Supreme Court split in rulings over vaccine mandates

Photo: Luis Alvarez/Getty Images

The Supreme Court was split in two rulings handed up Thursday over federal COVID-19 vaccine mandates.

The Justices ruled against the Biden Administration's mandate that employees of large companies either get vaccinated or get tested weekly. They upheld the federal mandate for healthcare workers in facilities that accept Medicare and Medicaid funding to get vaccinated.

The Supreme Court ruled 6-3 against the Occupational Safety and Health Administration's mandate for workers of companies with 100 or more employees to get vaccinated or tested. This blocks the mandate from taking effect while challenges move through the court system.   

The OSHA mandate applies to 84 million Americans, telling them to either obtain a COVID–19 vaccine or undergo weekly medical testing at their own expense, the majority said. The law empowers the secretary of the agency to set workplace safety standards, not broad public health measures.

"'This is no 'everyday exercise of federal power,'" the ruling said.

Justices Stephen Breyer, Sonia Sotomayor and Elena Kagan disagreed.

The high court ruled 5-4 to keep the healthcare worker mandate in place, with Chief Justice Roberts and Justice Brett Kavanaugh joining the more liberal Justices in the decision.   

In the ruling, the Justices said the core mission of the Department of Health and Human Services is to ensure that the healthcare providers who care for Medicare and Medicaid patients protect their patients' health and safety. 

In many facilities, 35% or more of staff remain unvaccinated, according to the ruling. The COVID–19 virus can spread rapidly among healthcare workers and from them to patients, and it's more likely when healthcare workers are unvaccinated.

"We accordingly conclude that the Secretary did not exceed his statutory authority in requiring that, in order to remain eligible for Medicare and Medicaid dollars, the facilities covered by the interim rule must ensure that their employees be vaccinated against COVID–19," the ruling said.

WHY THIS MATTERS

The Justices did not determine whether the mandates are legal but whether they stand while legal challenges make their way through the appeals process.

The Supreme Court is expected to eventually hear both cases. Thursday's rulings likely show how the justices will rule at that time.
 
American Medical Association President Dr. Gerald E. Harmon said the AMA was pleased that the opinion allows the Center for Medicare and Medicaid's interim rule requiring COVID-19 vaccines for healthcare workers to take effect.

The AMA  was disappointed that the court blocked the OSHA emergency temporary standard for COVID-19 vaccination and testing for large businesses from moving forward.

"Workplace transmission has been a major factor in the spread of COVID-19," Harmon said. "Now more than ever, workers in all settings across the country need commonsense, evidence-based protections against COVID-19 infection, hospitalization, and death -- particularly those who are immunocompromised or cannot get vaccinated due to a medical condition."

Recent data released by United Airlines shows that before their own vaccine requirement went into effect, on average, more than one United employee died each week from the virus, the AMA said.

While the Supreme Court ruling on the OSHA mandate stays the rule at the federal level, there is nothing stopping individual employers from imposing such a mandate, said Kathryn Bakich, health compliance practice leader and senior vice president at employee benefits consulting firm Segal.

"Employers shouldn't read into the decision a lack of support for vaccines, workplace vaccine requirements or meaningful public health measures," Bakich said.

THE LARGER TREND

The Supreme Court fast-tracked both cases, hearing oral arguments Jan. 7. 

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com