The U.S. Department of Health and Human Services (HHS) has revoked a 50-year-old rule that required public input on key regulatory decisions. The move could significantly alter how healthcare policies are shaped.
The Richardson Waiver, in place since 1971, ensured that HHS regulations affecting agency management, funding, and benefits gave the public a chance to voice their opinions. However, as of Feb. 28, HHS can now implement certain rules without seeking feedback from healthcare providers, patient advocates, or the public.
While HHS Secretary Robert F. Kennedy argues that skipping public comment streamlines operations, critics warn that doing so limits transparency and shuts out healthcare stakeholders from shaping policy.
Beth Feldpush, DrPH, is senior vice president of policy and advocacy for America’s Essential Hospitals, an advocacy organization that represents more than 300 hospitals nationwide. Feldpush said in a public statement that cutting public commentary reduces transparency and leads to weaker, error-filled regulations that have not been fully vetted. “In addition, the rapid implementation of policy changes would give states, providers, and beneficiaries insufficient time to properly prepare for implementation,” she said in the statement.
Local impacts and legal challenges
Amy T. Campbell, JD, is associate dean for law and health sciences and professor of law at the University of Illinois Chicago. She says the waiver’s full impact is uncertain because “It is not clear to which actions the Richardson Waiver was applied when active.” This makes it difficult to assess how much this change will affect regulatory decisions.
The change could make it harder for local healthcare providers and organizations to challenge regulations that affect funding and care delivery. Some laws, like the Social Security Act, still require public comment for certain Medicare decisions. It remains unknown how this shift will influence future policymaking, Campbell says.
However she adds that this does not mean the change is insignificant. The absence of the waiver could open the door for HHS to act more quickly and with less oversight on a range of policy decisions.
Legal experts caution that local institutions will need to closely monitor HHS regulatory actions and be prepared to challenge rules enacted without comment. The 2019 Supreme Court case Azar v. Allina Health Services, for example, reinforced the need for public notice. In the case, HHS had initiated a policy to retroactively reduce Medicare payments to hospitals. A group of hospitals sued because the policy hadn’t allowed for a public comment period.
Campbell says the case set a precedent for “fair warning” and “an opportunity to be heard,” which could apply to future legal challenges.
Advocates urge action
Local health departments and organizations rely on public comments to request resources that meet their populations’ needs. Without this process, they may find it harder to support their communities, and policies may overlook specific health disparities and demographic factors.
The policy change fits within a broader pattern of federal measures that could disproportionately impact economically vulnerable populations and individuals with disabilities.
Campbell recommends that stakeholders track regulatory changes and join coalitions that advocate for transparency. National organizations like the KFF and local Chicago groups such as the Shriver Center on Poverty Law, founded by Kennedy’s uncle, and the Legal Council for Health Justice may be key resources for monitoring and responding to policy shifts.
By Catherine Gianaro
Catherine Gianaro,a freelance writer and editor based in Chicago, has written about healthcare and higher education for more than three decades. With 90-plus awards in communications, she is well-versed in storytelling.
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HHS cuts public comment periods, sparking concerns over transparency
Fact checked by Katie Scarlett Brandt
The U.S. Department of Health and Human Services (HHS) has revoked a 50-year-old rule that required public input on key regulatory decisions. The move could significantly alter how healthcare policies are shaped.
The Richardson Waiver, in place since 1971, ensured that HHS regulations affecting agency management, funding, and benefits gave the public a chance to voice their opinions. However, as of Feb. 28, HHS can now implement certain rules without seeking feedback from healthcare providers, patient advocates, or the public.
While HHS Secretary Robert F. Kennedy argues that skipping public comment streamlines operations, critics warn that doing so limits transparency and shuts out healthcare stakeholders from shaping policy.
Beth Feldpush, DrPH, is senior vice president of policy and advocacy for America’s Essential Hospitals, an advocacy organization that represents more than 300 hospitals nationwide. Feldpush said in a public statement that cutting public commentary reduces transparency and leads to weaker, error-filled regulations that have not been fully vetted. “In addition, the rapid implementation of policy changes would give states, providers, and beneficiaries insufficient time to properly prepare for implementation,” she said in the statement.
Local impacts and legal challenges
Amy T. Campbell, JD, is associate dean for law and health sciences and professor of law at the University of Illinois Chicago. She says the waiver’s full impact is uncertain because “It is not clear to which actions the Richardson Waiver was applied when active.” This makes it difficult to assess how much this change will affect regulatory decisions.
The change could make it harder for local healthcare providers and organizations to challenge regulations that affect funding and care delivery. Some laws, like the Social Security Act, still require public comment for certain Medicare decisions. It remains unknown how this shift will influence future policymaking, Campbell says.
However she adds that this does not mean the change is insignificant. The absence of the waiver could open the door for HHS to act more quickly and with less oversight on a range of policy decisions.
Legal experts caution that local institutions will need to closely monitor HHS regulatory actions and be prepared to challenge rules enacted without comment. The 2019 Supreme Court case Azar v. Allina Health Services, for example, reinforced the need for public notice. In the case, HHS had initiated a policy to retroactively reduce Medicare payments to hospitals. A group of hospitals sued because the policy hadn’t allowed for a public comment period.
Campbell says the case set a precedent for “fair warning” and “an opportunity to be heard,” which could apply to future legal challenges.
Advocates urge action
Local health departments and organizations rely on public comments to request resources that meet their populations’ needs. Without this process, they may find it harder to support their communities, and policies may overlook specific health disparities and demographic factors.
The policy change fits within a broader pattern of federal measures that could disproportionately impact economically vulnerable populations and individuals with disabilities.
Campbell recommends that stakeholders track regulatory changes and join coalitions that advocate for transparency. National organizations like the KFF and local Chicago groups such as the Shriver Center on Poverty Law, founded by Kennedy’s uncle, and the Legal Council for Health Justice may be key resources for monitoring and responding to policy shifts.
Catherine Gianaro, a freelance writer and editor based in Chicago, has written about healthcare and higher education for more than three decades. With 90-plus awards in communications, she is well-versed in storytelling.
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