New federal vaccination mandate could complicate things for Montana hospitals

Montana’s more than 25,000 healthcare workers could be required to be fully vaccinated against COVID-19 following the Thursday announcement of a new national mandate from the Biden administration requiring all workers at hospitals that receive federal Medicare or Medicaid funds to be fully vaccinated.

Before the announcement, Montanan hospitals were subject to House Bill 702, which prohibits discrimination based on vaccination status, meaning employers cannot issue vaccine requirements for workers. Montana is the only state in the country with such a law.

Members of Montana’s medical community have been staunch critics of the law, saying it makes for an unsafe working environment for patients and employees alike. While enacted during the throes of COVID-19, the law is inclusive of all vaccinations, not just COVID-19 vaccinations.

But the national mandate requiring workers at health facilities that receive Medicare or Medicaid funds to be fully vaccinated against COVID-19 could create problems for healthcare facilities as they try to navigate both laws. Biden also issued mandates that would require vaccination or weekly testing for workers of companies with 100 or more employees, as well as all federal workers and millions of contractors that work with the federal government.

“We will be asking our legal counsel to review the new guidance, particularly in light of HB702,” said Montana Hospital Association Spokesperson Katie Peterson. “It appears to present some conflict between state and federal laws.” The Montana Hospital Association said it had not received formal guidance on implementing the new requirements from D.C.

There are 65 non-governmental hospitals in Montana that receive Medicaid or Medicare dollars, Peterson said. Those hospitals employed 25,297 workers in 2019, according to the U.S. Bureau of Labor Statistics. Nationally, the Biden administration said the new mandate would impact around 17 million healthcare workers.

“I think it’s very clear if it can go into effect, it will make things safer,” said Dr. Pam Cutler, president of the Montana Medical Association. “It will make life more complicated in Montana, where this is a controversial topic, but it will make things safer for patients and employees.”

Biden issued a similar requirement earlier this year requiring the full vaccination of all employees working at nursing homes or long-term care facilities that participate in Medicare or Medicaid. However, carved out in HB702 was an exemption for those workers.

“A licensed nursing home, long-term care facility, or assisted living facility is exempt from compliance with during any period of time that compliance with would result in a violation of regulations or guidance issued by the Centers for Medicare and Medicaid Services or the Centers for Disease Control and Prevention,” the bill’s text reads. There is no such exemption for hospitals.

Gov. Greg Gianforte’s office did not respond to a request for comment on the mandate, but he did tweet about it, saying, “President Biden’s vaccination mandate is unlawful and un-American. We are committed to protecting Montanans’ freedoms and liberties against this gross federal overreach.”

Gianforte has been a soft supporter of the vaccine, saying he will not impose a vaccine mandate and encouraging Montanans to do what’s best for themselves in consultation with their medical providers. At the same time, he has called the vaccine the “light at the end of the tunnel” and the way out of the pandemic.

As of Thursday, Montana had administered 961,328 doses of the vaccine with 470,413, or 51 percent, of the state’s eligible population fully vaccinated. On Thursday, the state recorded 1,001 new COVID-19 cases, bringing the seven-day average to 559, the highest average since January 12.

Last week, Gianforte issued an emergency rule asking school boards to let parents opt their children out of mask mandates. The rule fell short of ordering schools to give parents the final say.

The professional medical community in the state quickly criticized the rule and the studies put forth by Gianforte the Montana Department of Public Health and Human Services. On Wednesday, the Montana Nurses Association, which bargains and lobbies for nurses in Montana, issued a formal response to the rule. In the memorandum, the group dismisses the studies put forth by the Gianforte administration as “junk science.”

In the letter, the group points out the first of the studies put forth by the administration was not peer-reviewed. The second study, according to the letter, “clearly supports masking,” which the association said added to the confusion. The letter points out the third study provided was a NY Magazine article and not a scientific journal. Lastly, it says the fourth study submitted by the Gianforte administration relates to influenza and not COVID-19.

Because the rule “contains no regulatory content,” the association said a legal challenge would be “futile because the rule does nothing.”