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AAP weighs in on key Supreme Court cases

May 1, 2024

The U.S. Supreme Court has taken on a growing role in deciding consequential issues that impact child health. This summer, the court is expected to make key decisions on several cases, including those related to vaccine misinformation, gun violence prevention and reproductive rights.

The Academy participates in judicial advocacy to ensure that scientific evidence and pediatric professionals’ clinical expertise are heard in the courtroom. This year was no exception, as the Academy lent its expertise to key Supreme Court cases.

Below is a look at several of the cases the Academy is tracking.

Online vaccine misinformation

During the COVID-19 public health emergency, the Biden administration worked with social media companies to monitor and contain rampant public health misinformation and disinformation regarding the virus and vaccines. In Murthy v. Missouri, the attorneys general of Missouri and Louisiana, alongside other plaintiffs, argue that these actions constituted censorship in violation of the First Amendment.

The Academy led the submission of an amicus brief — joined by the American Medical Association (AMA), the American Academy of Family Physicians and other medical organizations — that explains to the court the harms posed by mis- and disinformation. The brief argues that the government has a “compelling interest” in combating vaccine misinformation, which drives down uptake of safe and effective vaccines.

If the court decides to rule on the First Amendment question, the Academy and other medical organizations’ expertise could be important to establishing the government’s “compelling interest,” a key component of the First Amendment analysis.

AAP President Benjamin D. Hoffman, M.D., FAAP, and AMA President Jesse M. Ehrenfeld, M.D., M.P.H., also co-authored an op-ed on MedPage Today in favor of the defendants, writing: “Stopping the spread of medical misinformation is an enormous task, and we cannot expect any single entity to accomplish this challenge.”

Gun violence prevention

The Academy is involved in two separate Supreme Court cases pertaining to firearm policy.

In U.S. v. Rahimi, the court is considering whether a federal law prohibiting possession of firearms by people subject to domestic violence restraining orders violates the Second Amendment. The case will have significant implications for federal and state gun violence prevention policies impacting children and families.

In an amicus brief, the Academy joined other medical groups in asserting that “when firearms are involved, domestic violence is far more likely to result in death and/or lasting psychological harm.” The medical groups argue that such protections are not a violation of the Second Amendment and that disarming domestic abusers saves lives.

The case is particularly significant because it is the first related to limiting states’ ability to regulate firearms since the 2022 Supreme Court decision in New York State Rifle & Pistol Association Inc. v. Bruen. The AAP filed an amicus brief in the Bruen case opposing limitations on states’ ability to regulate firearms.

The court also heard arguments in Garland v. Cargill, which deals with the legality of “bump stocks.” These rifle attachments allow a shooter to fire continuously, giving a semi-automatic weapon nearly the same firing rate as a machine gun.

For years, the Federal Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) had maintained that bump stocks were not to be classified as machine guns. In the wake of the 2017 Las Vegas mass shooting, in which bump stocks were used to aid a shooter in killing 60 festivalgoers, the ATF reclassified bump stocks as machine guns, subjecting some gun owners to new criminal liability.

At question in Garland v. Cargill is this reclassification of bump stocks as machine guns. The Academy penned an amicus brief, arguing that bump stocks are a “critical public health hazard” and that prohibiting them saves lives.

Reproductive rights

In the wake of the Supreme Court’s 2022 Dobbs decision, which overturned abortion protections enshrined by the court’s 1973 Roe v. Wade case, several cases have threatened to further erode reproductive rights.

In FDA v. Alliance for Hippocratic Medicine, access to medication abortion is at stake. The case looks at recent actions by the Food and Drug Administration (FDA) to expand access to mifepristone by allowing it to be prescribed more easily, including allowing dispensing by mail and at retail pharmacies.

In this case, the court will consider whether the FDA’s actions were “arbitrary and capricious.” However, justices first must decide whether the plaintiff physicians have the right, or “standing,” to sue.

The AAP joined an amicus brief with the American College of Obstetricians and Gynecologists and other medical groups arguing that mifepristone is safe and necessary for reproductive care.

Idaho v. United States seeks to address whether the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals to provide screening and stabilizing treatment to patients who present to emergency departments for care, overrides restrictive state abortion laws that prevent hospitals from providing abortion care in many circumstances. If the court rules in favor of the Biden administration, it could create a nationwide standard for exceptions to restrictive abortion laws for emergency situations.

Again joining other medical organizations in an amicus brief, the Academy asserted that abortion care can be needed in a variety of medical emergencies and that restrictive abortion laws — in this case, Idaho’s — criminalize the care that EMTALA requires.

Executive oversight of federal programs like Medicaid

In Loper Bright Enterprises v. Raimondo, the court is considering whether to uphold “Chevron deference,” a legal doctrine that compels federal courts to defer to executive agencies in interpreting ambiguities in laws passed by Congress as long as the agency’s interpretation is reasonable. This doctrine protects programs like Medicaid and Medicare by empowering executive branch agencies like the Centers for Medicare & Medicaid Services (CMS) to make timely and evidence-informed policy decisions.

At question in this case is the extent to which courts must defer to executive branch agencies when interpreting ambiguities in laws passed by Congress.

In an amicus brief, the Academy argued that Chevron deference is necessary to maintain the stability of federal programs like Medicaid. The Academy and other health groups asserted in the brief that the Chevron doctrine protects the expert, evidence-driven regulatory process and the future of important health-related regulations and policies.

The decision in this case also could have major implications for a broad array of AAP-supported child health regulations, as federal agencies could be constrained from finalizing and enforcing many health-related policies, including those impacting firearm safety, the environment, immigration, tobacco policy and vaccine policy.

The Academy will continue to follow developments in these cases and their implications for the health of children across the country.

The AAP released several ads featuring pediatricians advocating for the bipartisan Kids Online Safety Act. The videos can be found on the AAP's YouTube channel at https://bit.ly/onlinesafetyads.

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