On December 15, the Fifth Circuit Court of Appeals partially lifted a nationwide stay issued by a Louisiana federal district court that preliminarily enjoined the Centers for Medicare & Medicaid Services from implementing its COVID-19 mandatory vaccination rules for many health care employers. The court allowed the injunction to remain in place but only for the 14 states (all with Republican governors) who challenged the rule. Those states include South Carolina and Georgia but not North Carolina, Virginia, or the District of Columbia. A separate stay issued by a district court in the Eighth Circuit applies to an additional 10 states, mostly in the West.

The CMS rules were originally slated to take effect January 4. CMS could still proceed with this timetable in the states unaffected by the stays (assuming no other injunctions are issued). However, given the short deadline for employers to demonstrate compliance, CMS may decide to give affected employers additional time to comply before beginning enforcement efforts. This decision does not affect the substantive challenges to the rule, which could result in a broader affirmation or rejection of the mandate at a later point.