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More than half of states have withdrawn public health powers in the pandemic. best state

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More than half of states have withdrawn public health powers in the pandemic. best state

by Lauren Weber and Anna Maria Barry-Jester

Republican lawmakers in more than half of US states, angered by voters’ lockdowns and mask mandates, are taking away powers used by state and local officials to protect the public from infectious diseases.

A KHN review of hundreds of pieces of legislation found that, in all 50 states, legislators have proposed bills to curb such public health powers since the COVID-19 pandemic began. While some governors vetoed bills to be passed, at least 26 states pushed through laws that permanently undermine government authority to protect public health. In three additional states, an executive order, ballot initiative or the state Supreme Court limited public health powers for a long time. More bills are pending in some states whose legislatures are in session.

In Arkansas, legislators banned mask mandates except in private businesses or state-run health care settings, calling them “a burden on the public peace, health, and safety of the citizens of this state.” In Idaho, county commissioners, who generally have no public health expertise, can veto public health orders nationwide. And in Kansas and Tennessee, school boards, instead of health officials, have the power to close schools.

President Joe Biden announced broader vaccination mandates and other COVID measures last Thursday, saying he was forced to act in part because of such legislation: “My plan would also take elected officials in those states who are undermining you and these life-saving tasks.”

  • In at least 16 states, legislators have limited the power of public health officials to make mask mandatory, or order quarantine or isolation. In some cases, he empowered himself or local elected politicians to stop the spread of infectious disease.
  • At least 17 states passed laws banning COVID vaccine mandates or passports, or making it easier to obtain vaccine requirements.
  • At least nine states have new laws banning or limiting the mask mandate. Executive order or court decision limit five and mask requirements.

Much of this law takes effect because some areas have the highest number of COVID hospitalizations at any point in the pandemic, and children are back in school.

Lori Tremmel Freeman, head of the National Association of County and City Health Officers, said, “We could actually see more people getting sick, hurt, hospitalized or even dying, which is an extreme measure of the law and Depends on the deduction of authority.”

Public health academics and officials are frustrated that they have become the enemy rather than the virus. They argue that this will have consequences that will last long beyond this pandemic, reducing their ability to fight the latest COVID surge and future disease outbreaks, such as being able to isolate people during a measles outbreak. Happen.

But proponents of the new limits say they are a necessary check on executive powers and give lawmakers a voice in protracted emergencies. Arkansas State Sen. Trent Garner, a Republican who co-sponsored his state’s successful bill to ban the mask mandate, said he was trying to reflect the will of the people.

“What the people of Arkansas want is to be left in the hands of him and his family,” Garner said. “It is time to take power away from the so-called experts, whose views are grossly inadequate.”

After initially signing the bill, Republican Gov. Asa Hutchinson expressed regret, calling a special legislative session in early August asking lawmakers to make an exception for schools. they refused. The law is currently blocked by an Arkansas judge who deemed it unconstitutional. Legal battles are on in other states as well.

Legislators there also passed limits on local officials: They could lose 20% of some grants if jurisdictions make public health regulations stronger than state public health measures.

Losing the ability to order a quarantine has left health officer Karen Sullivan of Montana’s Butte-Silver Bow Department fearful about what’s to come — not only during the COVID pandemic but of future measles and whooping cough. for the outbreak.

“Between the Delta and the other variants, we’re quite frankly nervous about it,” Sullivan said. “Relying on ethics and goodwill is not a good public health practice.”

While some public health officials tried to fight the national wave of legislation, trying to implement the largest vaccination campaign in American history consumed a less public health workforce and little time for political action.

Freeman said his group of city and county health officials has little influence and resources, especially compared to the US Legislative Exchange Council, a corporate-backed conservative group that has developed a model for restricting the emergency powers of governors and other officials. promoted the bill. According to the KHN review, the draft law has inspired dozens of state-level bills. At least 15 states passed laws limiting emergency powers. In some states, governors can no longer establish masked mandates or close businesses, and their executive orders can be reversed by legislators.

When North Dakota’s legislative session began in January, a long slate of bills were sought to rein in public health powers, including ALEC-like language. The state did not have a health director to argue against the new limits as three resigned in 2020.

Fighting the bills not only took time but also looked dangerous, said René Moch, Bismarck’s director of public health, who testified against the measure restricting the mask mandate. He then received an attack of hate mail demanding that he be fired.

Jonathan Hounschild, director of the ALEC Task Force on Communications and Technology, said the new laws are meant to reduce the power of governors and restore the balance of power between the states’ executive branches and legislatures. “Governors are elected, but they were delegating a lot of authority to the public health officer they often appointed,” Hohnschild said.

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‘Like turning off the light switch’

When the Indiana legislature overrode the governor’s veto to pass a bill that gave county commissioners the power to review public health orders, it was disastrous for Dr. David Welsh, public health officer in rural Ripley County.

People immediately stopped calling him to report COVID violations, because they knew the county commissioner could overturn his authority. “It was like turning off a light switch,” Welsh said.

Welsh said another county in Indiana has already looked into its health department’s mask mandate by local commissioners.

He is considering stepping down after more than a quarter century in the role. If he does, he will join at least 303 public health leaders who have retired, resigned or fired since the pandemic began, according to an ongoing KHN and AP analysis. This means that 1 in 5 Americans have lost a local health leader during the pandemic.

“It’s a death blow,” said Brian Castrucci, CEO of the De Beaumont Foundation, which advocates for public health. He called the legislative attack the last straw for many seasoned public health officials who have battled the pandemic without adequate resources, while also being maligned.

Public health groups expect belligerent legislation ahead. ALEC’s Hounschild said the group is considering Michigan legislation that allowed the legislature to limit the governor’s emergency powers without the signature of Democratic Governor Gretchen Whitmer.

Curbing the authority of public health officials has also become campaign fodder, especially among Republican candidates leading on the right. When Republican Idaho Governor Brad Little was traveling out of state, Lieutenant Governor Janice McGatchin signed a surprise executive order banning the mask mandatory that he later campaigned for his upcoming campaign against him. He later reversed the ban, Tweet, “I do not like petty politics. I do not like political stunts on the rule of law.”

Phoebus was a sponsor of the 1989 legislation during the AIDS crisis. It banned employers from requiring health care workers to receive the HIV vaccine as a condition of employment, if one is available.

But 32 years later, that means Oregon may not require health care workers to be vaccinated against COVID. Calling lawmaking a “messy business”, Fobsch said he certainly would not have pushed the bill if he had known what he was doing now.

“Legislators clearly need to deal with urgent situations,” Fobsch said. “But we have to look to the horizon. It’s part of the job’s responsibility to see the results.”

KHN Data reporter Hannah Recht, Montana correspondent Katherine Houghton and Associated Press writer Michelle R. Smith contributed to this report.


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