Hospitals Squelch Looming Trouble in COVID, Immigration Bills


Like most people, we were hoping it was all over. But once again, we rose to make our case – and protected Texas hospitals and health care.

John Hawkins, President/CEO, Texas Hospital Association
John Hawkins

Months after the 88th regular session of the Texas Legislature ended – successfully for health care on many fronts, thanks to fierce THA advocacy – Gov. Greg Abbott called for the third extra session of the year. Hospitals and their operations hadn’t been a factor during the special sessions up until then. But when the governor announced the third special session in early October, two agenda items drew hospitals back into the fold: another effort to ban COVID-19 vaccine mandates by private employers, and border security legislation that would allow state and local law enforcement to arrest and detain people in Texas illegally.

Hospital advocates experienced some déjà vu when the familiar topic of COVID-19 vaccines reared its head. You might recall that during this year’s regular session, our ability to require vaccines in medical settings came under attack as a parcel of legislation sought to ban COVID-19 vaccine requirements in hospitals – including a passed bill that prohibited those vaccine mandates in governmental entities, such as government hospitals. It has long been THA’s position that hospitals should be given the ability to choose what is best for their facility when it comes to whether to require employee vaccination, and we successfully fought for the flexibility and exemptions hospitals needed in the bills that passed to ensure patient and staff safety. We also stopped other troublesome measures from advancing.

For the special session, lawmakers ultimately aspired to a COVID-19 vaccine mandate ban for all employers – and because of the political winds, we had to be more imaginative this time around. Lawmakers passed Senate Bill 7 banning vaccine mandates with no exemption for hospitals, despite our best efforts to obtain one. But after extensive negotiations with the bill’s author, Sen. Mayes Middleton (R-Galveston) and other key lawmakers, THA advocacy bore fruit: the final bill allows hospitals to institute “reasonable policies” for unvaccinated employees, including required wearing of personal protective equipment or reassignment elsewhere in the hospital. If there’s a dispute over whether a facility’s policy is reasonable, the Texas Workforce Commission must consult with the Texas Department of State Health Services to make that determination.

With that important consideration, our hospitals maintained crucial control over patient and worker safety. But with a fourth special session coming quickly on the heels of the third, we weren’t done with hot-button issues.

Senate Bill 4, by Sen. Charles Perry (R-Lubbock), sought to expand state law enforcement’s ability to arrest and detain undocumented nationals, including in hospitals and health care facilities. Through multiple rounds of negotiations with authors and lawmakers that began in the third special, Texas hospitals urged lawmakers to allow an exemption so undocumented immigrants seeking medical attention could not be arrested or detained while receiving health care. The final bill made that allowance, not allowing arrest or detainment of a patient receiving care as long as that care is being delivered “on facility premises.” With the fourth special session now adjourned, work continues to ensure hospitals are clear on the new guidelines.

While we were successful in mitigating the negative impact of both these measures, the advocacy they required well after the regular session gaveled out was another reminder that our advocacy must never go dormant. Anti-vaccine policies and anti-public health prevention measures continue to find new currency at the Capitol, and immigration restrictions won’t stop being a hot topic in our state any time soon. That’s something we all must keep in mind as a particularly wild year in Austin winds down.

Even with a legislative off-year upon us in 2024, we’ll keep preparing for similar legislative battles over the horizon. Any time these types of bills threaten prudent and safe health care delivery, we’ll be there to make the case for Texas hospitals and Texas patients.

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