As such, the door remains open to future First Amendment challenges to government efforts to combat medical misinformation.
Read ACP’s amicus brief submitted in this and statement in response to the ruling.
Bump Stocks
Garland v. Cargill (6/14/24)
Facts: Prior to 2018, the federal Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) maintained that bump stocks were not machine guns as defined by statute. After the public outrage following the October 1, 2017 Las Vegas shooting which involved bump stocks, the ATF changed its stance, reclassifying bump stocks as machine guns and exposing owners to criminal liability. This lawsuit challenged the ATF regulations, arguing that the ATF exceeded its authority in defining bump stocks as machine guns. The key question in the case was whether or not a bump stock can be classified as a machine gun under the National Firearms Act of 1934.
Ruling: SCOTUS struck down the rule banning bump stocks, rejecting the federal government’s argument that rifles equipped with bump stocks are machine guns and said that “ATF exceeded its statutory authority.”
Takeaway: As a result of this ruling, bump stocks are now legal to buy and possess in many states across the country unless they have their own laws on the books specifically banning them. The ruling does not prohibit state or federal legislators from enacting laws about bump stocks.
Read ACP’s amicus brief submitted in this case and statement in response to the ruling.