Courts Block Vaccination Requirement for Health Care Workers
- December 03, 2021
Two federal courts this week blocked the Biden administration from implementing a requirement that health care workers in hospitals and other facilities and settings that participate in Medicare and Medicated be vaccinated for COVID-19.
On November 29, the U.S. District Court for the Eastern District of Missouri granted a preliminary injunction to a coalition of ten states that argued the Centers for Medicare & Medicaid Services (CMS) overstepped its authority in issuing an emergency regulation (86 Fed. Reg. 61555) requiring health care workers to get vaccinated by January 4.
Finding the states likely to succeed on the merits of their claim, the court reasoned that given the “vast economic and political significance” of the vaccine mandate, “only a clear authorization from Congress would empower CMS to act.” The court noted CMS estimates that compliance with the mandate would cost roughly $1.38 billion in the first year alone, not taking into account the economic impact on facilities closing or limiting services “and a significant exodus of employees that choose not to receive a vaccination.”
The injunction applies in the ten states—Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota, and New Hampshire—that brought the challenge.
One day later, the U.S. District Court for the Western District of Louisiana enjoined the vaccine mandate in the remaining states not covered under the injunction granted by the Missouri federal district court. The Western District of Louisiana considered limiting the injunction to the14 plaintiff states that brought the challenge but decided “there are other unvaccinated healthcare workers in other states who also need protection.”
The states have argued that the vaccination requirement will exacerbate health care workforce shortages, particularly in rural areas, that CMS violated the Administrative Procedure Act (APA) in promulgating the rule, and that the mandate is unconstitutional.
CMS contended it has authority under the Social Security Act to issue the vaccination requirement, but the Western District of Louisiana said none of the cited statutory provisions “give the Government Defendants the ‘superpowers’ they claim.”
The Western District of Louisiana also held CMS was unlikely to satisfy the “good cause” exemption for skipping notice-and-comment rulemaking under the APA.
Both federal district courts denied the administration’s subsequent requests to stay the injunctions pending appeal.
The interim final rule required health care providers must establish policies to ensure all eligible staff receive the first dose of a COVID-19 vaccine before providing any care, treatment, or other services by December 5, 2021. By January 4, 2022, the rule required all eligible workers to receive either both doses of the mRNA vaccines or one dose of the Johnson & Johnson vaccine.
The cases are Missouri v. Biden, No. 4:21-cv-01329-MTS (E.D. Mo. Nov. 29, 2021) and Louisiana v. Becerra, No. 3:21-CV-03970 (W.D. La. Nov. 30, 2021).