Summary
The Supreme Court granted the Government’s applications to stay preliminary injunctions blocking a Department of Health and Human Services rule requiring covered Medicare and Medicaid facilities to ensure that their staff are vaccinated against COVID-19, subject to specified exemptions. The Court held that the Secretary had statutory authority to impose the vaccination requirement as a condition of participation and rejected respondents’ arbitrary-and-capricious and other statutory challenges. Justice Thomas, joined by Justices Alito, Gorsuch, and Barrett, dissented, concluding that the Government had not shown a strong likelihood that the relevant statutes authorized the mandate.
Topics
Practice areas
Questions Presented
- Whether the Secretary of Health and Human Services had statutory authority to require Medicare- and Medicaid-participating facilities to ensure that covered staff were vaccinated against COVID-19.
- Whether the interim final rule was arbitrary and capricious because the Secretary allegedly failed to adequately justify vaccination rather than testing, the treatment of persons with natural immunity, the departure from prior encouragement of vaccination, or potential staffing shortages.
- Whether the Secretary properly invoked the good-cause exception to notice-and-comment rulemaking.
- Whether the Secretary violated statutory consultation, regulatory-impact-analysis, or noninterference requirements by issuing the interim final rule.
- Whether the Government was entitled to stays of the preliminary injunctions pending appeal.
Holdings
- The Secretary's rule falls within the statutory authority to impose conditions on Medicare and Medicaid participation that the Secretary finds necessary in the interest of patient health and safety. Requiring covered facilities to ensure that their employees are vaccinated against COVID-19 was therefore within the Secretary's authority.
- The interim final rule was not shown to be arbitrary and capricious because the Secretary examined the relevant data and adequately explained the decisions to require vaccination rather than testing, to cover employees with natural immunity, and to move beyond merely encouraging vaccination, while also considering potential staffing shortages.
- On the stay record, the Secretary adequately invoked the good-cause exception to notice-and-comment rulemaking by finding that delay would endanger patient health and safety in light of the Delta variant and the approaching winter season.
- The Secretary was not required, before issuing the interim final rule, to consult with appropriate state agencies or prepare a regulatory impact analysis addressing effects on small rural hospitals, and the rule did not unlawfully exercise supervision or control over the manner of medical services or facility personnel.
Key quotations
“The rule thus fits neatly within the language of the statute.” (595 U.S. ___, at 5)
“the role of courts in reviewing arbitrary and capricious challenges is to “simply ensur[e] that the agency has acted within a zone of reasonableness.”” (595 U.S. ___, at 8)
“The challenges posed by a global pandemic do not allow a federal agency to exercise power that Congress has not conferred upon it.” (595 U.S. ___, at 9)
Factual background
The Secretary of Health and Human Services issued an interim final rule requiring facilities participating in Medicare and Medicaid to ensure that covered staff were vaccinated against COVID-19, subject to medical and religious exemptions and excluding full-time teleworkers. The Secretary found vaccination necessary to protect elderly, disabled, low-income, and medically vulnerable patients from transmission, and noted that substantial numbers of healthcare workers remained unvaccinated. Noncompliance could result in monetary penalties, denial of payment for new admissions, and termination from the Medicare and Medicaid programs.
Procedural history
Groups of States filed separate challenges to the interim final rule in the Eastern District of Missouri and the Western District of Louisiana. Both district courts entered preliminary injunctions, and the Fifth and Eighth Circuits denied the Government's requests for stays. The Supreme Court granted the Government's applications for stays pending appeal and any timely petition for certiorari.
Remand instructions
The Eastern District of Missouri and Western District of Louisiana preliminary injunctions were stayed pending disposition of the Government's appeals in the Eighth and Fifth Circuits and disposition of any timely petitions for certiorari. If certiorari is denied, each stay terminates automatically; if certiorari is granted, the stay terminates when the Supreme Court's judgment is sent down.