Health Care Worker COVID Vaccine Mandate Upheld by Supreme Court

Author: David B. Weisenfeld

January 14, 2022

While the Supreme Court blocked the Biden administration's COVID-19 vaccine-or-test Emergency Temporary Standard (ETS) from taking effect yesterday, it viewed a vaccine mandate affecting 10.4 million health care workers more favorably.

In a 5-4 ruling in Biden v. Missouri, the justices held that the Secretary for Health and Human Services (HHS) acted within his authority in issuing an interim final rule requiring that covered health care facilities that treat Medicare and Medicaid patients ensure that their staff are vaccinated against COVID-19. The rule also required providers to offer religious and medical exemptions.

The Court noted that health care workers ordinarily are required to be vaccinated for diseases such as hepatitis B, the flu, measles and the mumps. And, it found, the Secretary has the authority to implement all kinds of infection control measures at hospitals, nursing homes and other facilities.

Under the mandate, covered employers must fire noncompliant workers or risk fines and termination of their Medicare and Medicaid provider agreements.

During last week's oral arguments in the case, Louisiana Solicitor General Elizabeth Murrill argued, "This rule has no exceptions, and workers don't have a choice. [It's] get vaccinated or get fired."

But in its opinion, the majority asserted that health care workers overwhelmingly support this vaccine mandate. It also noted that the government had found that fear of exposure to the coronavirus "from unvaccinated health care staff can lead patients to themselves forego seeking medically necessary care."

In dissent, Justice Clarence Thomas - joined by Justices Alito, Gorsuch and Barrett - wrote that this ruling gives the government "virtually unlimited vaccination power" over millions of health care workers.

"These cases are not about the efficacy or importance of COVID-19 vaccines," wrote Justice Thomas. "They are only about whether CMS has the statutory authority to force healthcare workers, by coercing their employers, to undergo a medical procedure they do not want and cannot undo."

The Supreme Court's ruling means the vaccine mandate for covered health care workers can move forward.

"Today's decision by the Supreme Court to uphold the requirement for health care workers will save lives: the lives of patients who seek care in medical facilities, as well as the lives of doctors, nurses and others who work there," said President Biden in a statement that noted the ruling covers workers at 76,000 medical facilities. But he also expressed disappointment that the Court refused to uphold his administration's ETS, saying these requirements for employees at large businesses were "grounded squarely in both science and the law."