Document ID: ./input/supremecourt_opinions/opinions/21pdf/21a240_d18e.pdf
Page Number: 13.0

Cite as:  595 U. S. ____ (2022) 

3 

THOMAS, J., dissenting 

and Medicaid, it is at most a “tangential” one.  Merck & Co., 
Inc., 962 F. 3d, at 538. 

At oral argument, the Government largely conceded that
§1302(a) and §1395hh(a)(1) alone do not authorize the om-
nibus rule.  See Tr. of Oral Arg. 7, 10.  Instead, it fell back 
on a constellation of statutory provisions that each concern 
one of the 15 types of medical facilities that the rule covers. 
See 86 Fed. Reg. 61567 (2021).  Several of those provisions
contain language indicating that CMS may regulate those 
facilities in the interest of “health and safety.”  In the Gov-
ernment’s view, that language authorizes CMS to adopt any
“requirements  that  [CMS]  deems  necessary  to  ensure  pa-
tient health and safety,” including  a vaccine  mandate ap-
plicable to all facility types.  Application in No. 21A240, p. 
19.  The majority, too, treats these scattered provisions as 
a singular (and unqualified) delegation to the Secretary to 
adopt health and safety regulations.

The Government has not made a strong showing that this
agglomeration  of  statutes  authorizes  any  such  rule.  To 
start, 5 of the 15 facility-specific statutes do not authorize 
CMS to impose “health and safety” regulations at all.  See 
42  U. S. C.  §§1396d(d)(1),  (h)(1)(B)(i),  1395rr(b)(1)(A), 
1395x(iii)(3)(D)(i)(IV), 1395i–4(e).  These provisions cannot 
support  an  argument  based  on  statutory  text  they  lack. 
Perhaps that is why the Government only weakly defends
them as a basis for its authority.  See Tr. of Oral Arg. 25–
28. 

Next, the Government identifies eight definitional provi-
sions describing, for example, what makes a hospital a “hos-
pital.”  These define covered facilities as those that comply
with a variety of conditions, including “such other require-
ments as the Secretary finds necessary in the interest of . . . 
also 
health 
§§1395x(dd)(2)(G), 
(cc)(2)(J),
(p)(4)(A)(v), (aa)(2)(K), 1395k(a)(2)(F)(i).  The Government 
similarly  invokes  a  saving  clause  for  “health  and  safety” 

§1395x(e)(9); 
(ff )(3)(B)(iv), 

safety.” 

(o)(6), 

and 

see