The U.S. Supreme Court blocked the Biden Administration’s COVID-19 vaccine mandate for private businesses, but allowed the requirement for healthcare facilities that receive funds from the Centers for Medicare & Medicaid Services to continue. Healthcare workers must receive the vaccine’s first shot on Jan. 27 and the second dose by Feb. 28.

By a 6-3 vote, the court blocked the mandate, which was implemented by the Occupational Health and Safety Administration (OSHA) for companies with 100 or more employees and applied to more than 84 million workers. The court said OSHA exceeded its authority in doing so and that such an initiative should be considered by state governments.

“The question before us is not how to respond to the pandemic, but who holds the power to do so. The answer is clear: Under the law as it stands today, that power rests with states and Congress, not OSHA,” states the ruling. “In saying this much, we do not impugn the intentions behind the agency’s mandate. Instead, we only discharge our duty to enforce the law’s demands when it comes to the question who may govern the lives of 84 million Americans.”

The mandate for healthcare workers stayed in place via a 5-4 vote, with the court ruling that vaccine requirements for other maladies are common in the industry. The mandate for healthcare workers does not include a testing alternative to getting the shot.

“The challenges posed by a global pandemic do not allow a federal agency to exercise power that Congress has not conferred upon it,” states the ruling. “At the same time, such unprecedented circumstances provide no grounds for limiting the exercise of authorities the agency has long been recognized to have. The latter principle governs in these cases.”

Casey Duhart, an attorney with Acadia Healthcare in Tennessee, says the mixed rulings make sense. “OSHA is empowered to set workplace safety standards, not broad public health measures,” she says. “CMS, meanwhile, is empowered to set conditions on recipients who receive Medicare and Medicaid dollars.”

Each case will return to lower courts for permanent rulings. Ms. Duhart says it will be interesting to see if a testing option for healthcare workers will be a part of a potential future comprise as the lower courts wrangle with the issue.

Adam Taylor