Biden v. Missouri (21A240)

argument 21A240

Biden v. Missouri

Supreme Court of the United States 1h 26m 8 speakers 8 chapters transcribed 6 days ago official recording ↗

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What is the core legal question about the Secretary’s authority to impose COVID‑19 vaccine mandates on Medicare and Medicaid providers?

John G. Roberts 0:00

We'll hear an argument next in 21A240, Biden, President of the United States versus Missouri and the consolidated case. Mr.

Brian Fletcher 0:11

Fletcher. Thank you, Mr. Chief Justice, and may it please the Court. Hospitals, nursing homes, and other Medicare and Medicaid providers serve patients who are especially vulnerable to COVID-19 in settings that are especially conducive to the spread of the virus. The Secretary required those providers to make sure that their staff are vaccinated, subject to medical and religious exemptions, because he found that vaccination is the best way to prevent workers from infecting their patients with a potentially deadly disease. He also found that any delay in implementing that requirement would cause preventable deaths and severe illnesses. But the preliminary injunctions in these cases are delaying that urgently needed protection for Medicaid and Medicare patients in half the country.

Brian Fletcher 0:55

This Court should stay those injunctions for two reasons. First, requiring medical staff vaccination during a pandemic falls squarely within the Secretary's statutory authority to protect the health and safety of Medicare and Medicaid patients. Vaccination requirements are a traditional and common way to curb the spread of infectious disease. Many health care workers are already required to be vaccinated against diseases like hepatitis, measles, and the flu. And the medical community overwhelmingly supports COVID-19 vaccination requirements, which have been adopted by providers around the country. Those requirements are, in short, the paradigmatic example of a health and safety measure. Second, the Secretary's decision was thoroughly explained and supported by the record.

Brian Fletcher 1:38

The states do not seriously deny that requiring vaccination will save lives. Instead, they predict that it will cause staffing shortages, especially in some rural areas. But the Secretary carefully considered that concern. He explained that experience from around the country shows that most workers will choose to be vaccinated rather than to leave their jobs in response to vaccination requirements. And he concluded that the risk of some temporary staffing shortages is outweighed by the urgent need to protect all Medicare and Medicaid patients during a deadly pandemic. Congress assigned those quintessential predictive and policy judgments to the Secretary, and the States have identified no basis to disturb his conclusions.

Brian Fletcher 2:17

I'd welcome the Court's questions.

Clarence Thomas 2:20

Counsel, are you relying on 1302A?

Brian Fletcher 2:26

The Secretary invoked — that's the Secretary's general rulemaking authority under the Social Security Act, and he invoked that general rulemaking authority as he typically does when he makes rules under the Act, but we're not relying primarily on that. We're instead relying on specific authorities as to each category of covered providers that allow the Secretary to set standards that set the requirements for their participation in Medicare and Medicaid. I don't understand what you just said. I'm sorry. The answer is yes, but not only on 1302. We also have specific statutes that speak to each of the covered providers here.

Clarence Thomas 2:59

So If I look at the language in 1302, which says that you, the Secretary, shall make and publish such rules and regulations as may be necessary to the efficient administration of the functions with which each is charged under this chapter. you say there is more than that authorizing the secretary.

Brian Fletcher 3:25

Correct, yes.

Clarence Thomas 3:25

What is that more?

Brian Fletcher 3:27

So the more is set forth. It's different as to each category of providers. So take hospitals. There the additional authority is in Section 1395XE9, which authorizes the secretary to set such requirements as he finds necessary in the interest of the health and safety of patients in Medicare and Medicaid. The Secretary cited other similar requirements that authorize him to set conditions of participation for each of the categories of providers, for nursing homes, for ambulatory surgical centers. All of those categories of providers are subject to similar requirements that say the Secretary gets to determine the requirements for their participation in Medicare and Medicaid.