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Government Regulations in the Name of Public Health

Despite the now-common phrase ‘the unprecedented times’ people find themselves in, this pandemic is not the first incidence for the Supreme Court. As Brockell (2021) discusses in his article, Jacobson v. Massachusetts 197 U.S. 11 (1905) set the legal precedent for the vaccine mandate. Jacobson refused to comply with the state’s request to vaccinate against smallpox. Since 1855, the state law of Massachusetts granted its health authorities the right to require all adults to be vaccinated and revaccinated in the event of a smallpox outbreak. Jacobson was fined $5 per day of his refusal; he and other anti-vaccination believers appealed the fine first to the higher and, eventually, to the Supreme Court. In February 1905, the Supreme Court held that public health could supersede the rights of individuals. However, while the high court of Massachusetts and the Supreme court had ruled in favor of the board of health, they also clarified that “it is not in their power to vaccinate [Jacobson] by force” and highlighted that the “common good” laws had to be reasonable.

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The restriction placed by the courts on the “common good” laws resonates with what we’ve learned about declining Medicare services. Recently, the courts allowed a COVID-19 vaccine mandate for staff in health facilities that receive Medicare or Medicaid payments (QSO-22-09-ALL, 2022). As per 42 U.S.C. § 264 carried out by C.D.C., the government can enforce health measures to prevent the entry and spread of infectious diseases. Overall, the question of enforcing compliance should be considered in the context of different socio-economic groups and different state regulations. Like Medicaid benefits that differ by state, the enforcement strategies might differ and affect some groups more strongly.

With the uprising of the COVID-19 pandemic, the pressure for the government to implement effective healthcare decisions is at an all-time high. Its facets are being hotly debated: mask-wearing obligations, vaccination mandates, or quarantine guidelines. People who work in or depend on the federal system are more susceptible to the regulations. As mentioned earlier, Medicare and Medicaid-certified facilities are now required to ensure COVID-19 vaccine immunization of staff among Medicare- and Medicaid-certified providers and suppliers (QSO-22-09-ALL, 2022). C.M.S. has established a variety of enforcement tactics: civil monetary penalties, payments denial, and, finally, termination of participation from the Medicare and Medicaid programs (QSO-22-09-ALL, 2022). Once again, such measures beg the question of which socio-economic groups will be affected the most. The socio-economic groups that risk not having access to Medicaid or Medicare services are likely motivated to comply with governmental requirements since they are largely government-dependent. This strategy might be very effective in combating the COVID-19 pandemic in the long run.

The financial, emotional, and societal strain that the pandemic has already invoked could justify more vigorous actions at this time. However, the issue of enforcement may also lie in the power dynamic balance between the state and the federal government. The presidential administration’s attempts to issue all-covering mandates are frequently curtailed by state governors (Executive Order 21-175, 2021). An example of the conflict is the executive order by Florida governor Desantis regarding parental freedom to decide on mask-wearing in schools (2021). Any actions perceived as forceful and aggressive by the federal authorities may result in pushback from some state groups. To conclude, while it is justified for the government to continue enforcing the regulations, the authorities should carefully plan how such enforcement is done.


Brockell, G. (2021). Jacobson vs. Massachusetts: Smallpox ‘virus squads’ and the mandatory vaccinations upheld by the Supreme Court. Washington Post. Web.

Ensuring parents’ freedom to choose – masks in schools, No. 21-175 (Office of the Governor, 2021). Web.

Guidance for the interim final rule—Medicare and Medicaid programs; Omnibus COVID-19 health care staff vaccination, QSO-22-09-ALL (2022). Web.

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Jacobson v. Massachusetts, No. 70 (U.S. Supreme Court, 1905). Web.

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