Feds, Florida fight over health care COVID vaccine rule

As Governor Ron DeSantis battles passports and COVID-19 vaccination warrants – most recently by threatening the Special Olympics with a $ 27.5 million fine – there is a warrant he can’t stop.

The Centers for Medicare & Medicaid Services are enforcing a federal vaccine requirement for healthcare professionals who offer only medical or religious exemptions. The rule, which the US Supreme Court validated in January, contradicts a state law that requires employers to offer extensive exemptions not allowed by CMS.

Although the Florida Agency for Health Care Administration has promised not to monitor or report whether Florida health care facilities are following the requirement, that doesn’t stop the federal government from checking. The CMS required that 100% of Florida’s eligible health care workers be fully vaccinated or received an exemption by February 28.

CMS has reduced Florida’s federal allocation for survey and certification funding by $ 1.2 million and will pay contractors to see if healthcare facilities are following the law, which would typically be the state’s responsibility, a spokesperson said. of the CMS. The agency plans to cut funding to non-compliant states in future years until they begin overseeing the vaccine requirement, a February 9 memorandum says.

Brock Juarez, director of communications for the Florida Agency for Health Care Administration, said in an email on Thursday that the CMS’s moves do not change the agency’s policy.

“$ 1.2 million is a small price to pay to protect the freedom of health care workers,” he wrote.

Juarez added that he doubted that CMS would actually carry out its threatened sanction for non-compliant hospitals: termination from the program, which it would mean that hospitals would no longer be able to accept Medicaid or Medicare.

A record 5,242,984 people are currently enrolled in Medicaid across the state, according to the Florida Agency for Health Care’s April tally.

“The concept that the Biden administration would tie Medicare and Medicaid funding to a vaccination mandate – funding that pays for medical care for children, the elderly, the disabled and low-income people is half public policy,” Juarez wrote. . “I would be surprised if that was the path they choose to take.”

Christina Pushaw, a spokesperson for DeSantis, said in an email that state laws signed by the governor in November limiting vaccination mandates still apply.

Companies with 99 employees or fewer issuing vaccination warrants without exemptions will be fined $ 10,000 for employee violation, and larger companies will be fined $ 50,000 for employee violation, a Nov. 18 press release from the office said. DeSantis.

Florida law provides protections from employers’ vaccine mandates. No one, including health care workers, should lose their livelihood due to covid vaccination status. This is a personal medical decision and in Florida we respect it, ”Pushaw wrote.

State law differs from federal law by requiring exemptions prohibited by CMS, such as an exemption for a previous COVID-19 infection.

“Available evidence indicates that COVID-19 vaccines offer better protection than natural immunity alone and that vaccines, even after a previous infection, help prevent reinfection,” reads a CMS FAQ document.

Pushaw called this position “unscientific”.

State law also requires that people without qualified religious or medical exemptions have the ability to undergo weekly tests instead of getting vaccinated, which the CMS does not allow, citing evidence that vaccination is a more effective infection control measure.

CMS argues that states cannot prohibit hospitals from following the rule due to the supremacy clause of the United States Constitution, which states that federal law takes precedence over state law in the event of a conflict.

The hospital’s regulator cited 69 hospitals nationwide for failing to comply with the mandate and is working to bring them online, the agency told Politico on May 30, though political experts told the publication that they worry if the agency has sufficient resources for the task.

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The idea of ​​a mandate for the health vaccine has had widespread support from the medical community since before it was enacted.

In July 2021, over 50 medical groups, including the American Medical Association, the American Nurses Association, the American Academy of Pediatrics, the Association of American Medical Colleges, and the National Association for Home Care and hospice, have all asked healthcare employers to apply for vaccination against COVID-19 employees, according to a press release from the Association of American Medical Colleges.

“The AAMC, whose members continue to provide care to patients at the forefront of this ongoing pandemic, did not take this decision lightly,” AAMC President and CEO Dr. David J. Skorton. “Based on the large and compelling body of evidence and real-world experience of the safety and efficacy of COVID-19 vaccines, requiring vaccinations among those serving in health care institutions is the right decision to promote the health of children. our patients, their families and communities “.

Critics like DeSantis and Florida surgeon general Joseph Ladapo have said vaccination warrants will increase the current shortage of health workers in Florida and violate people’s bodily autonomy.

“Your rights or freedoms should not be limited by your decision to get or not get a COVID vaccine,” DeSantis said at a June 3 press conference to discuss the end of the Special Olympics vaccine requirement.

The vaccination mandate so far does not appear to have exacerbated the staff shortage, at least in nursing homes, where vaccination rates have increased by 25 percentage points nationwide from 63% to 88% since the mandate was announced in August 2021. until its deadline at the end of February, a May analysis by researchers from the Kaiser Family Foundation was found.

[email protected]; @CECatherman on Twitter

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