Biden v. Missouri

In Biden v. Missouri, the U.S. Supreme Court on January 13, 2022, addressed the legality of a federal vaccine mandate issued by the Centers for Medicare & Medicaid Services (CMS). The rule required COVID-19 vaccination for staff at healthcare facilities participating in Medicare and Medicaid. Missouri and several other states challenged the rule, obtaining preliminary injunctions from lower courts. The Supreme Court stayed those injunctions in a 5-4 decision, allowing the CMS mandate to take effect nationwide. The majority found that CMS had clear statutory authority under the Social Security Act to impose infection control measures to protect patient health. This ruling stood in contrast to the Court's simultaneous decision blocking the Occupational Safety and Health Administration's broader vaccinate-or-test rule for large employers. The CMS mandate ultimately affected approximately 10.4 million healthcare workers across the country.

The Supreme Court granted the federal government's application for a stay, lifting the lower court injunctions and allowing the CMS COVID-19 vaccine mandate for healthcare workers to be enforced nationwide, except for states that were separately exempted.

Whether the CMS vaccine mandate exceeded the agency's statutory authority under the Social Security Act, whether it violated the constitutional principle of federalism by intruding on state police powers, and whether the agency failed to comply with proper administrative procedures.

The ruling ensured that millions of healthcare workers were vaccinated, bolstering pandemic safety in medical facilities. It affirmed broad agency authority to safeguard patient health but intensified debates over federal overreach, personal medical autonomy, and administrative power in public health emergencies.