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Supreme Court Upholds COVID-19 Vaccine Mandate for Health Care, Blocks Mandate for Large Employers

January 13, 2022

The U.S. Supreme Court today upheld the Biden administration’s COVID-19 vaccine mandate for facilities receiving Medicare and Medicaid funding but blocked vaccine-or-test requirements for large private companies.

The court voted 5-4 to uphold the Biden administration’s vaccine mandate for health care, and 6-3 against the Occupational Safety and Health Administration’s (OSHA) Emergency Temporary Standard (ETS).

In the health care case, the court determined the federal government was within its authority to require COVID-19 vaccinations to protect Medicare and Medicaid beneficiaries. Justices Clarence Thomas, Samuel Alito, Neil Gorsuch, and Amy Coney Barrett dissented in the case.

“Ensuring that providers take steps to avoid transmitting a dangerous virus to their patients is consistent with the fundamental principle of the medical profession: first, do no harm,” the court’s majority opinion said.

The court added: “Vaccination requirements are a common feature of the provision of healthcare in America: Healthcare workers around the country are ordinarily required to be vaccinated for diseases such as hepatitis B, influenza, and measles, mumps, and rubella.”

The OSHA ETS would have required more than 80 million workers to get vaccinated or receive weekly testing. Justices Stephen Breyer, Elena Kagan and Sonia Sotomayor dissented from the majority ruling.

“Although Congress has indisputably given OSHA the power to regulate occupational dangers, it has not given that agency the power to regulate public health more broadly. Requiring the vaccination of 84 million Americans, selected simply because they work for employers with more than 100 employees, certainly falls in the latter category," the court said.

In a statement following the ruling, The Hospital and Healthsystem Association of Pennsylvania said:

"Pennsylvania’s hospitals and health systems support vaccination as the most effective way to protect individuals, Pennsylvania communities, and our health care system during the COVID-19 pandemic. HAP encourages all eligible Pennsylvanians—and especially health care workers on the front lines of caring for patients—to get vaccinated against COVID-19 and boosted.

In July, HAP’s board of directors adopted a consensus statement supporting adoption of proven infection control practices, including mandating the COVID-19 vaccine for its members’ workforces, with appropriate exemptions.

HAP applauds the phenomenal work Pennsylvania hospitals have done and continue to do to ensure that their staff—and their communities—are vaccinated. We also recognize that enforcing a vaccine mandate may exacerbate the strain and severe staffing and capacity crises Pennsylvania hospitals are already facing as the number of people they are treating for COVID-19 surges to record highs.

In light of today’s Supreme Court ruling, HAP is committed to continue working with our members across the state to help them navigate implementation of the federal vaccine mandate so they can both protect their patients, staff, and communities and ensure they have the workforce they need to continue to provide high-quality care for patients."

HAP will continue to follow the legal and regulatory developments regarding the federal COVID-19 vaccine mandates and provide updates to members. For additional updates on COVID-19 vaccine mandate legal proceedings, visit the American Hospital Association’s blog.

For questions, contact Jolene Calla, Esq., vice president, health care finance and insurance.