Supreme Court allows vaccine order for healthcare workers

The U.S. Supreme Court has allowed a federal mandate compelling millions of healthcare workers to get the COVID-19 vaccine.

The court issued an opinion Thursday afternoon upholding an order from President Joe Biden’s administration covering healthcare workers at facilities that receive funds from Medicare and Medicaid. However, the justices rejected a separate order that requires many large employers to have their workers vaccinated or submit to regular testing.

The court heard arguments on both orders Friday and analysts said the court seemed more tolerant of the mandate covering healthcare workers.

The Biden administration argued the vaccine mandate is a necessary step to protect patients from COVID-19, which has claimed the lives of more than 840,000 Americans. The White House argued federal law gave the administration the authority to impose the mandate on facilities receiving federal funds.

The court ruled 5-4 in support of the vaccine mandate for healthcare workers. Chief Justice John Roberts and Justice Brett Kavanaugh sided with the court’s more liberal judges: Stephen Breyer, Elena Kagan and Sonia Sotomayor.

The court ruling comes as more than 150,000 COVID-19 patients are being treated in hospitals nationwide, the highest number yet in the pandemic.

Unlike the mandate affecting many businesses, the vaccine order covering healthcare workers did not include a testing option. Under the order, healthcare workers in facilities getting Medicare or Medicaid funds must be vaccinated. There are limited medical and religious exemptions.

The White House said the vaccine order covers 17 million healthcare workers.

Rick Pollack, president and CEO of the American Hospital Association, said in a statement the organization will work with healthcare organizations "to find ways to comply that balances that requirement with the need to retain a sufficient workforce to meet the needs of their patients."

The hospital association has urged healthcare workers to be vaccinated and backed healthcare organizations requiring staff to get the vaccines.

Gerald Harmon, president of the American Medical Association, said he was grateful the court upheld the vaccine mandate for healthcare workers. But he said he was "deeply disappointed" in the high court's ruling that blocks the broader order covering many workplaces.

“In the face of a continually evolving COVID-19 pandemic that poses a serious danger to the health of our nation, the Supreme Court today halted one of the most effective tools in the fight against further transmission and death from this aggressive virus," Harmon said in a statement.

The vaccine mandate for healthcare workers inspired legal clashes in lower courts. Critics said the order infringes on individual liberties. They also argued the mandate would make it harder for healthcare organizations already dealing with serious staffing challenges. Some also said it was unfair to healthcare employees who have been serving continously during the pandemic.

The justices found the U.S. secretary of health and human services has the authority under federal law to impose a vaccine requirement.

The court also noted "healthcare workers and public health organizations overwhelmingly support the Secretary’s rule." The majority ruling cited petitions of support from the American Medical Association and the American Public Health Association.

In the majority ruling, the court said Congress has given the health secretary the authority to impose conditions on the receipt of Medicare and Medicaid funds in the interest of public health. U.S. Health & Human Services Secretary Xavier Becerra said the vaccine rule was necessary to protect patients in the pandemic.

"The rule thus fits neatly within the language of the statute," the court stated. "After all, 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."

"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 court concluded.

Rulings in lower courts have prohibited the federal government from enforcing the vaccine mandate for healthcare workers in 25 states. But ahead of the ruling, the Biden administration had announced plans to move forward with the vaccine mandate in the other 25 states.

The CMS has set a timetable for the vaccine mandate for healthcare workers in those 25 states. They must get their first vaccine by Jan. 27 and must be fully vaccinated by Feb. 28.

Initially, the deadline to be fully vaccinated was Jan. 4, but that was delayed due to the legal battle.

Pollack said he hopes the Biden administration would provide funds needed to help bolster the healthcare workforce.

"Without further support, hospitals and health systems will continue to struggle to maintain the workforce necessary to battle the virus while also maintaining the essential health services that patients and communities depend on each day," Pollack said.

In a 6-3 decision, the court rejected the Biden administration's broader ruling covering many employers in the private sector. The mandate had represented a key plank in the White House's plan to boost vaccinations and reudce the spread of the virus.

The order called for companies with 100 or more workers to require employees to be vaccinated or submit to weekly testing. The White House had said the order would cover 84 million Americans.

Some states have imposed their own regulations compelling healthcare workers to get vaccinated in recent months. Two states - California and New Mexico - have required healthcare workers to get COVID-19 booster shots.

More than 2,500 hospitals - 40% of the nation's hospitals - have imposed a vaccine requirement, the White House has said. Some healthcare organizations said they were holding off on requiring workers to get vaccinated until the legal questions were resolved.