The U.S. Department of Health and Human Services has withdrawn a controversial federal rule that threatened to kill more than 17,000 regulations and undercut health care for more than 20,000 American Indians in San Bernardino and Riverside counties.

In its notice published in the Federal Register on May 27, HHS stated that the rule — called SUNSET for Securing Updated and Necessary Statutory Evaluations Timely — was “expansive in scope, faced considerable opposition from stakeholders, and lacked a public health or welfare rationale for expediting rulemaking.”

The SUNSET rule was introduced by the Trump administration the day before Joe Biden was inaugurated. It tasked HSS and its sub-agencies to review, within five years, 17,200 of its 18,000 regulations. If the regulations were not reviewed in that time frame, they would automatically expire.

Critics said the rule would have affected everything from food and drug safety to manufacturing and medical care for millions of Americans. And the impact on health care in American Indian country could have been even more devastating.

Delia Sharpe, executive director of the California Tribal Families Coalition, said the rule threatened the access millions of American Indians have to critical health care and social services.

“We’re happy that the Biden Administration took the necessary action to withdraw the SUNSET Rule,” Sharpe said. “The SUNSET Rule was rushed to finalization in clear violation of tribal rights to prior consultation. Moving forward, we will continue working to enhance protections for tribes, especially those for children.”

Threatened vital programs

The SUNSET rule, according to the Tribal Families Coalition, was too broad in scope and threatened vital American Indian programs such as Tribal Temporary Assistance for Needy Families and the Indian Health Service, which serves more than 2.6 million American Indians in 37 states.

Additionally, the rule would have negatively impacted substance abuse and treatment programs for tribal members as well as child welfare and nutrition services, adoption and foster care, and transitional independent living programs for children, according to the CTFC.

The coalition was the lead plaintiff in a lawsuit filed against HHS in March 2021 in San Jose in an effort to have the SUNSET rule vacated. Joining CTFS in the lawsuit were the nonprofit Democracy Forward Foundation, Santa Clara County, the National Association of Pediatric Nurse Practitioners, the American Lung Association, the Center for Science in the Public Interest, and the Natural Resources Defense Council. .

Pleased with decision

In response to HHS’s withdrawal of the SUNSET rule, the plaintiffs in that lawsuit issued a joint statement saying it was pleased with the decision by the Biden administration.

“The Sunset Rule was an ill-considered and sweeping effort to deregulate healthcare and food safety, axe thousands of important public health protections, and tie the  Department of Health and Human Services’ hands at the worst possible time — all without going through any of the legal requirements,” the statement stated. “This is a victory not only for our nation’s public health and healthcare sector but also for the millions of Americans, including more than 36 million children, who would have been hurt by the resulting regulatory chaos, uncertainty, and elimination of key protections.”

The rule was supposed to take effect on March 22, 2021, but the lawsuit forced the HHS to suspend it for one year, then again until September 2022, while it reviewed the rule and the concerns of those opposing it.

HHS told Fierce Healthcare, a health care news platform, on May 26 that the SUNSET Rule would have required a “significant expenditure of resources” that would have “impeded the department’s routine operations and hampered its ability to carry out other key priorities and goals.”

HHS estimated that withdrawing the rule will save the agency nearly $70 million over the next 10 years.

Morongo weighs in

Teresa Sanchez, a member of the Morongo Band of Mission Indians who serves on the Tribal Council, credited the CTFC, among others, in helping protect critical health care and social services for American Indians, especially tribal elders, not only locally, but nationwide.

“Tribes were denied their rights under federal law when the Sunset Rule was enacted without consultation or consideration to the significant and disastrous impacts it would have had on tribes and tribal services,” Sanchez said in a statement Tuesday, June 7.