Document ID: ./input/supremecourt_opinions/opinions/21pdf/21a240_d18e.pdf
Page Number: 12.0

2 

BIDEN v. MISSOURI 

THOMAS, J., dissenting 

To obtain a stay, the Government must show that there
is (1) a reasonable probability that we would grant certio-
rari; (2) a fair prospect that we would reverse the judgments
below; and (3) a likelihood that irreparable harm will result 
from denying a stay.  Hollingsworth v. Perry, 558 U. S. 183, 
190 (2010) (per curiam).  Because there is no real dispute 
that this case merits our review, our decision turns primar-
ily on whether the Government can make a “strong show-
ing”  that  it  is  likely  to  succeed  on  the  merits.    Nken  v. 
Holder, 556 U. S. 418, 426 (2009).  In my view, the Govern-
ment has not made such a showing here.

The Government begins by invoking two statutory provi-
sions  that  generally  grant  CMS  authority  to  promulgate 
rules to implement Medicare and Medicaid.  The first au-
thorizes CMS to “publish such rules and regulations . . . as 
may  be  necessary  to  the  efficient  administration  of  the 
[agency’s] functions.”  42 U. S. C. §1302(a).  The second au-
thorizes CMS to “prescribe such regulations as may be nec-
essary to carry out the administration of the insurance pro-
grams” under the Medicare Act.  §1395hh(a)(1). 

The  Government  has  not  established  that  either  provi-
sion empowers it to impose a vaccine mandate.  Rules car-
rying  out  the  “administration”  of  Medicare  and  Medicaid
are those that serve “the practical management and direc-
tion” of those programs.  Black’s Law Dictionary 58 (3d ed.
1933).  Such  rules  are  “necessary”  to  “administration”  if
they  bear  “an  actual  and  discernible  nexus”  to  the  pro-
grams’ practical management.  Merck & Co., Inc. v. United 
States  Dept.  of  Health  and  Human  Servs.,  962  F. 3d  531, 
537–538 (CADC 2020) (internal quotation marks omitted). 
Here,  the  omnibus  rule  compels  millions  of  healthcare 
workers  to  undergo  an  unwanted  medical  procedure  that
“cannot be removed at the end of the shift,” In re MCP No. 
165, 20 F. 4th 264, 268 (CA6 2021) (Sutton, C. J., dissenting 
from denial of initial hearing en banc).  To the extent the 
rule  has  any  connection  to  the  management  of  Medicare