Decorative Scales of Justice in the Courtroom
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A federal district court judge in Louisiana on Tuesday issued a preliminary injunction against a COVID-19 vaccination mandate for health care workers issued by the Biden administration’s Centers for Medicare and Medicaid (CMS). Health care entities across Montana were planning to implement the requirement for their workers on Monday, Dec. 6.

The temporary block of the mandate comes in response to a lawsuit filed by Montana and several other states earlier in November. On Monday, a separate federal judge blocked the requirement for health care workers in 10 other states, but did not halt the mandate nationwide. 

In his 34-page ruling, Judge Terry Doughty, appointed by former President Donald Trump in 2017, said the federal government does not have authority to implement the mandate, which would have applied to approximately 17 million employees of facilities that receive Medicaid and Medicare funding. The ruling blocks CMS from enforcing the mandate until the case is resolved.

The government’s mandate, the court wrote, appears to exceed the constitutional powers of the executive branch and did not properly follow the rulemaking process for an administrative agency, making it likely the plaintiff states would succeed on the merits of the case. 

Additionally, the court sided with the plaintiffs in disputing the federal government’s argument that vaccines will decrease the transmission of COVID-19 and therefore increase patient safety in health care establishments.

“[I]t is important to preserve the status quo in this case. The liberty interests of the unvaccinated requires nothing less.”

Federal district court judge Terry Doughty

“Although CMS spent pages and pages attempting to explain the need for mandatory COVID-19 vaccines, when infection and hospitalizations (sic) rates are dropping, millions of people have already been infected, developing some form of natural immunity, and when people who have been fully vaccinated still become infected, mandatory vaccines as the only method of prevention makes no sense,” Doughty wrote.

The judge also wrote that the CMS mandate is overly broad in its application to employees, quoting from another court’s recent decision halting the Biden administration’s vaccine requirement for large businesses that called that rule “a one-size-fits-all sledgehammer.”

In a statement Wednesday morning, a CMS spokesperson said the agency is reviewing both of the recent injunctions from federal courts in Louisiana and Missouri and, while declining to comment directly on the litigation, reiterated that it is committed to protecting the health of patients and workers.

“Staff in any health care setting who remain unvaccinated pose both direct and indirect threats to patient safety and population health. That is why it is critical for health care providers to ensure their staff are vaccinated against COVID-19,” the spokesperson said.

Montana Attorney General Austin Knudsen and Gov. Greg Gianforte released separate statements Tuesday afternoon praising the court’s decision.

“In the past weeks, I’ve heard from healthcare workers across our state whose jobs were being threatened if they did not comply with President Biden’s overreaching federal mandate,” Knudsen said. “With the CMS mandate now blocked in Montana until the case is decided, medical facilities have no reason to threaten their employees if they don’t get the vaccine.”

The court’s decision came a day after Knudsen addressed hospital employees and community members opposing the vaccine requirement at Sidney Health Center. The hospital’s CEO had announced earlier in November that it would comply with the new federal requirements starting next week, sparking vocal opposition from some staff members and local residents.

Unvaccinated health care workers in Montana “can now breathe a sigh of relief,” Gianforte said. “Not only is the president’s mandate unconstitutional, but it would devastate Montana health care providers already struggling with a long-standing worker shortage.”

The Biden administration, in announcing several separate measures to boost vaccination rates through federal rules and contracting requirements, has said the mandates are necessary to protect Americans from serious illness, hospitalization and death caused by the coronavirus. 

Hospitals across the state had said they intended to begin implementing the CMS requirements on Monday by tracking employee vaccination status and confirming that workers had received at least the first dose of a COVID-19 vaccine to avoid compromising critical federal funding.

In a statement Tuesday night, Billings Clinic spokesperson Zach Benoit said administrators will “continue to closely monitor the situation for developments.”

“Billings Clinic’s top priority, and the most important focus, will always be to ensure that we are ready to serve our patients throughout our region with high quality, compassionate care, whenever they need us,” Benoit said. 

The CMS rule would have allowed employees to apply for religious or medical exemptions to the mandate, an option some opponents of mandatory vaccination said offered insufficient protection for individuals’ right to make their own medical decisions.

In his decision, Judge Doughty reflected on that personal liberty while acknowledging that the case would “ultimately be decided by a higher court than this one.”

“However, it is important to preserve the status quo in this case,” he wrote. “The liberty interests of the unvaccinated requires nothing less.”

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Mara writes about health and human services stories happening in local communities, the Montana statehouse and the court system. She also produces the Shared State podcast in collaboration with MTPR and YPR. Before joining Montana Free Press, Mara worked in podcast and radio production at Slate and WNYC. She was born and raised in Helena, MT and graduated from Seattle University in 2016.