Freedom for Health Care Workers Act

Floor Speech

Mr. Speaker, I rise today in strong opposition to H.R. 497, a bill I consider reckless that endangers the health and well-being of Americans. With this legislation, House Republicans are putting politics over science. The legislation would eliminate the COVID-19 vaccine requirement for healthcare workers. It ignores the fact that vaccination of healthcare workers saves lives and protects the most vulnerable.

The bill has had no hearings, no markups, no opportunity to examine its impact on our healthcare system. It is what we call regular order. But I am not saying that it should have had hearings or markups in committee just for regular order. I believe that if Republicans had taken the time to solicit input on this bill, they would have heard from healthcare leaders that H.R. 497 will jeopardize the health and safety of providers, patients, and their families. That is why we have committee hearings. That is why we have committee markups, to hear and get input from our constituents.

COVID-19 vaccines are safe and effective, and they have been essential to saving lives, rebuilding our economy, and protecting the health of our communities. More than 668 million COVID-19 vaccine doses have been administered here in the United States, which has resulted in 120 million fewer COVID-19 infections, 18.5 million fewer hospitalizations, and 3.2 million lives saved.

These vaccines are especially vital to protecting the most vulnerable in our community, including seniors, people with disabilities, and people living in nursing homes. The public health data clearly shows that increased vaccination in nursing homes has prevented additional hospitalizations and saved lives. New deaths among nursing home residents decreased by 83 percent once vaccination efforts began.

We also know that vaccination of healthcare providers has protected our healthcare workforce and saved lives by ensuring that patients can receive safe, essential, and timely care. Prior to the availability of COVID-19 vaccines, healthcare providers were at higher risk of becoming infected with COVID-19, endangering themselves and their families while leaving patients without access to care when they needed it most. That is why more than 50 healthcare organizations representing doctors, nurses, and hospitals, agree that requiring COVID-19 vaccination of healthcare workers saves lives and improves health outcomes.

My colleague from Indiana mentioned the U.S. Supreme Court. They actually upheld the vaccine mandate for healthcare workers.

Mr. Speaker, vaccines mandates are also not new. Healthcare workers are often required to receive vaccinations for a variety of infectious diseases. Many States have requirements that healthcare workers be vaccinated against communicable diseases like hepatitis, flu, and measles, mumps, or rubella.

Why wouldn't we want the same requirements to prevent the continued spread of COVID-19, especially amongst our most vulnerable?

Again, in response to my colleague from Indiana, the healthcare workforce has grown since the vaccine requirement, with more healthcare providers and staff employed, for example, on December 10, 2022, than prior to when the COVID-19 vaccine requirement went into effect. As of December 2022, employment in the healthcare sector was 1.2 percent higher than the previous peak of February 2020.

Data shows requiring COVID-19 vaccination of healthcare workers did not contribute to worsening of staffing shortages in nursing homes. Nursing homes who were experiencing staffing shortages prior to COVID- 19 had staffing levels remain stable after the COVID-19 vaccine requirement went into effect.

But I have to say, I was most disappointed yesterday. Yesterday, I was at the Rules Committee, last evening, where some of my Republican colleagues chose to ignore the broad-based scientific and medical consensus that the COVID-19 vaccine is safe and effective at reducing deaths and hospitalizations. Instead, some of my Republican colleagues chose to spend their time entertaining fringe theories about vaccine side effects and propagating vaccine myths, despite the fact that millions of Americans have received the COVID-19 vaccine safely and with no effect on their health.

It is just truly disappointing to me that this is what we have come to in the United States Congress. The last thing that I want on either side of this aisle is for any of us to make statements on this floor-- and I know you are not saying that, my colleague from Indiana--but I am just so afraid that so much of this rhetoric, particularly last night in the Rules Committee, is giving the impression to the public that they shouldn't take the vaccine. If you listened to the Rules Committee last night and the Republican comments, you would have assumed that; you would suggest that. I think it is very dangerous. People should be taking the vaccine.

Finally, this legislation, I want to say, is also a distraction from Republicans' true agenda on healthcare, which they are continuing to work on behind closed doors, and that is to cut healthcare and retirement for millions of Americans. Republicans have repeatedly pledged that they will refuse to raise the debt limit unless they can cut Social Security, Medicare, Medicaid, and other vital programs. They are so determined to cut Americans' healthcare that they are willing to recklessly risk defaulting on the national debt and wreaking havoc on the economy in order to do so.

If successful, their actions will result in millions of Americans losing benefits and lifesaving protections, including seniors, children with complex medical needs, people with disabilities, and pregnant and postpartum women. This is unconscionable.

I want to underscore that Democrats will not fall for this manufactured crisis, and we will not, under any circumstances, agree to cut these vital programs.

I hope I am wrong. I hope I won't see the other side moving toward these types of cuts. They are unacceptable to us.

I would just say, Democrats are committed to putting families first. We will continue to follow the science to fight COVID-19. We will build on the success of the most productive Democratic Congress in modern history and fight to ensure that Americans have access to affordable and quality healthcare, further lower healthcare, and prescription drug costs, and support our healthcare workforce.

This legislation is dangerous, and I strongly urge my colleagues to oppose it.

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Mr. PALLONE. Schakowsky), who is the Ranking Member of our Subcommittee on Innovation, Data, and Commerce.

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Mr. PALLONE. Castor), who is the ranking member of our Subcommittee on Oversight and Investigations.

Mr. ROBERT GARCIA of California. Mr. Speaker, I want to thank Ranking Member Pallone for yielding his time and for his leadership in this legislative body.

Mr. Speaker, I rise today to discuss the so-called Freedom for Health Care Workers Act. This legislation is an attack on public health and will endanger the lives of medical personnel and patients. Why should we remove vaccine protections for nurses and medical workers in our hospital and clinical settings?

This bill is not supported by our public health officials and certainly not supported by our nurses on the ground. Why would we endanger vulnerable populations? This is cruel and irrational.

Over 1 million people have died in this country due to the pandemic, many of them nurses and healthcare workers. One of them was my mother, Gaby Elena O'Donnell.

My mom was my rock. She was a kind, loving, and strong immigrant woman who dedicated her life to serving her country and community. She served our country as a frontline healthcare worker. My mom also taught me what real patriotism is, it is serving your neighbors through service and giving back to your country.

She was on the front lines of this pandemic helping as many people as possible. In the summer of 2020, my mom lost her life to COVID-19.

This vaccine could have saved my mom's life, but it was not yet available. I made a promise to my mom and to my community to fight for legislation that would protect them and keep them from the pandemic and keep them healthy.

No other family should have to go through what mine did and millions of others had to go through in this country. We know, due to science, that the vaccine saves lives, and our medical workers should be able to go to work knowing that their lives won't be endangered due to the service they are giving to our country. Vaccinating hospital and healthcare workers is a basic form of protection that they all deserve.

Mr. Speaker, for this reason, I urge my colleagues to vote ``no'' on the Freedom for Health Care Workers Act.

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Mr. PALLONE. Jackson Lee).

Ms. JACKSON LEE. Mr. Speaker, this is another moment that I am on the floor of the House, and I thank the ranking member of the Committee on Energy and Commerce who has been so dutiful throughout the years that we suffered, somewhat lonely and somewhat confused, about COVID-19.

We never experienced this trauma. It certainly brings me to a deep sense of loss to hear a Member speak about the loss of his mother. These are personal matters for many of us, some having lost dear friends, but nothing can equate to losing a beloved loved one.

So when we stand on the floor, we speak with a sense of compassion and concern. I think it is certainly fine for there to be individual--I turn the card. I flip the coin--individual examples of individuals seeking not to be vaccinated. They can find medical facilities that would allow them to work there.

It is no doubt that the actions of the Biden administration saved lives. There is no doubt that, on our side of this issue, 50 healthcare organizations, professional societies, and others, believe that vaccinations helped healthcare workers save their own lives and save the lives of others.

It is well-known that prior to the widespread availability of the COVID-19 vaccine, healthcare workers in the United States were more than three times more likely to die. I have seen it myself. In my community, the Texas Medical Center, all of the beds in every medical facility within the reach of my district and others had people in hallways, in emergency rooms, individuals who couldn't see their loved ones take their last breaths; individuals who flew in from other jurisdictions, other States, desperate to get the care they thought was here in Houston, Texas because, yes, we did have the ability to save lives with the medical technology that we were using.

Many States have requirements that healthcare workers be vaccinated against many things: hepatitis, flu, measles, mumps, or rubella. Why are we trying to stand against COVID-19 in this long litany of infectious diseases? COVID-19 vaccines have resulted in 120 million fewer cases and 18.5 million less hospitalizations and saved $1.15 trillion.

So if we just talked about the numbers, that in and of itself would say that this legislation is wrongheaded, but it is also important to recognize that the Mental Health America, 76 percent of the respondents were worried about bringing COVID home to their children.

These are healthcare professionals. We know of some of them who died, unfortunately, because they got COVID, and they didn't even see their families because of this whole issue of separating people who had COVID. Half of the respondents worried about bringing COVID to their partners or an older family member.

Many U.S. physicians found that the portion of the day spent treating COVID-19 patients was associated with higher PTSD scores, depression, and anxiety. This was not a fun time, but it was the commitment of medical professionals and those who wanted to be saved to use the vaccines and use all precautions.

Ms. JACKSON LEE. Mr. Speaker, these medical professionals in the early stages were suffering from higher PTSD scores, depression, and anxiety. Many healthcare workers at the beginning of the pandemic saw workers get sick and die from COVID almost right in front of them, and this contributed to their increased stress and anxiety.

We did push them to the limit when we didn't have massive testing or massive vaccines, I hate to say it, in the past administration. According to the University of Chicago, it was found that an increase in staff vaccination rates resulted in fewer COVID cases among staff and patients.

My final words, Mr. Speaker, is, yeah, this is a free country. Laissez-faire, do as you will, but this mandate for medical workers saved their lives, saved patients' lives, and saved families' lives. I don't understand why we are going down this route where soon it will happen in good time, but since I remember 6 million dead around the world as the number that is gleaming and 1.11 million in the United States, this legislation is not going in the right direction. I ask for opposition to the underlying legislation.

Mr. Speaker, I want to correct certain things that are being said on the other side of the aisle.

First of all, the fact of the matter is that the healthcare workforce has grown since the vaccine requirement. There are more healthcare workers now than there were before.

The other thing I keep hearing from my colleagues on the other side of the aisle is that the COVID-19 vaccines do not help prevent infection from the disease. That is factually incorrect. Although breakthrough infections do occur, especially with more transmissible variants of the disease, COVID-19 vaccines still help in preventing infection and reduce transmission.

In fact, according to a study released just this month, it is confirmed that vaccinated individuals were likely to be less infectious than unvaccinated individuals, and the likelihood of transmission fell by 11 percent for each dose of the vaccine.

Moreover, we know that vaccination and continued upkeep with boosters continues to protect the public from infection. According to CDC, the most recent COVID-19 boosters cut the likelihood of infection by more than one-half in those who have gotten them.

As I hope none of us will dispute, even when there is breakthrough infection, vaccines are safe, effective, and dramatically reduce the length of illness. That matters for healthcare workers because we still have thousands of people hospitalized every day with COVID-19, cancer, and other grave illnesses, and without COVID-19 vaccines, we would have fewer people there to take care of them.

COVID-19 vaccines reduce infections, and they save lives. We can't let disinformation dictate our policy choices in this debate. We have to refer to the science.

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Mr. PALLONE. Jacobs).

Again, I know that the previous speaker is a physician, and I respect her, but I have to continue to point out that this idea that vaccines don't help prevent infection from the disease is factually incorrect.

I mentioned before various studies, and I include in the Record a study by Berkeley Lovelace, Jr., that shows that the vaccine does cut the infection risk. [From NBC News, Jan. 25, 2023] Updated Covid Boosters Cut the Infection Risk From XBB.1.5 Subvariant by Nearly Half, CDC Finds (By Berkeley Lovelace Jr.)

The updated Covid boosters reduce the risk of Covid infection from the predominant omicron subvariant by nearly half, according to early data published Wednesday by the Centers for Disease Control and Prevention.

In adults up to age 49, the latest boosters from Pfizer- BioNTech and Moderna were 48% effective against symptomatic infection from the XBB.1.5 subvariant, the new report said. As of Jan. 21, that subvariant accounted for about 1 in 2 new cases in the U.S.

Protection was lower in older groups: The boosters were 40% effective in adults ages 50 to 64 and 43% effective in people 65 and older.

The findings are ``quite reassuring,'' Dr. Brendan Jackson, the head of the CDC's Covid response, said on a call with reporters Wednesday. ``These updated vaccines are protecting people against the latest Covid-19 variants.''

The Covid boosters were modified in the summer to target the BA.4 and BA.5 omicron subvariants, in addition to the original strain of the coronavirus first identified in Wuhan, China, in 2019.

BA.5 was the dominant variant in the U.S. in the fall, but now accounts for only 2% of new cases.

As of last Wednesday, only about 15% of people in the U.S. had received an updated booster, according to CDC data.

``With this data, we see there is a benefit that might convince some people to sign up and get a bivalent booster,'' said Dr. Peter Hotez, the co-director of the Center for Vaccine Development at Texas Children's Hospital and the dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston.

The CDC report is based on test results from more than 29,100 adults with Covid symptoms who were tested at pharmacies nationwide from Dec. 1 through Jan. 13.

People who were vaccinated but had not received the updated booster were compared to those who got the updated booster in the previous two to three months. Those who hadn't received the updated booster had their last vaccine dose about 13 months ago, Ruth Link-Gelles, who heads the CDC's vaccine effectiveness program, said on the call.

The protection provided by the booster is on par with what's typically seen with the flu vaccine. Flu vaccine effectiveness varies from season to season, but the shots reduce the risk of the flu by 40% to 60%, according to the CDC.

Dr. Greg Poland, the director of the Mayo Clinic Vaccine Research Group in Rochester, Minnesota, cautioned that the CDC's estimate on the updated boosters may be an overestimate.

People who got the updated boosters are probably ``much more likely to wear masks indoors or restrain their travel or not go to indoor restaurants,'' he said.

He also pointed out that the CDC data doesn't capture people who were vaccinated with the updated booster but were asymptomatic, or people who were sick enough that they went to the hospital.

Hotez said that while the CDC's findings appear promising, he'd like to see data on how well the boosters perform against symptomatic infections after five or six months.

He said he'd also like to see more data on how well the updated boosters work against hospitalization.

Jackson, of the CDC, said on the call that the agency is releasing data later Wednesday that found the updated boosters reduced the risk of death from Covid by nearly thirteenfold, compared to people who are unvaccinated.

The data, he said, also found that people who got the updated booster had more than twofold lower rates of death from Covid compared to vaccinated people who did not get it.

The CDC's report comes a day before a meeting of the Food and Drug Administration's advisory committee that will discuss simplifying the Covid vaccination schedule.

In a document posted online Monday, the FDA proposed using the bivalent formula in all Covid vaccines moving forward, not just for booster shots.

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Mr. PALLONE. Mr. Speaker, I include in the Record an article from the University of California San Francisco regarding COVID-19 vaccines reducing transmission. [From the University of California San Francisco, Jan. 2, 2023] Covid-19 Vaccines, Prior Infection Reduce Transmission of Omicron (By Laura Kurtzman)

Vaccination and boosting, especially when recent, helped to limit the spread of COVID-19 in California prisons during the first Omicron wave, according to an analysis by researchers at UC San Francisco that examined transmission between people living in the same cell.

The study demonstrates the benefits of vaccination and boosting, even in settings where many people are still getting infected, in reducing transmission. And it shows the cumulative effects from boosting and the additional protection that vaccination gives to those who were previously infected. The likelihood of transmission fell by 11% for each additional dose. vaccines reduce risk of serious illness from omicron infection

In dense populations such as prisons, vaccines were shown to significantly reduce the risk of hospitalization and death from Omicron infections.

Of over 20,000 confirmed Omicron infections in California prisons, there were 31 hospitalizations and no deaths attributed to COVID-19 infection.

Vaccinated residents with breakthrough infections were significantly less likely to transmit them: 28% versus 36% for those who were unvaccinated.

``A lot of the benefits of vaccines to reduce infectiousness were from people who had received boosters and people who had been recently vaccinated,'' said Nathan Lo, M.D., Ph.D, a faculty research fellow in the Division of HIV, Infectious Diseases and Global Medicine at UCSF and the senior author of the study, published Jan. 2, 2022, in Nature Medicine. ``Our findings are particularly relevant to improving health for the incarcerated population.''

The researchers analyzed deidentified data collected by the California Department of Corrections and Rehabilitation (CDCR). This included COVID-19 test results, vaccine status and housing locations for 111,687 residents, 97% of whom were male, between Dec. 15, 2021, and May 20, 2022.

Breakthrough infections were common, despite the residents' relatively high vaccination rate of 81% with the primary vaccine series. But the rate of serious illness was low. In just over five months, there were 22,334 confirmed SARS-CoV-2 Omicron infections, 31 hospitalizations and no COVID-19 deaths.

Vaccinated residents with breakthrough infections were significantly less likely to transmit them: 28% versus 36% for those who were unvaccinated. But the likelihood of transmission grew by 6% for every five weeks that passed since someone's last vaccine shot.

Natural immunity from a prior infection also had a protective effect, and the risk of transmitting the virus was 23% for someone with a reinfection compared to 33% for someone who had never been infected:

``A lot of the benefits of vaccines to reduce infectiousness were from people who had received boosters and people who had been recently vaccinated.''--Nathan Lo, M.D., Ph.D

Those with hybrid immunity, from both infection and vaccination, were 40% less likely to transmit the virus. Half of that protection came from the immunity that one acquires from fighting an infection and the other half came from being vaccinated.

The researchers said they were gratified to see that vaccination confers addition protection even for those who had already been infected, but they were surprised by how much the infection continued to spread, despite the residents' relatively high vaccination rates.

``Regardless of the benefits you see in vaccination and prior infection, there is still a high amount of transmission in this study,'' said Sophia Tan, a researcher in Lo's lab and the study's first author. ``We hope these findings can support ongoing efforts to protect this vulnerable population.''

This includes making efforts to keep residents current with boosters and increasing the vaccination rate of the prison staff, only 73 percent of whom had received the primary series at the time of the study.

The general rate of boosting could also be improved significantly. At the time of the study, just 59% of residents and 41% of staff had received all the doses recommended by the U.S. Centers for Disease Control and Prevention (CDC), based on their age and health status.

``Within the two months following vaccination, people are the least infectious, which indicates that boosters and large timed vaccination campaigns may have a role to reduce transmission in surges,'' Lo said. ``New ideas are needed since the risk of infection in this vulnerable population remains so great.''
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Mr. PALLONE. Mr. Speaker, I continue to reserve the balance of my time because I believe the other side has more speakers.

Mr. Speaker, one of the things that hasn't come up, and it didn't come up in Rules last night as well, we have exemptions for this mandate for people who have serious religious convictions or medical reasons to grant an exemption. No one has mentioned that, but I think it is important that that exists.

The mandate exists, but at the same time, if people have serious religious reservations or they have medical conditions that would result in having an exemption, those do exist. I think everyone should understand that.

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Mr. PALLONE. Mr. Speaker, if the gentleman has additional speakers, I continue to reserve the balance of my time.

I stress again that for people who have serious religious reservations, for people who have medical conditions, they can get exemptions from the mandate.

In addition to that, I know that the previous gentleman on the Republican side talked about risks and side effects. The FDA and CDC have been transparent that there are rare side effects that may happen to some individuals when they take the vaccines, but they and independent health experts all agree that the benefits of being vaccinated far outweigh the risks of any side effects.

Arguments from the other side of the aisle insinuating an inflated risk of side effects also ignore the risks associated with contracting COVID-19 as an unvaccinated individual. COVID-19 is a dangerous disease that has killed over a million of our fellow Americans, and the vaccines are safe and effective. They are strongly protective against severe illness and death.

Mr. Speaker, I am very concerned that some Members use their opportunity to speak on the floor--and I am not saying that the people who spoke here have, but last night I certainly heard it in the Rules Committee--to fan the flames of misinformation when describing the risks of side effects when the risks of being unvaccinated are so grave.

I just think that this is dangerous and opposed by virtually every public health and medical organization. They are saying that they recommend the vaccine. Again, there may be some rare side effects. There may be some people that, you know, would seek to have exemptions. Let's try to understand that this is often a difficult situation, but the bottom line is that vaccines have saved millions of lives, and we can't give the impression that that is not the case.

Mr. Speaker, I am just so concerned that we are seeing another example here on the floor today of what I call Republican extremism. Republicans are keeping up their commitment to extremism, in my opinion, by attempting to eliminate the COVID-19 vaccine requirement for healthcare workers.

Mr. Speaker, this is really dangerous legislation that is going to strain our healthcare system, exacerbate existing staffing shortages, and further limit American families' access to healthcare.

With H.R. 497, the Republicans are really putting politics over science. Democrats are committed to putting families first, where we can continue to follow the science to fight COVID-19. We are going to build on the success. We had a lot of success in the previous Congress in so many things to make sure that Americans have access to affordable and quality healthcare, to further lower healthcare costs and prescription drug costs, and to support our healthcare workforce.

Everything that we do here should be designed to not only prevent infection but prepare for future types of pandemics. I am just so concerned because I listened last night at Rules and here on the floor, and I just think that the impression is being given somehow that maybe people shouldn't take vaccines or that there are risks to vaccines that, in my opinion, are being stated that are way out of proportion or that somehow there is significant evidence out there that it doesn't matter if you get vaccinated or not because that is not going to cause more infection.

The bottom line is that this mandate was put in place for healthcare workers because the agencies involved that studied the science at the Federal level believed that it was going to be a good thing for the healthcare workers themselves, that they wouldn't get ill and die, that it would help in preventing the spread of COVID-19, and that it would give people a sense of security knowing that the people that are helping them when they are sick have also been vaccinated.

I just don't understand why all of a sudden now the Republicans say: Well, that is not really accurate. Let all the healthcare workers do whatever they want.

It makes no sense. I just think it is politically motivated, if you will, because they have certain people, I guess, their base voters, who are anti-vaccination. But you can't be anti-vaccination if you look at the science and what has been done with these vaccinations that saved so many lives, to make it so that now the situation with COVID-19 is much better than it has been in the last few years, which is why the President is saying that he can lift the healthcare emergency.

We have made a lot of progress. We have made a lot of progress because we have based our actions on science. To suggest today that we should eliminate this mandate, I think is very dangerous.

Mr. Speaker, I strongly urge my colleagues to oppose it, and I yield back the balance of my time.

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Mr. PALLONE. Mr. Speaker, on that I demand the yeas and nays.

The yeas and nays were ordered.

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