NASHP

Federal Vaccine Mandates and Legal Challenges

Recent federal vaccine mandate regulations and ongoing litigation are key to the vaccine mandate landscape and have a significant influence on state policy.

Federal Mandates
The Biden administration released the Path Out of the Pandemic COVID-19 Action Plan in September 2021.

As part of this plan, the Occupational Safety and Health Administration (OSHA) requires employers with 100+ employees to mandate COVID-19 vaccinations and requires any unvaccinated workers to undergo weekly testing.

This plan also extended the vaccination requirement to employees of contractors that do business with the federal government. In addition, the Centers for Medicare and Medicaid Services mandated COVID-19 vaccinations for all workers in health care settings that receive Medicare or Medicaid reimbursement.

Legal Challenges
OSHA mandate for large employers:

  • On January 13, 2022, the Supreme Court of the Unites States stayed the OSHA vaccine-or-testing Emergency Temporary Standard, ruling that OSHA does not have the authority to enforce this regulation without congressional action. With this decision, large businesses nationwide will not be required to mandate vaccines for employees, but states and individual businesses may enforce their own vaccine requirements.
  • On December 17th, a three-judge panel of the U.S. Court of Appeals for the Sixth Circuit reinstated the OSHA rule requiring workers at large companies to get vaccinated or undergo weekly testing, overturning the Fifth Circuit ruling on November 12. The mandate was initially set to take effect on January 4, but OSHA stated that it would not issue citations to large companies that do not comply with the vaccine mandate before January 10 and it will not issue citations for the COVID-19 testing requirements before February 9.
  • On November 12, the U.S. Court of Appeals for the Fifth Circuit temporarily halted OSHA’s rule (requiring workers at large companies to get vaccinated or undergo weekly testing).

Executive Order 14042 mandate for federal contractors:

  • On December 20, a federal judge in Missouri issued a preliminary injunction halting enforcement of the mandate in Alaska, Arkansas, Iowa, Missouri, Montana, Nebraska, New Hampshire, North Dakota, South Dakota and Wyoming.
  • On December 7, the U.S. District Court Judge for the Southern District of Georgia issued a preliminary nationwide injunction which halts national enforcement of the Biden administration’s vaccine mandate for federal contractors.
  • On November 30, a Kentucky federal court halted the vaccine mandate for federal contractors in Kentucky, Ohio, and Tennessee

CMS mandate for health care workers:

  • On January 13, 2022, the Supreme Court of the Unites States allowed the vaccine requirement for workers in health care settings that receive Medicare or Medicaid reimbursement to go into effect in 24 states in which it was previously enjoined.
  • On December 15, the 5th U.S. Circuit Court of Appeals partially lifted the nationwide ban against enforcement of the federal vaccination mandate for health care workers. This decision lifted the November 30th ruling blocking the mandate nationwide, but keeps the preliminary injunction in place for 14 states that had collectively sued in federal court in Louisiana (Alabama, Arizona, Georgia, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Montana, Ohio, Oklahoma, South Carolina, Utah and West Virginia). Also on December 15, a federal court in Texas issued an order blocking CMS from enforcing its mandate in Texas. As of December 15, the federal vaccine-or-test requirement for healthcare workers is halted in 25 states total — Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Mississippi, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, West Virginia, and Wyoming.
  • On November 30, following a lawsuit brought forward by 14 states, the U.S. District Court for the Western District of Louisiana granted a nationwide preliminary injunction, halting enforcement of the federal vaccination mandate for health care workers. This decision followed a previous injunction issued a day prior by the U.S. District Court for the Eastern District of Missouri which blocks enforcement of the CMS regulation in ten states (Alaska, Arkansas, Iowa, Kansas, Missouri, New Hampshire, Nebraska, Wyoming, and North and South Dakota).

State Actions
With the federal mandates for large employers blocked — and with further anticipated litigation on the separate mandate for federal contractors — states have enacted their own vaccination mandates or bans on such mandates. Use the map to find the status of these individual state efforts.

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