Dr. A v. Hochul
The Court declined to block New York's COVID-19 vaccine mandate for healthcare workers, leaving in place a rule that offers medical exemptions but no religious ones, as thousands of workers faced job loss.
Justices Gorsuch and Alito dissented forcefully, arguing that the Governor's own public statements — calling religious objectors people 'not listening to God' — showed the kind of official hostility toward religion that should have doomed the mandate immediately.
How it got here: Two federal district courts reached opposite results; the Second Circuit combined the cases and rejected all claims; the healthcare workers applied directly to the Supreme Court for emergency relief.
The Case in Depth
What happened
About twenty New York healthcare workers — doctors, nurses, and others — objected to the state's COVID-19 vaccine mandate on religious grounds, because all available vaccines had been developed or tested using cell lines derived from aborted fetuses, which their faith teaches them to oppose. New York's mandate allowed workers with medical reasons to opt out, but not those with religious objections. Governor Hochul publicly said the omission of a religious exemption was intentional, and suggested that religious objectors were not truly following God's will.
The question before the Court
Should New York healthcare workers with sincere religious objections to COVID-19 vaccines be shielded from the state's vaccine mandate — which allows medical but not religious exemptions — while their lawsuit works its way to the Supreme Court?
The Court's answer
No — the Court declined to block New York's vaccine mandate while the underlying lawsuit continued. The application for emergency injunctive relief was denied without explanation, leaving the mandate in effect and allowing the state to enforce the requirement that healthcare workers receive a COVID-19 vaccine with no religious exemption available.
Three justices — Thomas, Gorsuch, and Alito — would have granted relief. Justices Gorsuch and Alito wrote that, in their view, the mandate almost certainly violated the First Amendment because the Governor's own public statements showed the exclusion of a religious exemption was deliberate and targeted at what she characterized as theologically mistaken beliefs — the kind of official hostility toward religion that the Court's own precedents say requires striking down a law without further inquiry.
Curious how the Court got there? See the step-by-step legal reasoning →
Why it matters
Thousands of New York healthcare workers who objected to COVID-19 vaccines on religious grounds lost their jobs and became ineligible for unemployment benefits once the mandate took effect. The ruling left those consequences in place while the lawsuit continued, setting a signal — contested by three justices — that courts would not quickly intervene in pandemic vaccine mandates even when religious exemptions were denied.
What changes now
The underlying lawsuit continued in the lower federal courts after the Supreme Court declined to intervene. Healthcare workers who refused the vaccine lost their jobs and became ineligible for unemployment benefits in the meantime. The Court's order was temporary and did not resolve whether New York's mandate ultimately violates the First Amendment; that merits question remained open for further litigation.
What this does not decide
The Court did not rule on whether New York's vaccine mandate actually violates the First Amendment. It only declined to pause the mandate temporarily while the lawsuit continued. The underlying constitutional question — whether excluding religious exemptions while keeping medical ones is permissible — remained unresolved.
Concurrences and dissents
Dissent — Justice Gorsuch
Justice Gorsuch, joined by Justice Alito, argued the Court should have blocked the mandate immediately. He contended that Governor Hochul's own statements — declaring the exclusion of a religious exemption was intentional and that objectors were not 'listening to God' — showed the kind of official hostility toward religion that automatically renders a policy unconstitutional. He further argued the mandate failed both neutrality and general applicability tests, and that New York could not survive strict scrutiny given that nearly every other state had found ways to accommodate religious objectors. He compared the Court's inaction to its discredited 1940 Gobitis ruling.
How the Court got there
The legal reasoning, step by step
- Emergency injunctive relief requires courts to assess, among other things, whether the applicants are likely to succeed on the legal merits of their underlying claim. Here, the dissent argued, that question was not close — the mandate's constitutional problems were clear at each level of analysis.
- The Free Exercise Clause bars government from acting with hostility toward religion. Under the Court's 2018 Masterpiece Cakeshop ruling, even a 'slight suspicion' of animosity toward religion is enough to set aside a policy. The dissent argued Governor Hochul's repeated public statements — that the removal of the religious exemption was 'intentional,' that objectors were not 'listening to God,' and that 'everybody from the Pope on down' supports vaccination — went far beyond slight suspicion and should have ended the inquiry.
- Even without hostility, the Free Exercise Clause requires laws that burden religious practice to be both neutral toward religion and generally applicable to everyone. A law loses that status when it bans religiously motivated conduct while permitting comparable secular conduct that equally undermines the government's stated goal. New York's mandate allowed unvaccinated workers to stay on the job for medical reasons, but not for religious reasons — even though an unvaccinated worker poses the same public health risk regardless of why they are unvaccinated.
- Failing either the neutrality or general-applicability standard triggers strict scrutiny — the most demanding test in constitutional law — under which the government must show it has a compelling reason for the policy and has used the most limited means possible. The dissent argued New York could not satisfy this standard: nearly every other state had found ways to accommodate religious objectors, vaccination rates in New York healthcare facilities already stood between 90% and 96%, and the state offered no evidence that exempting the specific applicants would make any meaningful difference to public health.
- The dissent closed by analogizing the Court's refusal to act to its 1940 Minersville School District v. Gobitis decision, which upheld mandatory flag salutes for Jehovah's Witness children — a ruling the Court later overruled in West Virginia v. Barnette, after the original decision had prompted widespread attacks on Witnesses across the country. The dissent argued the pandemic, like wartime, creates pressure to override the rights of religious minorities, and that the Constitution demands the Court resist that pressure rather than yield to it.