What the Supreme Court’s tariff ruling means for medtech and device costs

The Supreme Court’s decision to strike down President Donald Trump’s emergency tariffs closed on chapter in a long-running trade fight. For the U.S. medical technology (medtech) sector, it may have opened another.

In its 6-3 decision in Learning Resources, Inc. v. Trump, the court held that the International Emergency Economic Powers Act (IEEPA) does not authorize the president to impose broad tariffs. The majority, led by Chief Justice John G. Roberts Jr., concluded that tariffs are “a branch of the taxing power” and that Congress did not clearly delegate that power in the 1970s emergency statute.

That means the tariffs Trump imposed under IEEPA must come down. It does not mean tariffs are going away.

Within hours of the ruling, Trump said he would turn to other trade laws to keep duties in place. In remarks at the White House, he called the court’s decision “deeply disappointing” and criticized the justices who ruled against him.

He initially announced a new 10% global tariff on all imports under Section 122, a provision that allows temporary duties of up to 15% for 150 days to address balance-of-payments concerns. He then said he would quickly raise the rate to 15%, the legal maximum, framing it as part of a broader push to “protect American industry” and “keep our economy strong.”

AdvaMed CEO: Clarity on IEEPA, but more tariffs likely

Scott Whitaker, president and CEO of AdvaMed, said the ruling sends an important signal about the limits of emergency powers, even as the industry assumes the administration will pursue tariffs through other channels.

“Today’s ruling by the Supreme Court makes clear that IEEPA cannot be used to levy broad tariffs on markets around the world,” Whitaker said in a statement. “With that said, we expect the administration will now pursue tariffs through other authorities to meet the President’s goal of eliminating trade imbalances and incentivizing U.S. manufacturing.”

Whitaker framed medtech as the kind of industrial base Trump says he wants to support rather than penalize.

“As an industry that is primarily U.S.-based, with trade surpluses in most major markets worldwide, we look forward to working with the president and his administration to find a way to help reach his goals of leveling the playing field, addressing foreign trade barriers and ensuring that the U.S. continues to lead the world in medical innovation and patient care,” he said.

In a longer article published on LinkedIn, Whitaker called medical technology “a uniquely American success story,” saying the sector supports approximately 3 million U.S. jobs, including nearly 500,000 in manufacturing, across nearly 17,000 facilities in all 50 states. He wrote that the industry generates roughly $200 billion in annual production output and exports about $75 billion in goods each year, with trade surpluses in most major markets, and that about 70% of the medtech used in America is made domestically.

Whitaker urged the administration to rely on tools that can be narrowly tailored to specific vulnerabilities, such as the Section 232 national security process, rather than broad, across-the-board duties that risk hitting a net-exporting industry alongside sectors with large deficits.

“As we move forward, it is essential that America’s medtech companies have the certainty and stability we need to invest, innovate and supply U.S. patients with the timely, cost-effective medical technologies they need,” he said in his statement.

Learning Resources, Inc, v. Trump

The case before the court grew out of challenges by importers to Trump’s use of IEEPA to impose sweeping tariffs on imports from most of the world. The administration argued that the statute’s grant of power to “regulate … importation” allowed the president to set tariff rates in a declared emergency.

Chief Justice Roberts and five justices rejected that reading. The majority opinion noted that IEEPA does not mention tariffs or duties, and that the government could not point to any other statute in which Congress used the word “regulate” to authorize taxation. The court also emphasized that no president in IEEPA’s 50-year history had interpreted it as a tariff statute.

Two parts of Roberts’ opinion — on the text and structure of the law — drew a six-justice majority, joined by Justices Sonia Sotomayor, Elena Kagan, Neil Gorsuch, Amy Coney Barrett and Ketanji Brown Jackson. A narrower portion, which relied on the “major questions” doctrine and the need for “clear congressional authorization” for actions with large economic consequences, was joined only by Gorsuch and Barrett, making that section a three-justice plurality, not a majority holding.

Justices Clarence Thomas and Brett Kavanaugh dissented, joined in part by Justice Samuel Alito. They argued that tariffs are a traditional tool for regulating imports and that the statute should be read more broadly, warning that the decision could complicate future responses to emergencies and unsettle trade arrangements that rely on IEEPA duties.

One key practical question the court did not answer is what happens to the money already collected. As of Dec. 14, 2025, the federal government had collected $134 billion in revenue from the tariffs at issue, according to U.S. Customs and Border Protection data cited in a court filing and reported by CNN. The majority opinion did not prescribe a refund mechanism, leaving the details to the U.S. Court of International Trade, other lower courts and the administration. In a dissenting opinion, Kavanaugh predicted that any effort to return the money would likely be “a mess.”

Medtech manufacturers are still managing higher costs

For medtech manufacturers and distributors, the Supreme Court’s decision landed after months of operating under higher import costs and shifting trade rules.

In an interview with Medical Economics conducted before the ruling, Casey Hite, CEO of Aeroflow Health, said the earliest tariff proposals were jarring.

“Really, it comes down to the initial size of the tariffs — it was mind-blowing,” he said. “We don’t have the ability to pass those additional costs off to our consumers, because 90% of our revenue is paid through third-party payers, health insurers, primarily, and those rates are set in the contracts that are negotiated well in advance and are in place for several years.”

In practice, that has pushed suppliers to look inward, rather than simply raising prices or cutting product lines. At the same time, AdvaMed and other industry groups have reminded policymakers that device supply chains are complex. Finished products may be made in the United States, but many rely on components manufactured abroad and vetted under strict Food and Drug Administration and international regulatory requirements. Changing a supplier, the trade group has warned, can take years and require substantial re-validation and quality-system work.

For practices, the legal debate over IEEPA and the separation of powers can feel far from day-to-day clinical work. Where it ultimately shows up is in purchasing and planning.

Tariffs can affect the price and availability of everyday items — syringes, gloves, blood pressure cuffs, home monitoring devices — as well as pricier diagnostic equipment. Practices working under fixed reimbursement and rising labor expenses have limited room to absorb additional supply costs, which can feed into decisions about what to stock, when to replace equipment and how aggressively to expand services.

Whitaker’s message after the ruling is that medtech does not oppose scrutiny of trade and manufacturing policy but wants tariffs to be applied in a way that recognizes how tightly devices are woven into U.S. health care.