Supreme Court ruling could soften upcoming mental health parity regulations

A new U.S. Supreme Court ruling that curbed federal agencies’ authority could soon have a big effect on employers’ mental health benefits.

Shawn Gremminger, the chief executive officer of the National Alliance of Healthcare Purchaser Coalitions, , speculated about impact Wednesday, during a webinar the coalition held to discuss Loper Bright Enterprises v. Raimondo, the case that overturned the Chevron doctrine.

Loper eliminated the need for federal courts to defer to federal agencies’ interpretations of federal law.

Federal agencies are now completing Mental Health Parity and Addiction Equity Act regulations for “non-quantitative treatment limits,” such as the rules for deciding when patients can get coverage for in-patient care.

Related: Proposed rules highlight coming mental health parity challenges 

The Loper ruling could help employers that sue over the final NQTL regulations, because the requirements in the proposed regulations were different from what was described in the statute, Gremminger said.

Parity: The federal Mental Health Parity and Addiction Equity Act requires employers with more than 50 employees to provide parity between any coverage for mental health care they offer and their coverage for other types of health care.

Existing regulations already require plans to provide roughly the same amount of care for mental health problems and other health problems.

Other effects: Christin Deacon, a health law and health policy consultant, said she thinks some other benefits matters, such as the general authority of federal agencies to develop No Surprises Act regulations, could be less affected because the laws governing those matters are more clear.

But legislation drafters in Congress could have a tough time, because they can no longer get over conflicts by making language vague and counting on federal agencies to use regulations to solve problems, Deacon said.

That strategy “is now completely disrupted,” Deacon said.

Deacon said courts had wondered for years about whether it made sense to let a federal agency administer its own regulations without much judicial oversight.

“It’s not shocking that Chevron was under attack,” she said.

The future: Deacon predicted that some other precedents would lead federal courts to continue to give federal agencies some deference, but she also predicted that the Supreme Court would knock down some other legal precedents that have determined the scope of federal agencies’ authority.

One precedent that could go away is Auer v. Robbins. The Supreme Court held in that 1999 case that the federal courts should give deference to federal agencies’ interpretations of their own regulations as well as to their interpretations of federal laws.

Another result of the end of the Chevron doctrine could be more litigation, Deacon said.

Federal agencies could also avoid colliding with the federal courts’ new views of regulations by being much more cautious about writing regulations. Agencies could focus instead on posting answers to frequently asked questions and other types of informal “sub-regulatory guidance,” Deacon said.