Survey data suggest that roughly half of all U.S. employers are not guaranteeing workers time off to get a COVID-19 vaccine or recover from its side effects. The situation is a major obstacle in the country’s fight against the pandemic: Fears of medical complications and subsequent job loss have deterred millions of Americans from getting a COVID-19 vaccine.

And yet so far, Congress and the Biden administration have refused to take even the most straightforward steps to address the problem, such as requiring employers to offer paid time off for vaccinations.

That failure may soon come to an end, if the much-discussed $3.5 trillion budget reconciliation bill ends up passing. Democrats’ current framework for that legislation, which is being held up by nine conservative Democrats in the House, would create a “paid family and medical leave” program that could give workers the time off they need to get vaccinated.

No Guarantee Of Paid Time Off

Survey data has repeatedly shown a connection between vaccination rates and employers providing paid leave. In May, the nonprofit health policy organization Kaiser Family Foundation (KFF) reported that nearly one in three unvaccinated adults “say that they would be more likely to get the COVID-19 vaccine if their employer gave them paid time off to get vaccinated and recover from any side effects.” Another KFF poll from June found that about 2 of every 10 unvaccinated employees would be more open to the shot with paid time off.

These results are consistent with those of a July Axios-Ipsos poll, which found that 25 percent of unvaccinated Americans would be more likely to get vaccinated if they had paid leave.

However, KFF polling in June showed that only half of workers say their employers have offered such benefits.

Despite such findings, both congressional leaders and the president have declined to use their power to require paid time off for COVID-19 vaccines, even as new, more virulent variants spread throughout the country.

For example, in December, the limited paid sick leave protections included in the original COVID-19 relief legislation passed under President Donald Trump expired — and Democrats in Congress did not renew the program in their COVID relief bill earlier this year.

More recently, the Biden administration delayed a promised Labor Department rule creating COVID-19 safety standards. A draft of those standards recommended paid leave protections for all workers. But after business groups lobbied the department and the White House’s office of regulatory affairs, the final rule only included mandated paid leave for health care workers.

That scaled-back rule leaves millions of other workers without job protections when they get vaccinated, causing two unions to launch lawsuits calling for more extensive protections.

Rather than require paid leave for COVID-19 vaccines, the federal government has opted to offer limited financial incentives.

In March, for example, Biden’s American Rescue Plan stimulus bill offered a tax credit to qualifying employers that provided workers paid leave to get vaccinated. In July, the Treasury Department expanded the program to encourage more vaccinations.

Around the country, many states have also failed to require time off for vaccinations. In the original draft of its COVID-19 safety standards, OSHA noted that the “patchwork of state and local regulations led to inadequate and varying levels of protection for workers across the country.”

New York and California, for example, have supplemental paid sick leave policies, while other states, like Pennsylvania, leave the matter  to localities. Eighteen states, on the other hand, now have laws barring local governments from enacting paid leave mandates.

The budget reconciliation bill could help address these shortfalls, depending on how a promised paid leave plan ends up being structured.

Right now, Democrats have only promised some form of leave program in their budget package, but the details have yet to be finalized. Biden’s proposed American Families Plan would establish a paid family and medical leave benefit for workers to be phased in over 10 years. It would eventually guarantee 12 weeks of paid leave, with the government expenditure being capped at $4,000 a month.

Surprise Bills and Health Care Gaps

In addition to fear of job loss, data suggest that America’s for-profit health care system — and its multitude of surprise bills — are also discouraging people from getting the vaccine.

A KFF survey from May found that a third of respondents were hesitant to get the shot because they were afraid of unexpected medical bills. Another KFF survey from June found that the uninsured were the demographic with the lowest percentage of vaccinations.

Fears of surprise billing have been exacerbated by some insurers sending customers bills for getting vaccines. While such bills were mistakes, since COVID-19 vaccines are supposed to be free for all Americans, the incidents were frequent enough that in April, the Department of Health and Human Services weighed in, requesting that vaccine recipients report medical facilities that attempt to charge them for vaccines.

The country’s substandard health care system has also exacerbated the pandemic in other ways.

A recent study by the nonpartisan consumer health advocacy group FamiliesUSA found that about 1 in 3 COVID deaths and more than 40 percent of infections were attributable to health insurance gaps.

Despite such data, Biden has abandoned the public insurance option plan he campaigned on. In May, the president left the measure out of his proposed budget and it is not included in the reconciliation budget bill currently being considered in Congress.

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