A nurse refusing a vaccine shot

The Republican-controlled US House of Representatives is expected to vote on two bills today that would have significant impacts for nursing homes.

While sounding potentially impactful, neither is expected to move out of the Democrat-controlled US Senate and make it to President Joe Biden’s desk.

Rep. Jeff Duncan (R-SC) last week introduced the Freedom for Health Care Workers Act to eliminate the federal vaccine mandate for employees of facilities that receive federal funding. The US Supreme Court last January allowed that mandate to proceed, and it covers an estimated 11 million workers. Notably, Duncan’s bill would also prohibit the Department of Health and Human Services from enacting a similar rule in the future.

Meanwhile, Rep. Brett Guthrie (R-KY) had earlier this session introduced the Pandemic Is Over Act to declare an immediate end to the public health emergency. The federal government has extended the PHE multiple times since it was first declared on Jan. 31, 2020, providing ongoing support for providers and easier access to healthcare for many Americans.

On Monday evening, Biden got ahead of an expected House floor vote and announced that his administration would itself end the PHE on May 11.

Todd Adams, director of Health Legislative Affairs for LeadingAge, said on a call with members Monday that neither Duncan’s bill nor Guthrie’s is expected to pass in the Senate, which is controlled by Democrats. 

“We bring up this legislation because it does serve an important function of staking out the policy decisions of the House Republican majority, particularly as they contrast with the administration’s pandemic policies,” Adams said.

Vaccine mandates have a checkered history in the courts.

Rep. Cynthia Tenney (R-NY) recently introduced the Health Freedom for All Act to prevent the Occupational Safety and Health Administration from trying to force businesses with 100 or more employees to require a vaccination and require weekly testing for unvaccinated workers. While small, independent nursing homes may have fewer than 100 employees, the OSHA mandate would hit large facilities and corporate entities that own multiple homes. 

In January 2022, the US Supreme Court blocked an original OSHA mandate for large employers created in November 2021 on the same day it left in place the mandate for healthcare workers. 

In New York, an Onondaga County Supreme Court judge struck down a COVID vaccine mandate for healthcare workers but state officials have filed an appeal, reported Becker Hospital Review. Stephen Hanse, president and CEO of the New York State Health Facilities Association/NYS Center for Assisted Living, told McKnight’s that much damage from the mandate has already been done. 

“I don’t see the court’s decision resulting in any substantive growth in workers coming into long-term care,” Hanse said. “Our primary focus right now is the healthcare workforce crisis in New York and the severe underfunding of Medicaid in nursing homes and assisted living facilities.”

Earlier this month, Health and Human Services Sec. Xavier Becerra said that approximately 1,000 nursing homes in the country still have “zero people” vaccinated against COVID. The Biden Administration is working with state regulators to assess penalties for those facilities, Politico reported

In November, 22 states petitioned the Centers for Medicare & Medicaid Services to rescind its healthcare worker vaccine mandate. Also that month, attorneys general for 10 states filed an amended complaint against the mandate, calling it “irrational.” CMs has yet to issue a formal response to that petition.

Regardless of whether vaccine mandates remain in place, the American Health Care Association/National Center for Assisted Living said it will continue partnering with public health officials and others to increase vaccine rates in nursing homes. “Our focus remains on encouraging the long-term care community, especially our residents, to be up to date on their vaccinations,” the organization said in a statement yesterday to McKnights, adding that it is continuing efforts to combat misinformation.