Supreme Court considers federal vaccination rules: 8 things to know

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The U.S. Supreme Court will hold a special session Jan. 7 to review challenges to the Biden administration's authority to impose a COVID-19 vaccination mandate for healthcare workers and a vaccinate-or-test requirement for workers at large businesses.

Eight things to know:

1. As part of its special session, the nation's highest court is considering two cases — National Federation of Independent Business v. Department of Labor and Ohio v. Department of Labor — which challenge the Occupational Safety and Health Administration's vaccinate-or-test mandate for businesses with 100 or more employees. The rule requires covered businesses to establish a mandatory COVID-19 vaccination policy, unless they require workers to be vaccinated or undergo regular testing and wear a face covering at work. It is expected to cover more than 80 million workers.

2. The U.S. Supreme Court is also considering Biden v. Missouri and Becerra v. Louisiana — two cases that challenge CMS' vaccination mandate. The mandate requires healthcare facilities participating in the Medicare and Medicaid programs to establish a policy ensuring eligible workers are fully vaccinated, with exemptions allowed based on religious beliefs or recognized medical conditions. It is expected to cover more than 17 million workers.

3. Challenges to the OSHA and CMS requirements came to the U.S. Supreme Court on an emergency basis as the omicron variant spreads throughout the country, according to SCOTUSblog reporter Amy Howe. While the Supreme Court could have decided to issue a brief order and decline hearing arguments, they agreed to consider the challenges Jan. 7.

4. During the special session, justices are not required to definitively decide whether the federal mandates are lawful, but they will consider whether the requirements can stay in place as lower courts continue to hear challenges to their legality, according to The Wall Street Journal.  A court spokesperson told the newspaper all justices are fully vaccinated against COVID-19 and have received boosters.

5. The OSHA and CMS requirements have both faced challenges in lower courts. The CMS mandate is blocked in half of the country by lower court decisions, and on Dec. 28, the agency released guidance that outlines enforcement action thresholds related to assessing compliance at facilities in the 25 states where its mandate is not currently blocked. On Dec. 17, a three-judge panel of the 6th Circuit Court of Appeals in Cincinnati reinstated the Occupational Safety and Health Administration's vaccinate-or-test mandate for businesses. However, a coalition of business and religious groups and Republican-led states have challenged requirements, The Washington Post reported, and are asking the nation's highest court to block them. 

6. With both mandates, challengers raise questions over federal agencies' authority to issue the rules. They argue that the Labor Department and HHS never received authority from Congress to impose the mandates and that the CMS mandate will worsen healthcare staffing shortages, according to the WSJ.

7. President Joe Biden's administration is defending the mandates. According to the WSJ, the federal government contends it is within its authority to impose vaccination requirements on facilities that accept Medicare and Medicaid funds. The Hill reported that the Justice Department argues that the 1970 law that established OSHA is clear that the policy "falls squarely within OSHA's statutory authority."

8. The Supreme Court does not have a timetable for issuing its decisions, but rulings could come within days, according to the WSJ.

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