Hospitals Confront the Fallout From Supreme Court Ruling on Vaccine Mandate

“I don’t think anyone should force you to do something against your will.”But many medical experts say mandates are effective in persuading more people to become vaccinated, which they say is essential to helping prevent the spread of the virus.“At a time when we’re closing in on 850,000 Americans having died in the worst global pandemic in a century, and when infections and hospitalizations are continuing to soar, it is the obligation of our public agencies to require and enforce essential public safety measures to protect the lives and health of all American workers,” said Zenei Triunfo-Cortez, president of the union National Nurses United.While 21 states and the District of Columbia have already mandated vaccines for health care workers, six — Texas, Montana, Arkansas, Indiana, Tennessee and Georgia — implemented bans that prohibited some employers from requiring vaccines. On Friday, Mr. DeSantis reiterated his position, posting on Twitter that Florida will reject federal mandates, “which are rooted in political, not medical science.”Still, federal laws ordinarily displace, or “pre-empt,” contrary state and local ones, and in allowing the mandate for health care workers, the Supreme Court at least implicitly ruled that it overrode state laws banning vaccination requirements at facilities participating in the Medicaid and Medicare programs.The specter of potentially losing federal funding if they do not comply has already persuaded some hospital chains to require vaccinations for workers who did not qualify for a medical or religious exemption.“If we do not comply with the CMS mandate, we could compromise our ability to serve our communities and provide care to patients under the Medicare and Medicaid programs,” a spokesman for HCA said in a statement. The clinic said about 85 percent of its employees were vaccinated.Exactly how many hospital workers are unvaccinated is unclear, and even under the new rules, health care workers are often able to get medical or religious exemptions.But the concern remains, particularly among nursing homes and smaller rural hospitals, that the mandate will exacerbate the existing staffing shortages that have crippled much of the country during this latest surge. “Even the loss of one nurse can have a negative impact on the number of patients for whom we are able to deliver care,” he said.In Texas, Gov. Greg Abbott signed an executive order banning employers from requiring vaccines last year, and more recently his office sued the Biden administration for requiring Army National Guard members in his state to get the shots.Although Texas filed its own lawsuit and had gotten a separate injunction, the state hospital association is advising hospitals to follow the federal rules in light of the Supreme Court decision.In California, vaccination rates have risen considerably since August, when Gov. Gavin Newsom’s administration ordered the state’s two million-plus health care workers to be inoculated by the end of September as a condition of employment.But that hasn’t been enough to prevent Omicron from hurting staffing levels at health care facilities across the state, where hospitalizations for Covid-19 have been spiking, as has been the case nationwide.Hoping to keep more hospital workers on the job, California health care officials this week changed state guidelines to temporarily allow asymptomatic health care workers to return to work immediately if they have tested positive for the virus.“In politics, if someone wins with 60 or 70 percent of the vote, they’ve crushed their opponent,” said state Senator Richard Pan, a Sacramento pediatrician who has led California efforts to tighten vaccine mandates.