The US Supreme Court Thursday stayed the Biden administration’s recent COVID-19 business vaccine mandate, but it permitted the vaccine mandate for facilities participating in Medicare and Medicaid programs.

In staying the Occupational Safety and Health Administration’s (OSHA) business vaccine mandate, the court reasoned that OSHA can “regulate occupational dangers” but lacks “the power to regulate public health more broadly.” The court concluded that “[r]equiring the vaccination of 84 million Americans, selected simply because they work for employers with more than 100 employees, certainly falls in the latter category.”

The Secretary of Labor enacted the vaccine mandate through OSHA, requiring employers with more than 100 employees to mandate employee vaccination by January 4, 2022, or face fines. The mandate provided an exception for workers agreeing to test weekly at their own expense and during non-work hours. After the US Court of Appeals for the Fifth Circuit stayed the mandate, the US Court of Appeals for the Sixth Circuit lifted the stay.

The Biden administration defended the mandate, arguing that the US Government can lawfully require employers to mandate employee vaccination or offer employees the option to mask and test. The administration reasoned that, amid an “extraordinary pandemic and a serious threat to employees,” the federal government can “address the grave dangers posed by COVID-19 in the workplace.” Still, the National Federation of Independent Business (NFIB) sought emergency relief from the US Supreme Court, challenging OSHA’s authority to issue the vaccine mandate. The court agreed, stating: “OSHA has never before imposed such a mandate. Nor has Congress.”

The court, however, permitted the Secretary of Health and Human Services (HHS) to require facilities participating in Medicare and Medicaid programs to ensure their staff is vaccinated. The court reasoned that Congress authorized the HHS Secretary to issue such requirements and that “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.”

The Secretary passed the rule in November 2021. The rule provides for medical and religious exemptions and does not apply to full-time teleworkers. Failure to comply with the rule may result in penalties, payment denial for new admissions and program participation termination. Louisiana and Missouri successfully challenged the rule as their respective district courts found the rule defective and enjoined its enforcement.

Earlier this month, the US Supreme Court heard expedited arguments on both federal vaccine mandates. During those arguments, the conservative justices seemed more skeptical of the OSHA mandate than the HHS Mandate.

President Joe Biden promptly responded to the court’s decisions, stating that the “decision by the Supreme Court to uphold the requirement for health care workers will save lives: the lives of patients who seek care in medical facilities, as well as the lives of doctors, nurses, and others who work there.” Biden then expressed disappointment in the court’s decision “to block common-sense life-saving requirements for employees at large businesses that were grounded squarely in both science and the law.”