Biden v. Missouri

On January 13, 2022, the Supreme Court of the United States rendered a decision in the case Biden v. Missouri, granting the Government’s applications to stay injunctions by two District Courts regarding enforcement of the Secretary of Health and Human Services rule that “in order to receive Medicare and Medicaid funding, participating facilities must ensure that their staff—unless exempt for medical or religious reasons—are vaccinated against COVID-19.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *1 (Jan. 13, 2022)(citing 86 Fed. Reg. 61555 (2021).)

By way of background:

On November 5, 2021, the Secretary issued an interim final rule amending the existing conditions of participation in Medicare and Medicaid to add a new requirement—that facilities ensure that their covered staff are vaccinated against COVID-19. 86 Fed. Reg. 61561, 61616-61627. The rule requires providers to offer medical and religious exemptions, and does not cover staff who telework full-time. Id., at 61571-61572. A facility’s failure to comply may lead to monetary penalties, denial of payment for new admissions, and ultimately termination of participation in the programs. Id., at 61574.

See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *3 (Jan. 13, 2022.)

“Shortly after the interim rule’s announcement, two groups of States—one led by Louisiana and one by Missouri—filed separate actions challenging the rule.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *5 (Jan. 13, 2022.)

The U. S. District Courts for the Western District of Louisiana and the Eastern District of Missouri each found the rule defective and entered preliminary injunctions against its enforcement. Louisiana v. Becerra, 2021 WL 5609846 (Nov. 30, 2021); Missouri v. Biden, 2021 WL 5564501 (Nov. 29, 2021). In each case, the Government moved for a stay of the injunction from the relevant Court of Appeals. In Louisiana, the Fifth Circuit denied the Governments motion. 20 F. 4th 260 (2021). In Missouri, the Eighth Circuit did so as well. See Order in No. 21-3725 (Dec. 13, 2021).

See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *5 (Jan. 13, 2022.)

Thereafter, “[t]he Government filed applications asking [the Supreme Court of the United States] to stay both District Courts’ preliminary injunctions, and [the Supreme Court of the United States] heard expedited argument on its requests.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *5 (Jan. 13, 2022.)

In its Opinion, the Supreme Court indicated that “Congress has authorized the Secretary to impose conditions on the receipt of Medicaid and Medicare funds that “the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services.”” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *5 (Jan. 13, 2022)(citing 42 U. S. C. §1395x(e)(9).) The Supreme Court went on to say that “COVID-19 is a highly contagious, dangerous, and—especially for Medicare and Medicaid patients—deadly disease.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *5-6 (Jan. 13, 2022.)

As such, the Supreme Court indicated:

The Secretary of Health and Human Services determined that a COVID-19 vaccine mandate will substantially reduce the likelihood that healthcare workers will contract the virus and transmit it to their patients. 86 Fed. Reg. 61557-61558. He accordingly concluded that a vaccine mandate is “necessary to promote and protect patient health and safety” in the face of the ongoing pandemic. Id., at 61613.

See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *6 (Jan. 13, 2022.)

The Supreme Court found that “[t]he rule thus fits neatly within the language of the statute”, and, “[a]fter 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.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *6 (Jan. 13, 2022.)

The Supreme Court “conclude[d] 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.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *9 (Jan. 13, 2022.)

The Supreme Court further found that “the interim rule is not arbitrary and capricious.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *10 (Jan. 13, 2022.)

In addition, the Supreme Court indicated that “JUSTICE ALITO takes issue with the Secretary’s finding of good cause to delay notice and comment.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *11 (Jan. 13, 2022.)

To that, the Supreme Court stated:

But the Secretary’s finding that accelerated promulgation of the rule in advance of the winter flu season would significantly reduce COVID-19 infections, hospitalizations, and deaths, 86 Fed. Reg. 61584-61586, constitutes the “something specific,” post, at 3 (dissenting opinion), required to forgo notice and comment. And we cannot say that in this instance the two months the agency took to prepare a 73-page rule constitutes “delay” inconsistent with the Secretary’s finding of good cause.

See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *11 (Jan. 13, 2022.)

The Supreme Court “agree[d] with the Secretary that he was not required to “consult with appropriate State agencies,” 42 U. S. C. §1395z, in advance of issuing the interim rule.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *11 (Jan. 13, 2022.) Moreover, the Supreme Court stated:

We similarly concur with the Secretary that he need not prepare a regulatory impact analysis discussing a rule’s effect on small rural hospitals when he acts through an interim final rule; that requirement applies only where the Secretary proceeds on the basis of a “notice of proposed rulemaking,” §1302(b)(1), followed by a “final version of [the] rule,” §1302(b)(2).

See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *11-12 (Jan. 13, 2022.)

Finally, the Supreme Court found that “the rule does not run afoul of the directive in §1395 that federal officials may not “exercise any supervision or control over the . . . manner in which medical services are provided, or over the selection [or] tenure . . . of any officer or employee of ” any facility”, as “[t]hat reading of section 1395 would mean that nearly every condition of participation the Secretary has long insisted upon is unlawful.” See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *12 (Jan. 13, 2022.)

In granting the applications for a stay, the Supreme Court determined:

The challenges posed by a global pandemic do not allow a federal agency to exercise power that Congress has not conferred upon it. At the same time, such unprecedented circumstances provide no grounds for limiting the exercise of authorities the agency has long been recognized to have. Because the latter principle governs in these cases, the applications for a stay presented to JUSTICE ALITO and JUSTICE KAVANAUGH and by them referred to the Court are granted.

See Biden v. Missouri , Nos. 21A240, 21A241, 2022 U.S. LEXIS 495, at *12 (Jan. 13, 2022.)

Included in the dissent were Justices Thomas, Alito, Gorsuch and Barrett.