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Supreme Court Stays Stays of Healthcare Workers’ Vaccine Mandate, Finding Federal Authority Within Regulation of Medicare and Medicaid Programs

Biden, et al. v. Missouri, et al., No. 21A240.

Secretary of the Department of Health and Human Services, et al. v. Louisiana, et al., No. 21A241.

Order and Opinion issued January 13, 2021.

The United States Supreme Court has granted the relief from stays entered in two United States District Courts enjoining the effectiveness of a Centers for Medicare and Medicaid Services (CMS) rule requiring Covid-19 vaccination of staff of facilities and providers receiving or participating in Medicare of Medicaid programs.

The Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), administers Medicare insurance for the elderly and Medicaid insurance for low income persons.

A core feature of both programs, the Supreme Court has observed, is that participation in those programs is contingent upon compliance with HHS patient health and safety regulations.

Medicare and Medicaid regulation is extensive and longstanding and include measures to guard against transmission of infectious diseases, the Court has found.

In November, 2021, HHS added Covid-19 staff vaccine compliance to regulations governing those receiving federal reimbursement or funding (“covered” facilities or entities), attaching penalties for failure to comply as well as potential termination of participation in federal financing.

In demanding that all persons working in covered facilities be vaccinated, the Secretary of HHS made findings concerning viral contagion and the likelihood that contagion would be inhibited by requiring vaccination.

In addition, the Secretary found that fear of contracting Covid-19 has inhibited people from seeking needed health care.

The Covid-19 vaccine mandate was promulgated as Interim Final Rule without notice and comment.

The Supreme Court has concluded that the Secretary of Health and Human Services has the authority to condition receipt of federal funding upon compliance with health and safety regulations.

Although the Covid-19 vaccine mandate for healthcare workers goes farther than other healthcare health and safety requirements, vaccination as a condition of employment is routine.  As vaccination is ordinarily administered by the states, prior to the Covid-19 pandemic there has been no need for the federal government to step in to the process.

The Supreme Court rejected arguments that the Secretary failed to consider alternatives to vaccination or to support departure from previous ‘encouragement’ — but not requirement — of vaccination.

Even if the Secretary’s considerations and findings could be seen to be flawed, the Supreme Court observed, courts are not to disturb the Secretary’s determinations as arbitrary and capricious where the Secretary has proceeded “within a zone of reasonableness.”  Slip op. (per curiam) at 8 (citation omitted).

Objections to the Secretary’s excusing notice and comment are ill founded, the Court opined, because the arrival of the “flu season” has sufficient specificity to justify haste in implementing the Covid-19 vaccine rule  The Court found it unnecessary for HHS to confer with the states or to develop impact assessments before enacting its rule.

Finally, the vaccine mandate does not prohibit HHS involvement in the supervision or control of participants’ provision of services or the termination of employees, the Court concluded.  If the reading urged were adopted, almost all prior conditions of participation would fail.

A federal agency cannot act outside the power conferred upon it in an emergency, the Court reiterated.  This does not mean, however, that an agency is precluded from exercising authority that the agency has long been recognized to possess when  emergency conditions exist.

We disagree. Justices Thomas, Alito, Gorsuch and Barrett dissent.  The dissenting justices have been unable to locate within the provisions cited by the government the authority to require an estimated ten million workers to submit to an irreversible medical procedure.  Rule-making powers that may be exercised for the administration of Medicare and Medicaid programs have not been shown to have a nexus with vaccination.  Adding to such general management authorities scattered references to ‘health and safety’ in order local such a nexus fares no better.

Bits of this and that. The ‘hodgepodge’ approach, as the dissent characterizes the majority’s analysis,  is not sufficient to support the majority’s finding that authorization for the Covid-19 mandate for healthcare workers exists.  References to health and safety measures found here and there will not suffice to support the kind of global regulatory power exercised here, nor can authority for exercise of such power be implied through ‘catchall’ language referring to undefined “other requirements” relating to health and safety.

Residual authority cannot be creatively implied, for it is a basic rule of statutory construction that where specific terms precede general terms, the general terms must consider matters similar to the specific terms.

General administrative requirements such as the provision of 24-hour services or record keeping cannot support a finding of authority for vaccination of all healthcare workers associated with covered facilities.

The one regulation that the dissent concedes might be relevant concerns infection control in long term care facilities but this relates to general sanitation, not vaccination.

The majority’s reliance on general regulatory powers granted to CMS does not provide evidence that authority to require healthcare employee vaccination exists.  The existence of some regulations does not support the majority’s finding that authority to issue the regulations in issue here has been granted.  Even the infectious disease control provisions concern sterilization and housekeeping and discuss vaccination only in the context of patient request for and consent to vaccination, and have nothing to do with the requirement imposed on employees through the Covid-19 rule.

Success in the Future is not Certain. The dissenting justices are of the opinion that the government applicants for relief from the federal district court stays have failed to demonstrate a strong likelihood of success on the merits, for in such vast measures as are in issue here, Congress must speak clearly, and nothing provided to the Court thus far shows that Congress has done so.

We disagree all the more. Justice Alito, joined by Justices Thomas, Gorsuch and Barrett, has provided a separate dissent.  Justice Alito opines that it is not likely that the federal government wil be able to show that there exists Congressional authorization to the Secretary to command that ten million workers submit to vaccination or lose their jobs.

The regulatory “hodgepodge” and scattered provisions as authorization was not forcefully argued by the government until its reply brief.  Stronger medicine than this is needed to cure the absence of any direct evidence to support legislative delegation to HHS to compel employee vaccinations.

Even if vaccination could be perceived to be authorized, the way in which HHS has conducted itself is fatally defective.  Administrative notice and comment, which is essential to ensuring public participation in rule-making, and which guards against lawmaking by unelected officials, has been undermined here.

Justice Alito, while recognizing that the majority has recognized only a likely hood of success on the merits, fears that the scope of the majority’s conclusions is dangerously broad.  The expansive view of regulatory powers embraced by the majority undermines fundamental principles of administrative law.  This in turn may induce extensive changes in executive branch behavior.

No good cause, no excuse. “Good cause” is necessary to excuse compliance with notice and comment provisions.  While no fixed standards supporting foregoing notice and comment exist, conditions excusing notice and comment require narrow construction.

The rationale for failing to comply with notice and commend procedures offered by the government fails to define what harm would ensue from the delay caused by notice and comment.  The ‘importance of vaccination’ will not in itself, define the harm to be avoided by suspending notice and comment.  It is not credible for HHS to argue that exigency excusing notice and comment exists where vaccines had already been in existence for ten months prior to the rule and millions of workers had been vaccinated by the time the CMS mandated issued.

No harm, yet still foul. CMS’ claim that no one was prejudiced by the failure to adhere to notice and comment  procedures obscures the fact that CMS must demonstrate good cause for doing so.  No requirement exists that respondents demonstrate a lack of good cause.  “No harm done” casts a backward glance that does not provide the good cause needed before suspending notice and comment.

Skipping the essentials bodes ill.  Notice and comment procedures are legislative limits on executive authority intended to ensure that executive agencies consider what they are doing “before restricting the liberty of the people they regulate”.  Alito dissent, slip op at 4.  (citation omitted). The majority’s adoption of CMS’ position endorses a regulate first, then listen approach which is especially dangerous where ten million workers must undergo an irreversible medical treatment or lose their jobs.

Biden v. Missouri, No. 21A240 and Becerra v. Louisiana, No. 21241. Order and Opinion January 13, 2022 (S.Ct.)

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Absent Administrative Notice and Comment, Amici Affected by the OSHA Vaccine Mandate Present Submissions to the U.S. Supreme Court Explaining Their Views

National Federation of Independent Businesses v. Department of Labor, No. 21A244,  consolidated with Ohio v. U.S. Department of Labor, No. 21A247. Oral Argument on  Applications for Emergency Stay of OSHA Vaccine Mandate set for Friday, January 7, 2022.

Biden v. Missouri, No. 21A240, consolidated with Becerra v. Louisiana, No. 21A241.  Oral Argument on Challenges to Stays of CMS Vaccine Mandate set for Friday, January 7, 2022. 

The principal parties will be heard on Friday, January 7, 2022 concerning whether the U.S. Supreme Court ought to intervene to stop the implementation of the U.S. Department of Labor, Occupational Health and Safety Administration (OSHA) Emergency Temporary Standard (ETS) mandating vaccination against the Covid-19 virus or testing/masking for all employers with more than one hundred employees.  Immediately thereafter, the Court will hear arguments concerning whether to dissolve stays imposed to halt the effect of a Centers for Medicare and Medicaid Services (CMS) Rule requiring vaccination of health care workers in federally supported settings.

The parties are also seeking certiorari before judgment in their respective cases.  Whether the Court will reach that issue at the same time that it addresses preliminary relief is not known.

What is known is that just as vaccination has engendered controversy nationally, interest groups, advocates, elected leaders, former officials, and professional associations have seized the occasion to submit their views to the U.S. Supreme Court in amicus briefs.

In broad brush, proponents of a stay of the OSHA vaccine mandate argue that OSHA does not have the authority to implement such a measure.  In the absence of explicit Congressional delegation of authority, OSHA cannot act outside known statutory parameters without clearly articulated guidance.  In addition, proponents of a stay assert that OSHA has no public health authority, as that is a police power reserved to the states.  OSHA has no authority to act on an emergency basiss where no emergency exists.  To like effect, OSHA erred in failing to permit notice and comment concerning its proposed vaccine mandate, as no actual emergency presenting a grave danger that requires intervention and excuses notice and comment exist.  

Proponents of a stay of the OSHA vaccine mandate argue that vaccination is ineffective concerning transmission of the Covid-19 virus and that the ‘vaccination’ itself is actually a gene-modifying medical treatment. 

In addition to the sweep of the OSHA measure, the federal intrusion on constitutionally protected individual interests in both bodily integrity and consent to medical treatment are implicated, requiring a hard look in advance of implementation.  

Finally, and not insignificantly, one amicus suggests that the imposition of vaccination or testing and masking measures within workplaces will precipitate medical segregation, an adverse social consequence. 

Those who applaud the arrival of the OSHA mandate assert that the Covid-19 pandemic is the most deadly viral infection event in U.S. history and that the workplace is a petri dish for contamination, making vaccination or masking and testing a valid first line of defense.  Some amici fear that if the mandate is not implemented, the consequences will spill over to their businesses to dismal effect. 

Presented below are thumbnails of the various amicus submissions concerning the OSHA vaccine mandate.  While the CMS Rule requiring health care provider vaccination is of great importance, limitations of time and space prevent development of those arguments here. 

 

 

Advancing American Freedom in Support of Applications for Stay or Injunction Pending Review

Advancing American Freedom in Support of Applications for Stay or Injunction Pending Review

These advocates for traditional values oppose the encroachment of the federal judgment and the administrative state.  There are grave dangers inherent in governmental invocation of emergency measures, particularly where, as here, the vaccine mandate does not address an emergency but presents a “work around” to avoid the necessity of Congressional action and/or administrative notice and comment.  OSHA’s emergency powers are to be used sparingly, and even as such, only one survived judicial challenge.  

 

America’s Frontline Doctors as Amicus Curiae in Support of Applicant

America’s Frontline Doctors as Amicus Curiae in Support of Applicants

Member physicians do not believe the vaccines prevent the spread of Covid-19, and, as result, there exists no basis for segregation of the vaccinated and the unvaccinated.  

The current vaccines are mischaracterized as such.  They are gene-modifying treatments that may reduce symptoms. 

The proper legal analysis should be derived from the strict scrutiny considerations of personal rights to refuse medical treatment.  The OSHA mandate would not survive such analysis, as it is not narrowly tailored to serve a compelling state interest.  They do not inhibit contagion, and thus do not serve the arguably compelling state interest in public health.  And the vaccine mandate is not narrowly tailored as the treatments do not consider risk factors or natural immunity.  There is evidence that natural immunity confers a long term benefit and there are also newly developed treatments to assist in addressing the virus.  

 

American Medical Association, et al.as Amici in Opposition to Applications for Stay 

American Medical Association, et al. as Amici in Opposition to Applications for Stay

These established medical professional associations perceive a severe risk to public health through higher workplace transmissions.  Vaccination can reduce the risk of contraction of the virus, result in less severe cases of illness, and less contagion. 

Testing offers no greater protection than nothing at all.  Masking may be helpful, but is not as good as vaccination. 

 

American Public Health Association, et al. as Amici in Support of Respondents

American Public Health Association, et al. as Amici in Support of Respondents

Public health associations observe that airborne viruses make the workplace particularly hazardous.  Covid-19 mortality is higher for in-person workers.  

Vaccination provides some insulation against transmission.  Moreover, vaccination diminishes transmission and therefore, mutation. 

 

Center for Medical Freedom, et al. as Amici in Support of Applicants

Center for Medical Freedom, et al. as Amici in Support of Applicants

Conservative groups opine that the vaccine mandate is”exactly what the Framers most feared when they established the federal government:  a raw exercise of arbitrary power.”  (Amicus Brief, p. 3).  

OSHA is a child of the commerce clause. There is no authority to regulate anything i the absence of commerce, and the impact of inaction on commerce is not a valid premise for commerce clause legislation.  

Reliance on Jacobson is misplaced, a statue measure was in issue there and as more than a century of subsequent law has been amassed, placing Jacobson’s vitality in question, and this is particularly so where Jacobson was conceived during the ascendancy of the eugenics movement. 

Justice Gorsuch has already rejected Jacobson as a premise for emergency extra-constitutional federal health measures.  

There is no federal police power that would support a vaccine mandate.  

Moreover, the premics of the mandate is flawed, as it is false to say the unvaccinated cause the pandemic.

Death attributable to the Covid-19 vaccines, which are ene therapy, suggest the vaccines themselves present substantial hazards.  

Separation of powers principles caution against implementation of the sort the OSHA vaccine mandate contemplates. 

 

Constitutional Accountability Center as Amicus Curiae in Opposition to Applications for Stay or Injunction Pending Review

Constitutional Accountability Center as Amicus Curaie in Opposition to Applications for Stay 

This progressive think tank and advocacy center submits that delegation with intelligible, principled guidance is appropriate, and that here that intelligible and principled guidance is found in the directive that OSHA may issue emergency orders where necessary to address a grave danger.  

Just because a measure is broad, this does not mean it is unintelligible.  Where such guidance has been provided, there should be no second-guessing agency action. 

 

Defending the Republic in Support of Emergency Applications for Stay or Injunction Pending Certiorari

Defending the Republic as Amicus Support Applications for Stay

Defending the Republic is engaged in challenging the vaccine mandate applicable to the Department of Defense, arguing that the mandate presents unconstitutional infringements on religious freedoms and the right to refuse medical treatment. 

The vaccine mandates represent unprecedented federal usurpations of power.  Nearly the entirety of the adult federal workforce is being conscripted to receive an experimental and irreversible medical treatment.  

 

Former OSHA Administrators Charles Jeffress, David Michaels, and Gerard Scannell as Amici in Opposition to Emergency Applications for Stay(or Injunction) Pending Certiorari Review

Former OSHA Administrators in Opposition to Applications for Stay

Three former Occupational Safety and Health Administration officials oppose a stay of the OSHA vaccine mandate, as it would impede implementation of measures intended to stop Covid-19.  

OSHA may regulate exposure to workplace hazards, including communicable disease, and may develop measures for immunization with religious exemptions.  OSHA can include the impact of workplace hazards on families, and has responded to concerns with bloodborne illnesses, hazardous waste, and respiratory conditions.  

Where the Secretary acts within statutory authorization, Chevon deference should be the norm.  

Simply because a condition exists outside the workplace does not mean that OSHA cannot address the condition within the workplace.  

 

IU Family for Choice, Not Mandates, Inc. in Support of Applicants

IU Family for Choice, Not Mandates, Inc. in Support of Applicants

An Indiana university coalition advocates for medical autonomy within the university community.  The group supports freedom of choice and opposes medical segregation or discrimination regarding access to education, employment, housing and community events.  

Covid-19 vaccines do not prevent infection and transmission.  The vaccines are better considered to be medical treatments ameliorating more serious aspects of Covid-19, but they are not a public health measure.  

OSHA does not have the authority to require unwanted medical treatment.  It is noteworthy that the Centers for Disease Control changed the definition of”vaccine” to conform to Covid-19 therapeutics. 

The OSHA Emergency Temporary Standard violates principles of bioethics concerning autonomy and choice in medical treatment.  

OSHA does not have police powers.  The states, not federal agencies, have police powers and those police powers are bound by the Constitution.  

OSHA cannot force the test/vaccine choice on the employee and pre-enforcement review requires a ‘harder look’ at such a measure.  Rigorous scrutiny is required where medical autonomy and consent are in issue.

Jacobson does not apply here because the OSHA mandate concerns a medical treatment, not a public health measure.  

A personal decision to refuse a medical treatment does not create a risk to others to whom disease might spread.  Refusal only impacts the person who refuses. 

The presupposition that vaccines would slow the spread of disease is in error.  

 

Jason Feliciano and the International Conference of Evangelical Chaplain Endorsers as Amicus in Support of Applications for Stay or Injunction

Jason Feliciano and the International Conference of Evangelical Chaplain Endorsers as Amicus in Support of Applications for Stay or Injunction

The individual and organizational amici provide credentialing for chaplains in the military.  The organization exists to promote religious free exercise.  

Amicus objects to the OSHA vaccine mandate as it is not a true vaccine, as the overwhelming survival rate of persons with Covid-19 infections suggests that there is no grave hazard, and as the mandate fails to consider religious concerns. OSHA does not have authority to impose measures where there is no hazard.  This is particularly problematic where the proposed measure does not inhibit transmission or contraction of the Covid-19 virus and associated illness.  Moreover, the fact that the Centers for Disease Control changed the definition of ‘vaccine’ to include the current injections is problematic.  

Those who resist vaccination are subject to punishment, either in the form of loss of their livelihoods, or, if masking and testing is chosen, in the form of fines, as the individual employee must bear the not insignificant costs of testing.  Further, testing does not provide valid information about contagion and thus is not helpful in curbing disease transmission, and a distinction between testing unvaccinated versus vaccinated individuals makes no sense, as both unvaccinated and vaccinated persons can transmit the Covid-19 virus.

Finally, the social costs of the vaccine mandate are difficult to calculate, as the mandate may usher in an era of medical segregation in which the vaccinated obtain a status superior to those who are not vaccinated.  

 

Liberty, Life and Law Foundation as Amicus in Support of Applicants

Liberty, Life and Law Foundation as Amicus in Support of Applicants

Concerned with constitutional liberties in the context of expanding federal powers, amicus foundation asserts that Jacobson was not a blank check.  Jacobson v. Massachusetts, 197 U.S. 11 (1905).  Congress must use especially clear language where, as here, Congress intends to upset the balance between federal and state powers.

Emergencies cannot be pretexts for denials of civil liberties and usurpation of powers.  The measures in issue raise concerns about bodily integrity, informed consent, and refusal of medical treatment.  

Jacobson was a narrow ruling which recognized the potential for government overreach.  Current analysis should require a compelling government interest.  Even if a compelling government interest could be found, the government has not chosen the least intrusive means of serving that interest.  

 

Local Unions 1249 and 97 of the International Brotherhood of Electrical Workers in Support of Emergency Applications for a Stay Pending Certiorari Review  

Local Unions 1249 and 97 of the International Brotherhood of Electrical Workers in Support of Emergency Applications for a Stay Pending Certiorari Review 

The electrical workers’ unions think that unvaccinated members should not be forced to choose between vaccination and supporting their families.  The vaccine mandate is well outside OSHA’s traditional bailiwick.

Unions can work with management quite effectively to develop Covid-19 policy.  Particularly as the virus and infections will change over time, it is preferable to allow for hands on negotiation rather than to accept top-down demands. 

Traditionally, OSHA does not regulate employers and employees.  Here, there are significant personal cost consequences to employees and a demand that employees subite to an irreversible medical procedure that affects the individual both when working and when not working. 

Although it is true that a hazard need not be solely a workplace hazard for regulation to be proper, the federal government does not routinely impose costs on employees.  

 

Members of Congress as Amici Curiae in Support of Applicants

Members of Congress as Amici Curiae in Support of Applicants

One hundred eighty three members of both houses of Congress fer the disregard of separation of powers principles that th eOSHA vaccine mandate represents.  Congress has not authorized OSHA’s action:  theser exist no deletion of power nor an intelligible principle to support delegation of power to OSHA.  Public health care does not fall within OSHA”s emergency powers, yet OSHA wants to expand those powers outside the workplace.  There is no grave danger that OSHA might address nor is a virus a toxic or hazardous agent as contemplated in the OSHA act.  

The vaccine mandate lacks the ‘necessity’ the OSHA statute requires and the measure itself does not inhibit contagion and contamination.  A rule that does nothing to address a (non-extant) grave danger is not a measure that is “necessary,” as the OSHA statute contemplates.

Equally problematic is the absence of any limiting principles application to ASHA’s actions, which gives rise to non-delegation concerns.  The purpose of reducing the number of unvaccinated individuals on its face exceeds OSHA”s jurisdiction to regulate some workplace safety concerns.  And even if there were authority to act, the failure of Congress to state clearly the principles to guide OSHA causes ‘major questions’ doctrine problems as the vaccine mandate upsets the federal – state power balance. 

 

National Disability Rights Network and the Judge David L. Bazelon Mental Health Law Center as Amici in Opposition to Applications for Stay 

National Disability Rights Network and the Judge David L. Bazelon Mental Health Law Center as Amici in Opposition to Applications for Stay 

Advocates for the physically and mentally disabled support the OSHA Emergency Temporary Standard because, they assert, the physically and mentally disapbled are particularly vulnerable to Covid-19 workplace infection, and face higher mortality rates if they are infected.  Those who refuse vaccination or refusing masking and testing present a new workplace hazard.   Studies suggest that the Emergency Temporary Standard is a necessary measure in mitigation.  Enjoying the Emergency Temporary Standard would disproportionately affect medically vulnerable and disabled persons. 

 

National Employment Lawyers Association and Jobs with Justice Education Fund in Opposition to Emergency Applications for a Stay or Injunction Pending Review

National Employment Lawyers Association and Jobs with Justice Education Foundation Amicus Brief

Acceptance of petitioners’ arguments would open many existing workplace regulations to challenge.

If workers are given a liberty interest superseding federal regulatory powers, then workers may refuse to work. 

The federal government has regulated workplaces in the past, i.e., with drug testing, permitting physical qualifications for work, mandating retirement, and regulating the use of hard hats or the advisability of beards.

With respect to major questions, judicial line drawing between major and minor issues is not committed to the judicial branch.

Petitioners’ Commerce Clause argument would invalidate all federal employment legislation.  It is well established that federal regulation may be applied to noneconomic activity with economic consequences.  

 

Small Business Majority, et al. in Opposition to Emergency Applications for Stay or Injunction Pending Certiorari

Small Business Majority, et al. in Opposition to Emergency Applications for Stay or Injunction Pending Certiorari

Small businesses fear that a stay will cause them to lose the protections that would flow from large businesses’ compliance with the OSHA vaccine mandate.  As some states have interfered with eemployers’ efforts to require vaccination, federal intervention is needed.  

 

Standard Process, Inc. in Support of Emergency Application for Administrative Stay, Stay, and Alternative Petition for Stay Certiorari Before Judgment

Standard Process Inc. as Amicus in Support of Stay and Certiorari Before Judgment

This whole food nutritional supplementation manufacturer fears that the OSHA vaccine mandate will precipitate mass employee resignations,and that, owing to Standard Process’s rural location, those employees will not be replaced.

Testing is not accessible in the way that the government would like to believe.  Equally importantly, employer compliance costs are extraordinary and are neither private nor self-contained.  

In all, the vaccine mandate needlessly undermines both private and public interests. 

 

Texas Values, et al. as Amici n Support of Applicants

Texas Values, et al. as Amici in Support of Applicants

States’ ‘family values” policy advocates object to widespread regulation of employees without notice and comment and without proper concern for religious exercise.  The administrative state is particularly prone to disregarding religious liberty. OSHA has taken the position that employees’ religious interests are outside OSHA’s purview, but even with their ‘proper’ administrative nice, those concerns do not receive fair treatment, as employers may disregard religious concerns where addressing them would require more than de minimis costs.  The public has been denied a voice in the development of this sweeping measure, a measure which lies outside OSHA’s statutory authority.  

 

Tore Says LLC in Support of Petitioners

Tore Says LLC as Amicus in Support of Petitioners

This multimedia news outlet focuses on the thinking of the founding fathers with particular concern for the Ninth and Tenth Amendments to the U.S. Constitution.

Corporations have constitutional rights, and ought to be free from government intrusion, as the government has only those rights which are granted to it by the people.  The Ninth Amendment guarantees against federal intrusion and the Fourteenth Amendment guarantees against state intrusion. 

Because of the Ninth Amendment, there is no authority for the government intrusion that the vaccine mandate represents, but even if there were such a power to intrude, that power would be reserved to the states.  

Public health traditionally is entrusted to the states.  No federal police power exist to support the board exercise of federal powers in issue here.  

 

Washington Legal Foundation in Support of Applicants 

Washington Legal Foundation in Support of Applicants

This foundation supports free enterprise, individual rights, limited government, and the rule of law.  The vaccine mandates are causing supply chain issues and rising prices.  The vaccine mandate is not within OSHA’s authority but if it were notice and comment would be needed, not an emergency measure implemented outside ordinary procedure.  

The mandate presente employees with a forced choice between vaccination,testing, or losing employment.  

The emergency measure is odd in that in June, 2020, the U.S. Court of Appeals for the District of Columbia Circuit observed that OSHA need not issue a mandate.  This is all the more curious because the nation is more than one year, and closer to two years, beyond the inception of the pandemic, and the government wants to use an ‘emergency’ measure.

This is a fitting case for granting certiorari before judgment, given the time constraints presented by the Emergency Temporary Standard, which will expire by its terms in six months.  

 

We the Patriots USA in Support of Emergency Applications for Stay or Injunction Pending Review and for Certiorari Before Judgment

We the Patriots USA in Support of Emergency Applications for Stay or Injunction Pending Review and for Certiorari Before Judgment

This group defines itself as promoting constitutional rights and offers that the vaccine mandate represents the largest disruption of personal choice and bodily integrity in history.  

Since Jacobson, substantive due process rights have developed in recognition of individual fundamental unenumerated rights under the Fourteenth Amendment.  

Tiers of tests for unenumerated rights have been inconsistently applied, sometimes utilizing strict scrutiny, and sometimes not, depending on whether bodily integrity or self-determination is in issue.  Abortion is recognized as a fundamental right, while refusal of medical treatment requires balancing of personal and state interests, with the scales favoring the state.  This uneven treatment of similar questions needs to be addressed.  

The vaccination or testing/masking alternatives are not true alternatives because the costs of testing, which must be borne by employees, are so prohibitive that the average employee is forced to submit to vaccination.  

The Commerce Clause concerns economic issues only and is not concerned with non-economic public health activity, which belongs to the states.  

It is not proper to characterize any skepticism concerning the vaccines as an “anti-vax” position.  The reliance on inconsistent statements of “experts” about Covid-19 is of great concern.  

The OSHA vaccine mandate is a major question because mandatory medical treatment for vast portions of the population is a major political and economic question.

State power to administer public health measures should be retained.  The regulation of containment and remediation of viral transmission is a state matter, but in any case the regulation of a virus is not a regulation of activity within the Commerce Clause.

Upholding the vaccine mandate would open the door to unprecedented federal regulation of public health questions.  

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A Vaccination Compliance Cauldron: Ten States Insist Federal Covid-19 Healthcare Providers’ Mandate Is Constitutionally, Statutorily, and Procedurally Unsound

Missouri, et al. v. Biden, et al., No. 21-cv-01329 (E.D. Mo.). Complaint filed November 20, 2021.

Ten states have joined in challenging the action of the United States Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) in promulgating an Interim Final Rule with Comment Period (IFC) that conditions health care providers’ receipt of federal funding and reimbursement on employee or contractor vaccination against COVID-19.  

Providers and Employees Threatened. Health care providers whose employees fail to comply with the federally mandated demand that all health care workers be vaccinated against Covid-19 may lose federal funding,   As vaccination refusal will threaten employer compliance with the federal measure, unvaccinated employees may lose their jobs.

Exacerbation, Not Mitigation.  The states submit that this sweeping federal incursion on health care administration threatens to exacerbate an already extant crisis in health care provision, which crisis only deepened during the COVID-19 pandemic, forcing states to undertake drastic measures to ameliorate the deadly synergies of two crises which individually would have sufficed to cause health care services to crater. 

          To the extant shortage of workers and threat of harm from viral infection the federal government has added a compliance burden that, the states contend, violates the interests of the states, the healthcare providers and entities within the states, and the healthcare workers who must submit to vaccination or face termination. 

State Standing.  Having brought their complaint in the United States District Court for the Eastern District of Missouri, the states and their attorneys general assert standing premised on exercise of parens patriae powers or statutory authorizations. 

Effective Immediately.  The Interim Final Rule, also called  the CMS vaccine mandate, became effective on publication on publication in the Federal Register on November 5th.  Its protocol demands at least partial vaccination compliance by the first week of December, a deadline that only compounds the problems the rule has caused, the states note.  

          Most significantly, the states argue, the Interim Final Rule is not merely factually detrimental to the provision of health care services, the rule itself and the manner in which the rule was crafted is in violation of central components of the Administrative Procedures Act (APA) and the United States Constitution.

The CMS Vaccine Mandate Makes Matters Worse.  The complaining states assert that the sweeping federal incursion on providers’ rights will exacerbate and extant shortage of workers.  The federal scheme is an unconstitutional abridgment of rights traditionally reserved to the states, and is not only legally flawed but also is, as a practical matter, administratively disastrous, as the health care needs of densely populated urban areas are markedly varied from those of rural settings.  

The CMS vaccine mandate must be set aside.  The states ask that the federal court declare the CMS vaccine rule be declared invalid constitutionally and in violation of the Administrative Procedures Act (APA) and other statutes, and that its enforcement be enjoined.

Not an overnight development.  Healthcare workforce shortages predate the COVID-19 pandemic by decades, the states recount.  Nursing shortages, already critical, have been made all the more so by the demands for urgent and other care precipitated by the pandemic. Many nursing professionals feel they cannot continue to work as they have been.  Many have been attracted to positions offering better working conditions are higher compensation. 

          Staffing shortages threaten the capacity of hospitals to administer care.  To address pandemic care needs, states relaxed standards for the provision of services, permitted workers to work without vaccination, and expanded telehealth services.

          The states are critical of the implementation of the administrative rule per see where doing so represents and Executive Branch about face from federal non-involvement in vaccination to a nationwide push for COVID-19 vaccination compliance that threatens workers with loss of employment and provider entities with loss of available federal funding.   

Reaching beyond providers.  Where health care workers cannot work, providers will be unable to provide services, and the patient public will be denied care.  Each of these outcomes, the states observe, is contrary to sound policies of health care delivery.

A diverse panoply of providers under a single rubric.   There are fifteen categories of Medicare and Medicaid providers, encompassing urban and rural clinics, hospitals, long-term care facilities, and home health agencies. 

          CMS reports that nearly all hospitals within the United States are connected in some measure to Medicare and Medicaid.  Although CMS has recognized the diverse purposes and practices of these categories of providers and suppliers, CMS has embroidered on all covered providers and suppliers the measures applicable to long-term care facilities, the states observe. 

          Moreover, CMS appears to recognize the adverse consequences of the vaccine mandate:  failure to comply will threaten health care workers with loss of employment, which in turn will deepen an already critical worker shortage, which in turn will impact access to care.

No comment.  The states point out that there has never before been a federal vaccination mandate, and that the newly-effective rule is unsound on multiple grounds.  The states notes that CMS abandoned the comment period ordinarily required for rules of the magnitude of the unprecedented healthcare vaccine mandate.  Moreover, CMS has failed to locate with accuracy its authority to promulgate the vaccine mandate.

Unauthorized rule-making. The states argue that there is no statutory authority for the CMS vaccine mandate, and that none of the authorities cited by the CMS as authorizing the mandate do so.  This legally unsupported rule will cause the states great economic harm, particularly as states will not only be threatened with loss of federal resources but the states’ own administrative resources have been conscripted to serve the federal government. 

Hindsight unavailing.  The states submit that the CMS has relied on post-hoc rationalizations to support the rule, an impermissible approach which renders the measure arbitrary, capricious, and not in accordance with law. 

Constitutionally intrusive.  The states argue that compulsory vaccination is traditionally a power reserved to the states.  The federal expansion of power over the states violates the Tenth Amendment, the states submit.

Doctrinally unsound.  The states argue that the CMS vaccine mandate is unsound as it is a measure of national breadth and depth that is not supported by clear Congressional directive, and thus runs afoul of the major questions doctrine.   Similarly, the co of a Congressional articulation of an intelligible guiding principle, the CMS vaccine rule violates principles of non-delegation.

Outside professional bounds.  The states observe that the CMS vaccine mandate is precluded by the Social Security Act, which forbids supervision or control over the practice and provision of medicine and medical services.

Procedurally flawed.  The states submit that the Administrative Procedures Act (APA) is not inaptly named, and that no sound excuse exists for CMS’ failure to adhere to notice and comment procedures which permit interested persons’ participation in administrative processes.  

          CMS not only failed to adhere to these processes but its rule became effective on publication with initial compliance to be completed within thirty days.  Additionally, CMS failed to comply with the sixty-day pre-publication requirement of the Social Security Act.  

Input not sought.  CMS failed to confer with the states concerning the mandate as it is required to do.

Unconstitutional conditions imposed.   The federal government may not impose conditions on funding unrelated to the programs impacted or without notice to the states that vaccination would be required in order to obtain federal funds.  

State resources conscripted.  In enacting measures which threaten providers’ finances through demands on employees, the states observe that is is an infringement on state powers for the federal government to demand that state administrative resources be expended in service of federal aims.

Declaratory and injunctive relief sought: looking forward. The states have requested declaratory and injunctive relief which would nullify the CMS vaccine mandate and prohibit its enforcement.  At this writing the federal court has not issued any orders relating to the case, although in light of the abbreviated time frame for compliance with the CMS vaccine mandate, it is anticipated that there will be activity related to this case soon.  

Missouri, et al. v. Biden, et al., No. 21-cv-01329 (E.D. Mo.) Complaint






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Federal District Court in New York Enjoins Pandemic Precautions Restraining Religious Gatherings

Soos, et al. v. Cuomo, et al., No. 1:20-cv-651 (N.D.N.Y.) (GLS/DJS).  (Order granting injunctive relief entered June 26, 2020).

Since the inception of public health concerns about potential harms should coronavirus (COVID-19) contamination be left unchecked, New York state and city officials have issued not less than seventeen orders dictating who may congregate where and for what purposes.  Religious services fell among the most rigidly curtailed events.

Notwithstanding harms predicted to ensue from close unprotected contact with others, in June mass protests erupted across the United States.

Thousands gathered in New York without official objection.  The governor counseled citizens to be “smart” by practicing social distancing.  It has been reported that, apparently without further elaboration, the Mayor of New York opined that protesting racism presented a “different  question” than did religious events, certain of which he had previously vociferously condemned.

On motion brought by religious leaders, the United States District Court for the Northern District of New York declined to find the public health orders to be “neutral laws of general applicability” presumed to be constitutionally sound even if such laws incidentally burden religion.

The state and local course of conduct created de facto exemptions specifically inhibiting the free exercise of religion, the court found.  The court could not identify a compelling interest which would justify any distinction that would permit public gatherings for some purposes but not for religious purposes. Where irreparable harm could be presumed to flow from the prevention of religious free exercise rights, the court enjoined enforcement of any indoor restrictions greater than those imposed on non-essential entities and any outdoor restrictions.  In both indoor and outdoor settings, social distancing precautions are to be employed.

Soos v. Cuomo No. 20-cv-00651 (N.D.N.Y.) Order June 26 2020