Biden’s Vaccine Mandates Between Vertical and Horizontal Separation of Powers

The U.S. Supreme Court struck down the Biden administration's vaccine-or-test mandate, ruling that the Occupational Safety and Health Administration (OSHA) had exceeded its authority (NFIB v. OSHA). Simultaneously, the Court upheld a regulation issued by the Centers for Medicare and Medicaid Services (CMS) mandating vaccines for nearly all employees at hospitals and healthcare providers receiving federal funds (Biden v. Missouri). Beyond the ideological polarization among the justices, these cases are particularly significant as they underscore the tension between vertical and horizontal separation of powers in the U.S. constitutional system. A comparison of these two rulings offers valuable insights into the principles of federalism, the separation of powers doctrine, and the issue of democratic legitimacy within the administrative state.