Skrmetti and Cisgender Affirming Care

by Craig Konnoth

In United States v. Skrmetti the Supreme Court will consider whether Tennessee’s broad prohibitions on gender-affirming care for minors violates the Equal Protection Clause. Tennessee’s statute prohibits providers from administering “a medical procedure” to “[e]nabl[e] a minor to identify with…a purported identity inconsistent with the minor’s sex” or “[t]reating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.” These prohibited procedures include “[s]urgically removing, modifying, altering, or entering into tissues, cavities, or organs” and “[p]rescribing, administering, or dispensing any puberty blocker or hormone.”

Notably, the law provides exceptions for children who need these treatments for conditions not related to gender dysphoria. The Tennessee law “permits the use of puberty blockers and hormones to treat congenital conditions, precocious puberty, disease, or physical injury.”

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A Disproportionate Share Payment Calculation Case in the Post-Chevron Era

By Zack Buck

Yet another case that examines the authority of administrative agencies to interpret health care laws will make its way to the Supreme Court next term. And the case could have major implications for hospital financing as well.

In June 2024, the U.S. Supreme Court granted cert in Advocate Christ Medical, et al. v. Becerra, a case that centers on the appropriate calculation of so-called disproportionate share hospital (DSH) payments, which are made to hospitals that treat a high percentage of low-income patients. The Supreme Court will review a 2022 D.C. District Court summary judgment decision for the defendants as affirmed in 2023 by the DC Circuit Court of Appeals.

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Evidence and Authority in Abortion Law

by Rachel Rebouché

Two years after deciding the case that overturned a constitutional right to abortion, the Supreme Court heard two cases on abortion law this term. The first involved a challenge to the U.S. Food and Drug Administration’s approval and regulation of mifepristone, the first drug in a medication abortion. The second concerned the intersection of Idaho’s state abortion ban, which has no exceptions for medical emergencies, and the application of the federal law, the Emergency Medical Treatment and Labor Act (EMTALA), which requires that emergency departments stabilize patients needing emergency care in Medicare-funded hospitals.

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The Ever-Expanding Right to Refuse to Provide Healthcare

by Elizabeth Sepper

For the past decade, a blockbuster religion law case has been a feature of every Supreme Court term. The Court dramatically eased the ability of employers to claim religious exemptions. It overturned long-standing Establishment Clause precedent. And it revolutionized Free Exercise Clause doctrine to favor objectors to public health measures and antidiscrimination laws.  With no religious liberty claim on the docket, the 2023-24 term promised to be the exception.

Nevertheless, in a pair of abortion cases, the Court took the opportunity to broadly interpret federal conscience law to override patients’ rights to emergency care. The first, Food and Drug Administration v. Alliance for Hippocratic Medicine (AHM), challenged the FDA’s approval of mifepristone, the abortion pill. The second, Moyle v. United States, involved the conflict between state abortion bans and the Emergency Medical Treatment and Labor Act (EMTALA), a federal law that requires life- and health-saving care, including abortion, in emergency departments. Neither seemed to implicate the Church Amendment of 1973, which allows individual providers and institutions to refuse to perform or participate in abortion for religious or moral reasons.

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Another Weapon in the Arsenal: Ghost Guns, the Second Amendment and the Downfall of the Administrative State

by Michael R. Ulrich

Many advocates, legal scholars, and public health researchers concerned about the gun violence epidemic in the United States have viewed the Supreme Court’s Second Amendment doctrine as the greatest barrier to reform. A rare victory for the government, announced at the end of the 2023 Supreme Court term, may signal a modest retreat from the Court’s 2022 holding that historical antecedents are the sole dictator of constitutionality. Whether optimism is warranted or not, a new blockade has emerged in 2024. Gun control may be caught in the crosshairs of the Court’s commitment to dismantling the administrative state. With Garland v. VanDerStok, which concerns restrictions on ghost guns, slated for the current term, advocates, scholars, and researchers may soon discover that the Court’s crackdown on federal agencies poses an obstacle to gun regulation comparable to that of the Second Amendment.

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Inter-Loper: Loper Bright and Judicial Intrusion on Agency Prerogatives

by Nathan Cortez

If you wanted quick medical advice, you’d ask your friend with an MD or BSN. Not a JD. Likewise, if you wanted to know how to regulate nitrogen oxide under the Clean Air Act, you’d probably trust the scientists at Environmental Protection Agency (EPA) over the judges on a court that referred to the gas as nitrous oxide (laughing gas). But under the Supreme Court’s recent opinion in Loper Bright Enterprises v. Raimondo, a 6-3 conservative majority ruled that courts get the final say on such matters.

Loper Bright was a blockbuster decision, though not unexpected. Here, I’ll discuss what it might mean for health agencies like the EPA, U.S. Food and Drug Administration (FDA), and Department of Health Human Services (HHS).

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