Average Joe SCOTUS: American Hospital Association v. Becerra

In another health care snooze fest, SCOTUS is looking at HHS and their shenanigans regarding how they reimburse certain hospitals for drugs through the Medicare Part B program.

The situation is this. You all know hospitals have to give some patients drugs, right? Well, some hospitals, known as 340B hospitals, apparently get their drugs at ultra-low prices. As a result, HHS was like, “Why the fuck are we paying you full price for drugs that you’re buying on the cheap? This is bullshit. We ain’t doin’ this no more.”

HHS also tried to say, “These are our rules to enforce, so this shit isn’t even up for judicial review.” They cited a previous precedent, used often in judicial review, from Chevron U.S.A. v. Natural Res. Def. Council. This precedent basically said that courts can’t just make up their own rules on how a regulation should work. If the regulating body (HHS in this case) has a “reasonable” interpretation of the regulation, and congress specifically didn’t say they should do something different, it’s their regulation to interpret it, and the courts should stay the fuck out of it. This is partly why they think it’s not up for judicial review.

But the 340Bs were like, “Fuck you, we use that money to help people, we’re not getting rich over here. Plus, you can’t just change the rules willy-nilly however the fuck you want. You’ve at least got to do some research first, and set your reimbursement to a number that shows you know what the fuck this shit actually costs.”

Counsel for HHS was like, “Hey, these cost surveys are a lot of work, and the government accounting office so much as told us not to do so many surveys. So we’re just doing what congress told us. Not to mention, many of these hospitals accepted the rate we gave them as perfectly fucking fine. So I don’t see the problem here, buddy.”

After deliberation, SCOTUS was like, let’s address the idea that this shit isn’t up for judicial review. We’re the Supreme Fucking Court. We’re like a regular court, but with sour cream added. We will decide what we can review, thanks. Chevron is a precedent we set. So we could fuck Chevron right in the ass, just like we did with Roe v. Wade if we want, you randy punks. But even if we leave Chevron alone, someone still has to rule on “reasonable interpretation” of the statute. Who do you think that is? That’s right. It’s us, mother fucker. So sit the fuck down with this, “Not open for judicial review” shit.

After that, they had to decide if the rule was reasonable, to which all nine justices were like, “HHS, are you fuckwads on crack? You couldn’t even be bothered to put together an Excel spreadsheet with pricing info and shit? You just cut the price by throwing darts at a dartboard? You know that’s fucking stupid, right? You give us no choice but to side with the AMA you dumb fucks.”

And with that, the HHS were told to go back to the drawing board, and if they want to cut pricing, put together a fucking pricing survey to back up their reasoning for the prices they put forward.

Hear oral arguments and read about the case at the links below.


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