Biden vaccine rule for health workers blocked in Iowa, 9 other states

JEFFERSON CITY, Mo. (AP) — A federal judge Monday blocked President Joe Biden’s administration from enforcing a coronavirus vaccine mandate on thousands of health care workers in 10 states including Iowa, which together had brought the first legal challenge against the requirement.

The court order said that the federal Centers for Medicare & Medicaid had no clear authority from Congress to enact the vaccine mandate for providers participating in the two government health care programs for the elderly, disabled and poor.

The preliminary injunction by St. Louis-based U.S. District Judge Matthew Schelp applies to a coalition of suing states that consists of Alaska, Arkansas, Iowa, Kansas, Missouri, Nebraska, New Hampshire, North Dakota, South Dakota and Wyoming. Similar lawsuits also are pending in other states.

“I believe the vaccine is the best defense against COVID-19, but I also firmly believe in Iowans’ right to make health care decisions based on what’s best for themselves and their families, and I remain committed to protecting those freedoms,” Iowa Republican Gov. Kim Reynolds said in a statement. “President Biden should do the same.”

Iowa has five state-run health care facilities that receive Medicare and Medicaid funding: the Iowa Veterans Home, the Cherokee and Independence Mental Health Institutes, and the Glenwood and Woodward Resource Centers. By August, according to the Iowa Capital Dispatch, the state’s Veterans Home had experienced five outbreaks over the course of the pandemic — more than any other long-term care facility in Iowa.

The federal rule requires COVID-19 vaccinations for more than 17 million workers nationwide in about 76,000 health care facilities and home health care providers that get funding from the government health programs. Workers are to receive their first dose by Dec. 6 and their second shot by Jan. 4.

Health care systems in Iowa include those that on their own — and not in response to a federal requirement — implemented vaccine mandates for staff that went into effect in recent weeks.

UnityPoint Health, the Des Moines-based system that’s one of the largest in the region, for example, reported 97 percent of its staff had either received the shots or got approved for an exemption. At its Cedar Rapids hospital, UnityPoint Health-St. Luke’s, about 99.5 percent of hospital staff were fully vaccinated or approved for an exemption by Nov. 9, according to officials.

Mercy Medical Center in Cedar Rapids said earlier this month that about 98.1 percent of its employees had been fully vaccinated against the coronavirus or had received a medical or religious exemption.

The federal court order against the health care vaccine mandate comes after Biden's administration suffered a similar setback for a broader policy. A federal court previously placed a hold on a separate rule requiring businesses with more than 100 employees to ensure their workers get vaccinated or else wear masks and get tested weekly for the coronavirus.

Biden’s Democratic administration contends federal rules supersede state policies prohibiting vaccine mandates and are essential to slowing the pandemic, which has killed more than 775,000 people in the United States. About three-fifths of the U.S. population is fully vaccinated.

But the judge in the health care provider case wrote that federal officials likely overstepped their legal powers.

“CMS seeks to overtake an area of traditional state authority by imposing an unprecedented demand to federally dictate the private medical decisions of millions of Americans. Such action challenges traditional notions of federalism," Schelp wrote in his order.

Even under an exceedingly broad interpretation of federal powers, Congress did not clearly authorize CMS to enact "this politically and economically vast, federalism-altering, and boundary-pushing mandate," wrote Schelp, who was appointed to the bench by former President Donald Trump.

While a vaccine requirement might make sense for long-term care facilities, Schelp wrote, CMS lacks evidence for imposing it on other health care providers and ignored evidence that the mandate could jeopardize understaffed facilities.

Officials at CMS had no immediate comment about the preliminary injunction.

Michaela Ramm of The Gazette contributed to this report.