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How the health care worker vaccine mandate will work, with SCOTUS' go-ahead


Today, the Supreme Court gave the Biden administration a win and a loss on COVID-19 vaccine rules. First, the loss - the Occupational Safety and Health Administration, or OSHA, trying to require vaccination or weekly testing for workers at large private companies. The justices blocked that rule. Then the win - the court upheld a mandate for health care workers at facilities that get federal money. The agency behind that rule is the Centers for Medicare and Medicaid Services, or CMS, and Chiquita Brooks-Lasure is the administrator of CMS.


CHIQUITA BROOKS-LASURE: Thank you so much for having me.

SHAPIRO: This has been a confusing time with the vaccine mandates stuck in courts. Now that your agency has a green light, when is this rule for health care workers going to take effect?

BROOKS-LASURE: Well, you are right that it's been confusing, but we're so excited about the Supreme Court ruling because we think, as CMS, it's our responsibility to give patients the assurance of safety in their care, particularly as a key part of combating the pandemic. So we are already, in 25 states, in the process of implementing the vaccine standards. And now in the additional states, we will move forward with the Supreme Court ruling. And this means...

SHAPIRO: So if I'm an unvaccinated health care worker in one of those states, how long do I have to get in compliance?

BROOKS-LASURE: So our new date for the states that were - that the Supreme Court has just ruled on is March 15. So that's when we want to get everyone to be vaccinated.

SHAPIRO: And what's enforcement going to look like? I mean, how soon would people face consequences for not complying? And what would those consequences look like?

BROOKS-LASURE: So we are really focused on working with facilities. And this is a requirement on facilities to have plans in place. We're doing quite a lot of technical assistance outreach. I was in Philadelphia a couple of weeks ago, listening to systems to hear what they're doing. And so...

SHAPIRO: It sounds like you're saying you don't want to threaten punishment. But the whole point of a rule is that if people don't follow it, there are consequences, right? So what are those consequences?

BROOKS-LASURE: That is absolutely true that we want to make sure that we're working with people, but the consequences will be - we have a variety of options, whether it's civil monetary penalties for facilities that don't have plans in place...

SHAPIRO: You mean, like, withholding federal funding.

BROOKS-LASURE: That's right. So whether it's fines, whether it's withdrawing federal funds or, of course, as a last resort, would be to terminate them from the program.

SHAPIRO: And previously, your agency has said that this rule would not require a booster, a third shot. Do you think that could change going forward?

BROOKS-LASURE: It is the responsibility of the CDC to define how fully vaccinated will be defined, and we will be following the recommendations of the CDC.

SHAPIRO: Now, you've said that, so far, this rule or the anticipation of it has not led health care workers to quit. Staffing is already so thin. Many hospitals cannot afford to lose even a few workers. Does it concern you that implementation will drive some people away?

BROOKS-LASURE: What really is concerning us is the virus and its effect on staffing. And really, that is the driving force of a lot of our concern and - around making sure that staff are vaccinated. The reason why we are seeing so many shortages across the country is really about people being - the virus being quarantined because they've been exposed to people with COVID-19 or because they've contracted it. So when we think about how do we address shortages, which are a huge issue - I'm sure you're hearing about facilities not being able to do elective surgeries, etc. We really see vaccination as our key defense in addressing this pandemic.

SHAPIRO: On the other mandate for private employers, which the Supreme Court struck down today, that decision does not prevent Congress from passing such a requirement. Is the administration going to encourage lawmakers to look at that and pass such legislation?

BROOKS-LASURE: I can't speak to - we're all digesting, so I can't speak to what we might ask Congress to do. I know that we, CMS, are certainly joining the president and OSHA in saying how we're really disappointed and know this is a major setback.

SHAPIRO: Chiquita Brooks-Lasure is the administrator for the Centers for Medicare and Medicaid Services.

Thank you.

BROOKS-LASURE: Thank you again. Transcript provided by NPR, Copyright NPR.

Ari Shapiro
Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.
Ashley Brown
Ashley Brown is a senior editor for All Things Considered.