The Biden Administration is considering measures to make it very financially uncomfortable for those refusing the COVID-19 vaccine who would otherwise be able to receive it, especially for public and private institutions refusing vaccine mandates.
The Biden administration is considering using federal regulatory powers and the threat of withholding federal funds from institutions to push more Americans to get vaccinated — a huge potential shift in the fight against the virus and a far more muscular approach to getting shots into arms, according to four people familiar with the deliberations.
The effort could apply to institutions as varied as long-term-care facilities, cruise ships and universities, potentially impacting millions of Americans, according to the people, who spoke on the condition of anonymity to discuss sensitive conversations.
The conversations are in the early phases and no firm decisions have been made, the people said. One outside lawyer in touch with the Biden administration on the issue is recommending that the president use federal powers sparingly.
There is a particular focus in the discussions on whether restrictions on Medicare dollars or other federal funds could be used to persuade nursing homes and other long-term-care facilities to require employees to be vaccinated, according to one of the people familiar with the talks.
If the Biden administration goes forward with the plans, it would amount to a dramatic escalation in the effort to vaccinate the roughly 90 million Americans who are eligible for shots but who have refused or have been unable to get them.
The discussion at the highest level of government also signals a new phase of potential federal intervention as the White House struggles to control the delta variant of the virus, which is spreading more rapidly than even some of the more dire models predicted.
But such drastic moves are likely to trigger further backlash from many Republican-leaning regions where vaccine hesitancy has been highest, agitating conservatives already skeptical of the Biden administration and its use of federal power. The administration has already said that federal workers and contractors must be vaccinated or wear masks, and the Pentagon is considering similar requirements.
Several experts noted that even if President Biden’s team could force Americans to begin getting shots as soon as this week, it still takes five to six more weeks for mRNA inoculations — which require a second shot — to be fully effective. That means infection rates could keep rising in the short term no matter what steps are taken on vaccinations.
When asked about vaccine mandates after a Thursday event on electric vehicles, Biden said his administration was looking at its options as he encouraged all Americans to get vaccinated. The White House declined to comment for this story.
The talks within the administration come amid calls from many public health experts for a more aggressive federal approach to vaccinations. The country reported more than 100,000 new coronavirus cases Wednesday, an infection rate on par with early February, before vaccines were widely available. On Thursday, the rolling seven-day daily average of new infections was at 95,000 new cases.
“I think wisely using the federal spending power is absolutely right,” said Lawrence Gostin, who directs Georgetown University’s O’Neill Institute for National and Global Health Law and said he has discussed the idea of using federal funds as an incentive with Biden administration officials.
Gostin said he has suggested the White House use its power judiciously, not by “bludgeoning the private sector” but rather by “starting with high-risk settings with an absolute ethical obligation and legal obligation to keep your workers and your clients safe.”
Other leading experts have publicly floated the idea of using more federal incentives to push for vaccinations as a lever that Biden and his administration could use.
“If you look through history, there are presidents who — even in the absence of legal authority — influence people, you might say,” said Ezekiel Emanuel, a bioethicist at the University of Pennsylvania who recently organized a joint statement from nearly 60 medical groups urging every health facility to require workers to get vaccinated. “We keep referring to this covid thing like it’s an emergency and then we don’t behave like it’s a wartime emergency.”
Time to pull out the big guns then. Expecting others to pay the piper when 100 million Americans still refuse to get the vaccine is immoral, and Biden has an imperative to step in here.
Here's hoping it's soon.
Get the vaccine, folks.
Now.