Supreme Court ruling puts Florida health care providers in a bind over vaccine mandate

Face Medical Surgical White Mask with COVID-19 inscription lying on Florida State Flag. Coronavirus in Florida
'Vaccination requirements are a common feature of the provision of healthcare in America,' the SCOTUS ruling read.

The U.S. Supreme Court on Thursday blocked enforcement of a vaccine mandate requirement for large employers, handing a win to Gov. Ron DeSantis and other Republicans who had sharply criticized the move by the Joe Biden administration.

But the court at the same time is keeping in place a rule requiring vaccination of health care workers employed at hospitals and providers that rely on federal funding.

That creates an immediate conflict in Florida where the GOP-controlled Legislature in November passed a law pushed by DeSantis to ban vaccine mandates in the state unless employers offered up a broad range of exemptions.

DeSantis on Thursday said his administration would enforce the Florida law, which bans private employers from mandating vaccines without offering employees a number of different opt outs. The law also bans vaccine mandates for public employers. Companies that violate the law face stiff penalties, up to $50,000 per violation for employers with more than 100 employees,

“We’re going to make sure that that is enforced, and we’re going to make sure we’re providing protections for people so that they don’t have their livelihoods ruined by an unconstitutional and really ham-handed federal mandate,” DeSantis said.

But Florida Hospital Association President and CEO Mary Mayhew said the SCOTUS ruling makes clear the Centers for Medicare & Medicaid Services (CMS) can implement and enforce vaccination requirements for nearly all employees at facilities that accept Medicare and Medicaid funds.

“Hospitals are obligated to remain compliant with the programs’ conditions of participation and must comply with this federal vaccine requirement now upheld by the highest court,” said Mayhew, who prior to joining the FHA worked in the DeSantis administration, serving as Secretary of the Agency for Health Care Administration. “Florida’s hospitals are committed to ensuring access to care for millions of elderly Floridians who depend on Medicare.”

Mayhew said hospitals don’t want to be caught in the battle between the DeSantis and Biden administrations and “may still need clarity from the courts regarding federal preemption regarding the Florida state law.”

Christina Pushaw, the press secretary for DeSantis, exulted in the Supreme Court ruling on non-hospital employers, saying on Twitter that it was a “huge win for workers’ rights; huge blow to the tyranny of the administrative state. The regime was wrong. (DeSantis) was right.”

The decision by the court to block the mandate crafted by federal workplace regulators was widely expected, especially after the round of skeptical questions from justices. Biden’s administration sought to require employers with 100 or more employees to ensure their workers get vaccinated or tested.

The court ruled 6-to-3 to block the private employer mandate, while the court was split 5-to-4 over whether to allow the health care worker mandate to remain in place.

That slim majority concluded federal health officials had the power to place the mandate on nurses, doctors and others employed at health care providers that rely on Medicare and Medicaid funds from the federal government.

“Of course the vaccine mandate goes further than what the secretary has done in the past to implement infection control,” wrote the court. “But he has never had to address an infection problem of this scale and scope before. In any event, there can be no doubt that addressing infection problems in Medicare and Medicaid facilities is what he does. And his response is not a surprising one. Vaccination requirements are a common feature of the provision of healthcare in America.”

In a follow up post, Pushaw suggested SCOTUS erred in upholding the CMS mandate. Pushaw wrote on Twitter: “It should be stopped too. I understand the legal framework is different from OSHA, but all regulations should be supported by evidence, and this mandate is not.”

The rulings don’t end the legal battles over either mandate, but instead centered on whether or not the rules could be enforced during ongoing court challenges.

Florida hospitals and nursing homes that buck the federal CMS rule risk losing billions of dollars in federal health care money. They could also be prosecuted by the state Attorney General’s office if they violate the Florida law.

The Agency for Health Care Administration on Jan. 4 sent out a provider alert announcing that it would not survey health care facilities for compliance with the CMS vaccine mandate rule. The alert was issued in response to a Dec. 28 CMS memorandum announcing the agency would enforce the rule requiring vaccination mandates in certain states, including Florida. The memorandum reversed a policy from a previous CMS memorandum issued Dec. 2.

“A health care worker who is terminated by a private employer as a result of a COVID-19 vaccination mandate that violates (Florida law) may file a complaint with the Attorney General’s Office,” AHCA said in the alert.

Leading Age Florida Communications Director Nick Van Der Linden said the association would be reaching out to AHCA to get “clarity.”

In the meantime,  Van Der Linden said, Leading Age will continue to work with its member facilities to combat vaccine hesitancy.

“We have conducted hundreds of member calls where we provide the latest information so our members can help educate their residents and staff,” Bahmer said in a statement. “We’ve seen great success with that. Currently, 83% of all staff in our member communities are fully vaccinated. Several of our members already had mandates in place before it was a requirement.”

Florida Health Care Association spokesperson Kristen Knapp said skilled nursing facilities are experiencing a “historic labor crisis” and the SCOTUS ruling could exacerbate the situation. The group represents the majority of the state’s 690 nursing homes.

“We are extremely concerned that the court’s decision to allow the CMS mandate to go forward will cause nursing homes to lose even more staff at a time when we are grappling with significant staffing shortages that are impacting access to care,” she said.


Renzo Downey of Florida Politics contributed to this report.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


  • Alex

    January 13, 2022 at 4:26 pm

    Oh good.

    More reason to change the number of Justices to 15.

    • Alex

      January 14, 2022 at 7:20 am

      Gorsuch refuses to wear a mask, even while sitting next to Sotomayor who has diabetes, a covid risk factor.

      Every other federal court requires everyone to wear a mask because the preponderance of the evidence says they work.

      Welcome to far right disrespectful asshole court.

      • Mauricio

        January 18, 2022 at 9:19 am

        Sotomayor is so stupid and misinformed she thought there were 100,000 children on ventilators. This isn’t Cuba. The state does NOT own doctors just because they pay them. BOTH MANDATES NEED TO GO!

    • Antonio

      January 14, 2022 at 9:11 am

      There is no good reason to change the number of justices. Not getting your way is one of the worst.

      • Alex

        January 14, 2022 at 11:07 am

        Nevermind McTurtle stole an appointment from Obama because he could.

        Flake Trump appointed idiots.

        That’s the BEST reason.

        • Antonio

          January 15, 2022 at 11:41 am

          McConnell, like Pelosi, is a crap human. That said, as Senate leader he didn’t “steal” any appointment from Obama.

          And if you are upset about Trump justices, that was only possible due to former Democrat Senate Majority Leader Harry Reid changing the rules and lowering the voting threshold for confirming judges from 60 votes to 50 votes. If the rules had not been changed by Reid, Trump would not have been able to have his justices confirmed.

          But please keep doubling down on your childish reason to change the rules.

  • Marty

    January 13, 2022 at 5:07 pm

    Maybe the gene pool will be strengthened by this ruling. I wonder how many of the justices are vaccinated.

  • tom palmer

    January 13, 2022 at 5:41 pm

    The idea that health care workers shouldn’t be vaccinated is beyond comprehension but that’s par for the course in Tallahassee these days.

    • Brandon

      January 13, 2022 at 5:50 pm

      It’s common sense as to why a newly developed vaccine shouldn’t be mandated, even in healthcare. I work in a hospital, and many of my vaccinated co-workers are STILL getting sick with COVID. We are also made to wear PPE, such as masks, faceshields and gowns AT ALL TIMES. HOW will we pose a safety risk to patients when we are all covered up? There is literally no point to this mandate.

      • Alex

        January 13, 2022 at 6:09 pm

        If the virus can get in, it can get out, and you’re not considering the idea of triage if a new more deadly variant arrives.

      • JLL

        January 13, 2022 at 6:21 pm

        IT IS NOT A NEWLY DEVELOPED VACCINE!!! I wish you people would do your research!!!
        Severe acute respiratory syndrome (SARS) and Middle
        East respiratory syndrome (MERS) are two diseases
        caused by coronaviruses closely related to the virus
        that causes COVID-19. Researchers began working on
        developing vaccines for these diseases after they were
        discovered in 2003 and 2012, respectively.
        • None of the SARS vaccines ever made
        it past the first stages of development
        and testing, in large part because the
        virus disappeared. One MERS vaccine
        (MVA-MERS-S) successfully completed
        a phase 1 clinical trial in 2019.
        • mRNA vaccines have been studied before for flu,
        Zika, rabies, and cytomegalovirus (CMV).
        • As soon as the genetic code became available for SARS-CoV-2
        (the virus that causes COVID-19), scientists began designing
        the mRNA for the vaccine, which provides instructions for
        cells to build the unique spike protein for SARS-CoV-2.

      • heather

        January 13, 2022 at 10:04 pm

        When you are in healthcare and see pts die due to this vaccine ( yes I have seen unvaxxed and vaxxed die too from covid ) but this is a risk benefit issue…. There is no recourse if one has an adverse effect. If yu mandate this then you must be liable and YES this should be taken of the market given all the problems with it.. In addition, why now? I have worked in it before you were brave enough to enter the ER doors and we take care of way more infectious disease than you know and there IS NO vax for them…. Read the medical books before commenting .

        • Alex

          January 13, 2022 at 10:38 pm

          Too bad nothing you just said is credible.

          • Diana

            January 15, 2022 at 8:03 am

            The Vax doesn’t stop you from getting covid or giving covid. The vaccinated and non vaccinated are still getting covid. Healthcare workers that do not want it should not be threatened with losing their jobs!! What is the benefit to a patient if the nurse / doc has vax if the provider can still get and give virus? Think about that. How is the Vax stopping the spread?. It isnt!!! If it works as they say to lessen the severity of covid illness, then you have vaccinated asymptomatic people caring for you and spreading it without knowing. Benefit please??? The Vax is causing heart problems in young males and a host of other health issues. Check VAERS and Pfeizers own data they were forced to release!!

      • You don't know everything

        January 15, 2022 at 10:46 am

        Because people wear masks under their noses and no one does right 100% of the time

    • Diana

      January 15, 2022 at 7:57 am

      The Vax doesn’t stop you from getting covid or giving covid. The vaccinated and non vaccinated are still getting covid. Healthcare workers that do not want it should not be threatened with losing their jobs!! What is the benefit to a patient if the nurse / doc has vax if the provider can still get and give virus? Think about that. How is the Vax stopping the spread?. It isnt!!! If it works as they say to lessen the severity of covid illness, then you have vaccinated asymptomatic people caring for you and spreading it without knowing. Benefit please???

  • Manuel (Manny) Lozano

    January 13, 2022 at 7:25 pm

    The covid 19 pandemic should be treated as a PLAGUE! As such, anyone who refuses to be fully vaccinated without a valid MEDICAL REASON should be TAXED for their cost to society!!!

    • Brandon

      January 13, 2022 at 7:38 pm

      You are absolutely stupid, vaccinated people are STILL being infected regardless. Go ahead and get your 10 shots a year, but don’t force a mandate on people who MAY OR MAY NOT REACT BADLY to the vaccine. There are reports of people developing heart problems after taking the vaccine, so WHY should that be forced upon ANYONE without liability to any party who forces you to take it?

      • Alex

        January 13, 2022 at 8:48 pm

        Woah, reports?

        Some small percent still get sick?

        Oh no!


        • heather

          January 13, 2022 at 10:08 pm

          look at VAERS

          • Alex

            January 13, 2022 at 10:41 pm

            There’s adverse reactions to aspirin honey.

            Go find someone stupid enough to believe your hyperbolic nonsense.

      • Tom’s Mother

        January 17, 2022 at 3:59 pm

        Police wear protective vest but occasionally a bullet still enter their body. So if they aren’t a 100 % effective, why even wear one …now lets talk seat belts, I read a story on the internet where a person was using a seat belt, and when their car went over a cliff he still die. I told my son, Tom, that he no longer needed to use a seat belt because they don work.

    • Jerry

      January 13, 2022 at 8:44 pm

      The vax doesn’t stop transmission.
      I know people personally who had bad reactions from the vaccine that made them sicker than when they had the virus. A coworker of mine said he got the shot and got so bad he thought about calling 911. He had COVID last summer and barely was sick at all. So the vaccine made him sicker than the virus!
      And I have family members that had bad reactions. And when I was a child, my parents had to take me to the ER because I had a bad reaction to the whooping cough vaccine. So no, there is no way in hell I’m getting this COVID vaccine. It’s too new. And I don’t trust the mRNA technology.

      • Alex

        January 13, 2022 at 8:47 pm

        Our resident anti-vaxxer and his bs. ^

        • Caspian

          January 13, 2022 at 10:44 pm

          No bs when it comes to both the risk of the vaccine, the ability to prevent infection or hospitalization. There is a reduction in effectiveness both over time and with each booster. In fact repeated infections can increase your ability to be infected and decrease the immune response. Science does not stop because politics is involved and you have been sold a bill of good.

          • Colt Seavers

            January 14, 2022 at 8:15 am

            Wrong lefties, Health Care Providers should follow the same protocol as with the previous corona virus AKA the flu and common cold. Everything is gonna be just fine. Un-bunch your stinky panties and start enjoying life lefty weirdos. Take up a hobby, turn off CNN, stop being political dorks already.

        • Mike

          January 13, 2022 at 11:12 pm

          Alex how about you post a picture of yourself. You’re probably extremely overweight like 80% of Americans. I bet you’re the type to be vaccinated and still walk into a restart until with your mask on then sit down and eat with it off for 45 minutes while the room air blows the virus around. Or get drunk at home. Unhealthy sheep. So many prominent scientists have spoken up including Harvard epidemiology, retired head of French virology and disease control. Natural immunity is 100xs better than your boosters. Unvaxed here the whole time. Covid is a joke. Live my life workout every day. Don’t social distance. You’re a sheep. I had delta. Body aches for a few days and no fever. You telling me your booster is better than my immunity? Go get a biology degree, troll.

          • Alex

            January 14, 2022 at 8:21 am


            All 100% completely wrong.

            For every little poorly done study that supports your nonsense, I can post 10 well constructed and conducted/more recent studies that contradict it.

            It’s called I have the VAST bulk of the evidence, and you have jack-shit.

            But please, enjoy being an ignorant child in la la land.

          • Alex

            January 14, 2022 at 8:36 am

            Oh yeah, and how many people did you infect while you had delta huh?

            No, don’t tell me. I already know.

            You don’t care because you’re also a selfish, self-centered asshole.

          • Mike

            January 14, 2022 at 10:33 am

            And anyone who continues to be a fat slob should be treated like a plague and taxed as well. Diabetes. More industrial farming. More waste. Consume consume consume… Majority of Americans are overweight addicts and still not dying of Covid. Go outside and get some fresh air. Then look up CDC data if your brain can compute. They don’t even try to hide the facts because people like you are too busy.

            Alex. I stayed home while “sick”… you are full of hate and fear. Or just a payed for troll/bot. Got get the new omnicron vaccine and then don’t forget your booster next month xD

          • Alex

            January 14, 2022 at 10:59 am

            I already explained you were wrong, and you decide in you wisdom to double down. Lol

            Stated another way – you’re a liar on TOP of being scientifically illiterate.

            What else do you have except more lies and stupidity?

          • Diana

            January 15, 2022 at 8:10 am

            Hi Mike! Thank you for the common sense. I can’t believe the fear induced psychosis or just possibly poor critical thinking skills of many of these people commenting. Im looking at moving to Florida to get away from such NOOBS!!!! But it seems they are everywhere!!!

    • Caspian

      January 13, 2022 at 10:40 pm

      Flee your fear as it has infected you beyond being human.

    • Antonio

      January 14, 2022 at 9:20 am

      Should we tax the obese? Mandate exercise?

  • Thea Thorne

    January 13, 2022 at 8:54 pm

    The fact is that this “vaccine” is not FDA approved and is still only under the experimental status. I wonder if anyone read the paperwork they signed to take the jab? Requiring an experiment of any kind violates the Nuremberg Code- read it for yourself. This so called “vaccine” doesn’t prevent infection or prevent transmission so under the definition of a vaccine – oh wait- they changed the definition of a vaccine to fit their needs!!!- anyways, I digress, this experimental jab is no vaccine- no true vaccine. It also is altering the DNA of people who take it! Does that sound like a good thing to you? Over 400 soccer players have died worldwide- healthy, young athletes! not to mention all the other deaths by this so called vaccine. I could go on and on how bad this jab is, but if you want to take it, then you have the right to take it, but I and anyone else should be allotted that same ability to make a decision for ourselves or do we no longer live in the land of the free and the home of the brave? 🙁

  • Alex

    January 13, 2022 at 9:18 pm

    And you learned it all on facebook


    • heather

      January 13, 2022 at 10:09 pm

      facebook censors everything why? because pharma is hiding things very sensitive information … you will see

      • Alex

        January 13, 2022 at 10:43 pm

        Now you spew conspiracy nonsense.

        “You just wait!” – the eternal blabber of conspiracy lunatics with no credible evidence.

  • Josey Wells

    January 16, 2022 at 10:47 am

    My doctor came in and told me he had some good news and some bad news. I opted for the bad news first. He said I had covid and likely could die from it, so I asked then what exactly is the good news? He said you dont have worms. Far Right Science.

  • Clee

    January 17, 2022 at 3:58 pm

    Let’s talk about the SCOTUS ruling on health care and “federal” workers; facilities that accept funding (CMS). Did the ruling open up mandates on individuals receiving Medicare/Medicaid funding? I.E if you are too heavy, smoke, did not take shot(s), etc. then drop your “federal” insurance coverage. In otherwards, what did the ruling say as opposed to what it did not say. Thoughts????

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