KHN’s “What the Health?”: The Policy of Vaccine Mandates

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Should Covid Vaccines Be Mandatory? As with almost everything else related to the pandemic, the answer to that question has become predictably partisan. As the federal government prepares to enact regulations that require large employers to ensure their workers are vaccinated, the GOP governors seek to ban such mandates and leave employers in the thick of it.

Meanwhile, on Capitol Hill, the Democrats are still working to reach consensus on a package of improvements in social spending, the size of which will largely depend on how much they can cut prescription drug prices.

This week’s panelists are Julie Rovner from KHN, Alice Miranda Ollstein from Politico, Jen Haberkorn from the Los Angeles Times and Mary Ellen McIntire from CQ Roll Call.

Among the takeaways from this week’s episode:

• Congressional Democrats’ struggle to compromise a $ 3.5 trillion spending package on health and other welfare programs is likely to push them past their self-imposed late October deadline to pass a bill. The leaders wrestle over what to cut while complying with demands from the moderates in the party to cut spending.
• Everything in this package appears vulnerable at this stage of the negotiations. Party leaders are considering a variety of strategies including rejecting some proposals or setting up the new benefits for a shorter period of time to test whether they work and the public appreciates them.
• It seems that the Democrats’ priorities will include proposals to improve children’s outcomes. But the health programs at stake – new benefits for Medicare, insurance for low-income residents of states that haven’t expanded their Medicaid programs, and the expansion of improved premium subsidies for the Affordable Care Act – all have and will have strong electorate be hard for leaders to settle.
• The proposal to top up long-term care programs in the billions could draw the short straw. It does have some strong allies in Congress, however, including Sens. Ron Wyden (D-Ore.) And Bob Casey (D-Pa.).
• Democratic leaders hope to fund some of the initiatives in this package by cutting Medicare’s drug spending. A poll by KFF this week showed that this is a very popular notion, even among Republicans. But drug manufacturers are fighting this strategy with big advertising campaigns and political donations. All you have to do is take out a few vulnerable lawmakers to thwart the effort, as Democrats have wafer-thin majorities in both the House and Senate. However, House spokeswoman Nancy Pelosi appears determined to include some sort of provision for drug price negotiations in the bill, even without the full impact of her original plan.
• The Department of Labor has reportedly sent a proposed rule requiring large employers to vaccinate their workforce to the Department of Management and Budget for review. That means the rule could come soon. But in conservative states like Texas, where Republican governor Greg Abbott has banned mandates, he is bound to run into opposition. The subject is likely to land in federal court.
• The battle for vaccine mandates underscores the divide in the Republican Party between the business-minded faction looking to overcome the pandemic and the party’s more liberal wing. Some of the most conservative political leaders lean towards this libertarian wing and see the vaccination mandate as a way to inspire the grassroots. However, the experience of some large companies suggests that companies and many workers have no objection to mandates. One example is United Airlines, where 99% of workers have been vaccinated.
• As the federal courts beat the Texas abortion law back and forth, it seems headed for a review by the Supreme Court. Some analysts suggest that the urgency of the matter could lead the court to consider the Texas issue before hearing a case about another Mississippi abortion limit law in December. But the Supreme Court generally likes to have cases fully debated in lower courts before going before the judges, so a decision on Texan law may have to wait.
• The subject of abortion gets a fair amount of advertising time in the Virginia gubernatorial race. Democratic candidate Terry McAuliffe tells voters he will campaign to keep abortions legal in the state and suggests that his opponent Glenn Youngkin not do so. It’s a strategy California Governor Gavin Newsom used when he successfully battled dismissal in an election last month.

Also this week, Rovner interviewed Beth Macy, bestselling author of Dopesick: Dealers, Doctors and the Drug Company That Addicted America and executive producer of a miniseries of the same name now streamed on Hulu.

Panellists also recommend their favorite health policy stories of the week, which they think you should read as well, for added recognition:

Julie Rowner: KHN’s “6 Months to Live or Die: How Long Should a Patient with Alcoholic Liver Disease Wait for a Transplant” by Aneri Pattani

Jens Haberkorn: The Washington PostCovid and Cancer: A Dangerous Combination, Especially for People of Color“By Laurie McGinley

Mary Ellen McIntire: NPRs “Assessing “sincere” religious beliefs is difficult for employers who prescribe vaccines“By Laurel Wamsley

Alice Miranda Ollstein: The 19th^NS‘S “Kansas has become a beacon for access to abortion. That could go away next year“By Shefali Luthra

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