Last week, Gov. Greg Abbott issued an executive order that banned any entity in Texas from requiring vaccinations for employees or customers. Many health systems and other employers had already implemented vaccine mandates for in-person staff, leaving their policies in danger of resulting in a fine from the state or potential lawsuits.
The order conflicts with the federal rule that says all employers with more than 100 people must be vaccinated and Abbott’s previous stance on the decisions private companies make. In August, an Abbott spokesperson told the Texas Tribune, “private businesses don’t need government running their business.” But with pressure from more conservative gubernatorial candidates mounting, Abbott changed his tune.
But so far, none of the local health systems with vaccine mandates have suspended their vaccine mandates. At Cook Children’s in Fort Worth, the COVID-19 vaccine is a condition of unemployment unless there is a medical reason. That policy, a spokesperson said, is not changing in light of the governor’s executive order. Children’s Health put an Oct. 1 deadline on getting vaccinated and said they are at 99 percent today. While the system is monitoring news from the state and federal government, it says the vaccine mandate is still in place.
Methodist Health isn’t budging either. “In July, Methodist Health System announced we were mandating our workforce be vaccinated against COVID-19. That mandate is currently being implemented in a manner we believe is compliant with the governor’s order,” Methodist said via statement. Baylor Scott & White Health has extended the vaccination deadline to Nov. 15 but said: “We remain committed to protecting patients, colleagues and communities through our fully vaccinated workforce policy.”
Medical City Healthcare, a division of national hospital operator HCA, has never had a vaccine mandate. “While Medical City Healthcare encourages all colleagues to be vaccinated for COVID-19, there is currently no requirement to receive the vaccine,” the system said via statement.
At UT Southwestern and Parkland, the government providers are required to follow state regulations. Earlier this year, government entities were barred from vaccination mandates, so the new order doesn’t affect their policies. But because many low-income and uninsured residents receive treatment from Parkland, it may be widening the gap in care quality. “Up to this point, there have been two standards of care—better off, insured people could go to health systems where they were assured that their caregiver would be vaccinated and poor folks who were mandated to roll the dice with potentially unvaccinated caregivers at public hospitals,” says Michael Malaise, senior vice president, communications and external relations of Parkland Health & Hospital System. “So no—per the Governor’s executive order, we were not permitted to protect our patients and staff with a vaccine mandate.”
These systems reflect the attitude of the Texas Hospital Association. “The time is now to set politics aside and let hospitals do what’s best to protect their patients,” the organization said via statement. “Texas hospitals strongly oppose efforts underway to hamstring them from being able to require vaccination of their staff, many of whom are at the bedside every day with children and adults who are vulnerable to COVID-19. This political action undercuts the central mission of hospitals, and patients and staff cannot be put at unnecessary risk. Hospitals have soldiered on for months at ground zero of this pandemic. As experts in healing and saving lives, hospitals must have the trust, respect, and flexibility to mandate vaccines in their own facilities to protect the people of Texas.”
Local employers like Southwest Airlines and American Airlines have already said that Biden’s mandate trumps the state order, and Dallas Mavericks owner is also staying firm on requiring vaccinations. The conflict between the two orders will most likely end up in federal court.
On Friday, dozens of business groups wrote a letter in opposition to the Texas Senate version of the bill, SB 51. Signatories included the Dallas Regional Chamber, Texas Realtors, the Texas Medical Association, the Texas Hotel and Lodging Association, and several other chambers of commerce. “We believe strongly that legislation of this kind represents an unprecedented intrusion into the liberty of employers to operate their businesses as they see fit. Texas’ successful business climate is premised upon this fundamental liberty, but this legislation undermines it by placing employers in an impossible position between federal and state mandates,” the letter reads.
What’s next? The Texas Legislature, which is in another special session, is working on a bill that would allow employees to refuse the vaccination for “reasons of conscience,” which is a looser standard than the firmly held religious belief or medical excuse currently in place. The Bill, HB 155, has 24 Republican sponsors. “An employee of an establishment who is the subject of a violation may bring an action in a district court in the county in which the violation occurred for injunctive or equitable relief or compensatory or punitive damages,” the bill reads. Employers who have been requiring the vaccine are worried that they could be inundated with lawsuits. With legal challenges coming from all directions, a final decision is unlikely to come soon. But for employers who are left in the dark in the meantime, the uncertainty only adds to their headaches.