Health workers face Jan. 4 deadline for Biden vaccine mandate

Workers at health facilities that receive federal funding, including major hospitals and nursing homes, will need to be fully vaccinated by Jan. 4 under a sweeping emergency rule released by the Biden administration Thursday.

The rule covers approximately 76,000 health care facilities and more than 17 million health care workers — the majority of health care workers in the country. 

The rule applies to all employees, regardless of whether they are clinical or not. According to administration officials, it also covers students, trainees, and volunteers who work at a facility that receives federal funding from Medicare or Medicaid.

Administration officials will be speaking with providers on Thursday to walk through the new requirements.

Health experts say a vaccine requirement could go a long way toward protecting vulnerable patients, especially in facilities like nursing homes, and stopping preventable outbreaks. 

In August, President Biden told nursing homes they had to vaccinate their staff if they wanted to continue receiving federal funding. But the nursing home mandate never materialized; instead it was replaced in September by the much broader policy.

Nursing homes had been concerned that a mandate could exacerbate workforce shortages, but by making all health workers subject to the rules, the administration created a level playing field and likely eliminated the risk of unvaccinated employees leaving for other health jobs. 

According to senior administration officials, the effective date of Jan. 4 will align health facilities with the administration’s other vaccination requirements, including one for federal contractors and a vaccine-or-test rule for private businesses with more than 100 employees.

Importantly, health facilities will be subject to stricter rules than other workplaces, and there will not be a testing alternative. 

“There is not a testing option,” a senior administration official told reporters during a call to preview the new policies. “We have a higher bar for health care workers given their critical role in ensuring the health and safety of their patients. And so it’s either vaccination or an exemption.”

The official said the goal of the rule is to bring health care providers into compliance, not to punish them, so there will be numerous opportunities before a facility is penalized. Even then, there would be steps in terms of severity, and the administration would only remove the facility from Medicare or Medicaid as a last resort.

“Termination would really only occur if, after providing a facility with an opportunity to make corrections and come into compliance, they chose not to do so,” the official said. Still, “we will not hesitate to use our full enforcement authority to protect the health and safety of patients.”

The Biden administration has leaned strongly into vaccine mandates even in the face of heavy GOP opposition. Officials have touted mandates as the reason for increased vaccination rates nationwide; the administration last month released a report that found businesses and organizations that instituted them saw at least a 20 percent increase in their vaccination rate.

While the new rules won’t take effect until Jan. 4, officials are calling on all employers to ensure that as many of their workers are vaccinated as quickly as possible.