Thread by @ToddZywicki

Missouri v. Biden ago.mo.gov/docs/default-s…

"Although it is not the Courts duty to ask whether CMS’s decision was “the best one possible” or even whether there were “better [] alternatives,” the
Court must ensure there exists a “rational connection between the facts found and the choice
made....

"As an[ ] example, CMS rejected mandate alternatives in those with natural immunity
by a previous coronavirus infection. But, elsewhere, it plainly contradicts itself regarding the value of natural immunity. Id. at 61,604 (“[A]bout 100,000 a day have recovered from infection....

"These changes reduce the risk to both health care staff and patients substantially, likely by about 20 million persons a month who are no longer sources of future infections.”) Such contradictions are tell-tale signs of unlawful agency actions."

"What is more, besides applying to
all facilities equally, the mandate applies to all facilities’ staff equally, 'regardless of . . . patient
contact.'...

"The mandate goes so far as to cover a third-party
vendor’s 'crew working on a construction project' whose members use the same bathrooms 'during their breaks.'...

"CMS provides no reasoned explanation for this overbroad approach, and it further belies its asserted interest in protecting patients from COVID."

This last point on the need for some logical means-ends nexus is very important and might also undermine the US government's mandate for a blanket vaccination of federal employees and especially many employees of government contractors.

The court's discussion of the potential devastation to health care providers, especially in rural areas, is incredible. One rural hospital, for example, has only one anesthesiologist who is unvaccinated (with NI, is my bet) and firing would mean no surgeries at all.

""The Court finds that in balancing the equities, the scale falls clearly in favor of healthcare
facilities operating with some unvaccinated employees, staff, trainees, students, volunteers, and contractors, rather than the swift, irremediable impact of requiring...

"healthcare facilities to choose between two undesirable choices—providing substandard care or providing no healthcare at all."

Classic example of urban, elite, inside-the-beltway mindset dreaming up a regulation without any idea that most of the country does not live in the Acela Corridor.