Supreme Court Signals Reticence to Protect Public Health

For some, the just-completed 2025-2026 term of the Supreme Court of the United States (SCOTUS) represents a series of “glancing blows” related to the protection and promotion of the public’s health. SCOTUS could have endorsed President Trump’s unilateral use of tariff powers in the interests of public health emergencies, but instead rejected his authority in Learning Resources v. Trump. SCOTUS was asked to endorse a Fifth Circuit Court of Appeals decision disallowing telemedical prescriptions of the abortion drug, mifepristone. In Danco Laboratories, LLC. v. Louisiana, it temporarily sidestepped the opportunity. And in Trump v. Barbara, the Court rejected the premise that the Fourteenth Amendment “birthright citizenship” clause does not say what it actually does — that anyone born or naturalized in the U.S. is a citizen. 

Had any one of these decisions gone the other way, public health repercussions would have been immense. Perhaps SCOTUS deserves a collective, national “thank you” for these decisions this term. Before applauding the Court over what could have been, however, take note of what a majority of the Justices actually decided this term. In several key areas of constitutional and statutory law, communal health concerns took a backseat in SCOTUS opinions. In select cases, public health and safety missed the train entirely.

Standard of Care

As per SCOTUS’ 2025 decision in United States v. Skrmetti (allowing states to prohibit some transgender medical treatments among minors), whenever courts are called upon to adjudge medical standards, adverse outcomes can result. Such is the case in Colorado. In Chiles v. Salazar, SCOTUS uprooted Colorado’s legislative ban of conversion therapies (i.e., spoken guidance on how to change minors’ sexual orientation) among licensed health providers. Few debate the profound negative impacts of these therapies for gay and lesbian patients. Yet, the Court — in an 8-1 decision — prioritized the First Amendment rights of state-licensed counselors to espouse debunked medical information. Colorado’s licensure regulation was labeled as unconstitutional viewpoint discrimination. 

Alongside Chiles, the Court required a reassessment of a lower court decision denying religious exemptions to school vaccination requirements under the First Amendment. In Miller v. McDonald, the Second Circuit Court of Appeals was instructed to look closely at SCOTUS’ 2025 decision, Mahmoud v. Taylor (allowing parents to opt their kids out of Maryland public school LGBTQ+ instructions on religious grounds). Realistically, the only option for the Second Circuit following SCOTUS’ direction is to determine that parents have a First Amendment free exercise right to exempt their school-age children from vaccination mandates. Child vaccinations represent the pediatric standard of care. Many doctors will not even treat kids whose parents refuse to vaccinate them. A SCOTUS-backed finding that these parents have First Amendment rights to exempt out of vaccine requirements will lead to opt-outs nationally, exposing future generations of kids to preventable diseases.

Public Health and Safety

Public health does not appear to be at the forefront of SCOTUS in decisions like Chiles and Miller. In United States v. Hemani, communal health is not even considered by the Justices interpreting the scope of the federal Controlled Substances Act (CSA) which Congress passed explicitly to protect “the health and general welfare of the American people.” Rejecting prosecutions of persons under the Gun Control Act for mere possession of controlled substances (i.e., marijuana) on Second Amendment grounds, Justice Gorsuch for a 9-0 majority valued firearm possession over Congressional concerns for the safety of Americans. Not a single Justice raised countervailing public health issues. Hemani presents an affront to the Court’s 2024 decision in United States v. Rahimi, holding that individuals subject to domestic violence restraining orders “may be temporarily disarmed consistent with the Second Amendment.” 

As the Court explored the depths of Second Amendment rights, it turned a blind eye to public health and safety not only in Hemani, but also in Wolford v. Lopez. In Wolford, Justice Alito writing for a 6-3 majority abolished Hawaii’s public safety laws requiring persons to seek authorization of private property owners to possess guns on site. 

Thus, Second Amendment rights are alive and well notwithstanding predictable victims of gun violence emanating from the Court’s reticence to balance health and safety. Even worse, as the Trump administration erases existing federal gun regulations, SCOTUS has already agreed to hear two cases next term debating whether the Second and Fourteenth Amendments guarantee possession of AR-15 platform and similar semiautomatic rifles.

Public Health Emergencies

Even when SCOTUS asserted its constitutional role as judicial interpreter, it sidestepped follow-up opportunities to carry it through. For example, in Learning Resources v. Trump, noted above, the Court rejected President Trump’s use of tariffs under the International Emergency Economic Powers Act (IEEPA). Months later, however, SCOTUS flatly refused certiorari in a separate case on June 15, 2026 challenging President Trump’s use of tariffs under alternative statutory routes. 

In Trump v. Illinois, SCOTUS found in its per curiam decision President Trump lacked emergency statutory authority to call on state National Guard troops to quell protests in Chicago because he did not follow proper procedures. Instead of “leaving well enough alone,” Justice Kavanaugh observed in his concurring opinionon Dec. 23, 2025, that the President could have simply relied on antiquated provisions of the federal Insurrection Acts to direct troops. Unsurprisingly, President Trump threatened to do just that in response to uprisings in January 2026 in Minneapolis extending from Immigration and Customs Enforcement (ICE) occupation there. Presidential unleashing of military or National Guard service personnel to control constitutionally protected assemblies in Minnesota or elsewhere is not a solution to a public health emergencies, but rather a primary cause. Overzealous exercises of presidential emergency powers threaten the safety of thousands of Americans. 

SCOTUS’ sidestepping palpable public health issues across a spectrum of constitutional and other cases this term presents its own impacts measurable in avoidable morbidity and mortality. Constitutional freedoms have always carried external costs, but the public’s health deserves greater protections than this Court deems worthy.