The vaccine mandate for healthcare workers is back in place for half the country following an appeals court ruling

The issue seems destined to be decided by the U.S. Supreme Court.

The status of the federal vaccine mandate for healthcare workers became more muddled on Wednesday, with an appeals court reinstating the mandate for 26 states.

The New Orleans-based 5^th U.S. Circuit Court of Appeals ruled that a prior court decision to issue an injunction on the mandate should apply only to the states that had been part of the lawsuit in question.

The states covered by the injunction are the 14 plaintiffs in the case, while a separate injunction pertains to 10 states in a different case.

In its ruling, the three-judge panel (including two appointees by President Barack Obama and one by President George W. Bush) indicated the Supreme Court likely will be called on to issue a comprehensive national ruling.

Pending further rulings, health systems with facilities in multiple states now may be faced with implementing the mandate at some sites and considering whether to make vaccination voluntary at others. As of Wednesday afternoon, CMS had not confirmed whether it would seek to enforce the mandate where doing so is permitted.

Injunctions on the mandate remain in place in the following states:

Alabama

Alaska

Arizona

Arkansas

Georgia

Idaho

Indiana

Iowa

Kansas

Kentucky

Louisiana

Mississippi

Missouri

Montana

Nebraska

New Hampshire

North Dakota

Ohio

Oklahoma

South Carolina

South Dakota

Utah

West Virginia

Wyoming