Supreme Court Rules Against OSHA Large-Employer Vaccine Mandate, but Upholds Mandate for Health Care Workers

In two just-issued decisions, NFIB v. Department of Labor Biden v. MissouriThe Supreme Court ruled in favor of the Occupational Safety and Health Administration’s Covid vaccination mandate for large employers employing over 100 workers (employees that remain unvaccinated must wear masks and undergo regular Covid testing), but it upheld the Centers For Medicare and Medicaid Service vaccine mandate for healthcare workers who work at facilities receiving Medicare and Medicaid.

These decisions, which I outlined recently in a NBC article are my opinion for the reasons I cited, are both correct. The Court’s OSHA decision is not my favorite. NFIB v. Department of LaborThis ruling is a 6-3 split on ideological lines. The majority of six conservative justices were in it, while the liberals disagreed. This is the main passage from the per curiam majority opinion.

Administrative agencies can be described as a creature of law. Accordingly, they have only the power that Congress has given them. The Secretary has provided. The Secretary has authorized 84,000,000 Americans to either obtain a COVID–19 vaccine or undergo They can have weekly medical screenings at no cost. No. “everyday exercising federal power”MCP Number. 165,
20 F. 4th, at 272 (Sutton, C. J., dissenting). This is instead of a significant encroachment into the lives—and health—of a A large number of workers.

“We expect Congress will speak clear when authorizing agencies to exercise vast economic and political power.” Alabama Assn. Department of Health and Human Servs. v. of Realtors. , 594 U. S. ___, ___ (2021) [the recently decided eviction moratorium case]…. It is clear that OSHA’s mandate can only be considered as such an exercise.

It is now clear whether the Act authorizes Secretary’s mandate. The Act does not. It does not.
Public health measures. See 29 U. S. C. §655(b) (directing the Secretary to set “occupational safety and health stand
ards” (emphasis added)); §655(c)(1) (authorizing the SecreIf necessary, tary may impose temporary emergency standards Protect “employees” from There is a grave riskAt work The Act covers hazards employees may face while at work, confirming the fact. See, e.g., §§651,
653, 657. No other provision in the Act addresses public safety and health, something that falls beyond OSHA’s scope.

This does not mean OSHA is unable to regulate the occupation-specific risks related to COVID–19. Where’s the virus Because of their particular characteristics, poses an extra danger
This includes regulations and policies that are specific to the job of an employee or their workplace. It is permissible. For example, we don’t doubt that OSHA Could Control Researchers Who Arbeit With The
COVID–19 virus. OSHA could regulate the associated risks.
It is difficult to work in cramped or crowded environments.vironments. However, such places can be dangerous.Both the daily risk of fers and fers can be found in both type and degree. contracting COVID–19 that all face. OSHA indiscriminate approach fails to account for this crucial distinction— between occupational risk and risk more generally—and acCordingly, the mandate adopts the nature of a general public health measure rather than an “Occupational Safety or health standard.” 29 U. S. C. §655(b)….


The Court has rightly focused on “major Questions” doctrine. Congress must “It is important to be clear when authorizing an agency with vast economic or political power. You can also conclude rightly that Congress did NOT authorize OSHA not to use its Emergency Temporary Standard authority for imposing such a broad vaccine mandate. If the Court had ruled in the opposite direction, OSHA would have been able to control virtually every workplace condition. It is not clear to me that the Court distinguishes between hazards specific to workplaces from those which also exist elsewhere. Three of the dissenting justices have rightly pointed out that OSHA does not make this distinction.

Instead, OSHA’s mandate has an “indiscriminate”, meaning that not all covered workers face “grave danger” as per the ETS statute. They could mitigate the danger by simply being vaccinated themselves (the government acknowledges OSHA has found no “grave danger” for workers who are not currently vaccinated).

Justice Neil Gorsuch, joined by Alito and Thomas in a concurring opinion, argued that OSHA’s mandate is also contrary to the doctrine of nondelegation. I  agree with much of his argument.

These are good points made by the three liberal justices in their joint dissent. However, it doesn’t address the fact that there isn’t a clear delegate to allow for emergency authority to be used in such an expansive manner.

I will likely have further thoughts about this case in the future.

Biden v. MissouriA 5-4 Court upheld CMS’ mandate for health-care workers to get vaccines. Brett Kavanaugh, Chief Justice Roberts, and Brett Kavanaugh were among the liberals who made up the majority. The key section of the majority opinion is here, and I tend to agree.

Congress authorized this Secretary will impose conditionsThere are restrictions on how you can receive Medicare or Medicaid money. “The Secretary considers necessary in the best interest of health
Safety and security of those who receive furnished services 42
U.S. C. §1395x(e)(9).* COVID–19 is a highly contagious, dangerous, and—especially for Medicare and Medicaid patients—deadly disease. Hu and Secretary of Healthman Services determined that a COVID–19 vaccine manDate will significantly reduce the chance that Healthcare workers can contract the virus from others and then transmit it to their patients. To their patients. 86 Fed. Reg. 61557–61558. He agreesIt was concluded in ingly that progamming requires a mandate for vaccines“Move and Protect Patient Health and Safety” Continued pandemic

Thus, the rule is easily integrated into the language used by the statute. It is important that providers avoid making mistakes. Contagious transmission of a deadly virus to patients is possibleSistent is the core principle of the medical prosfession: first, do no harm. This would mean that it is “the exact opposite of”. A facility needs efficient, effective administration. supposed to heal people so they are ill with COVID–19.”Florida v. Department of Health and Human Servs., 19 F. 4th 1271, 1288 (CA11 2021).

The States and JUSTICE THOMMAS [in his dissent]This gives you a more focused view The authorities in question contend that the appearThe Secretary can only impose a few bureaucratic rules on the basis of the ingly broad language above.Assisting with the technical administration for Medicare and Medicaid

However, the practice of Health and Human Ser is a long-standing oneVices involved in the implementation of relevant statute authorities is a completely different story. Healthcare facilities who wish to be eligible for Medicare or Medicaid must follow the above-mentioned steps.way been obliged to meet a number of conditions.Not only is it safe, but also effective to provide healthcare.
Simply sound accounting.

A question was made to the Secretary during oral argument. könnte, using exactly the same statutory authority at issue This requires that hospital staff wear gloves and sterilize in.Wash your hands with a specific method and at a particular time. intervals, and the like, Missouri answered yes… The mandate for vaccines goes beyond these limits. What the Secretary did in the past for implementationContamination control He has not had to deal with an infecThis problem has been solved before. In any event There is no doubt about the importance of addressing infections in He is a Medicare and Medicaid specialist.

 Vaccination reQuirements These are You can find more information at common This feature is available This is The Provision This is American healthcare workers Around the Country are required to get vaccinated against disThere are many ways to ease hepatitis B and influenza. Rubella... As the SecThese pre-existing state requirements, retary said, are The main reason that the agency did not adopt vaccination before is because of this.Participation requires that you watch cine.

In some cases, it may not be clear whether the regulation is actually improving patient safety and health. In such a case, the condition could not be imposed on state government-controlled facilities, because it would violate the longstanding requirement – embedded in the Supreme Court’s Spending Clause jurisprudence – that such conditions must be clearly stated. However, vaccination to stop the spread of a fatal disease is possible in a number of hospitals and nursing homes. This case isn’t borderline. It is an easy task. It is certain that this will make a significant impact on the patient’s safety and “health.”

It is surprising that CMS ruled in a 5-to-4 vote. A larger majority would have been my expectation. Thomas makes some good points, just like OSHA’s liberal dissenters. Thomas cannot escape the reality that there is more to the power of protecting the “health, safety, and security” of Medicare facility and Medicaid patients than administrative and clerical regulations. If it does, then vaccinating healthcare workers is easy.

Final analysis shows that the differences between these two cases are due to both the CMS regulation’s less expansive nature and the different language of the statutes. In my NBC article, I discuss the former in more detail.