The proliferation of mandates for COVID-19 shots is increasingly being backed up with penalties, including surcharges and banishments for the unvaccinated.
It reflects a growing impatience with people who have snubbed the shots after polite nudging, free doughnuts and even cash failed to persuade them.
Delta Air Lines said Wednesday that it plans to impose a $200-per-month fee on unvaccinated employees enrolled in the company health care plan as of Nov. 1. The unusual policy was announced days after the Food and Drug Administration granted its first full approval of a COVID-19 vaccine.
United Airlines told employees to be fully vaccinated by Sept. 27 or face termination. Many insurers say they will no longer cover co-pays for COVID-19 treatment because hospitalized patients are predominantly unvaccinated.
An Alabama doctor said he will no longer see unvaccinated patients as of October.
More than half of the U.S. population has opted for vaccination, and the FDA’s full approval of the vaccine from Pfizer and German company BioNTech is giving corporate America confidence to get heavy-handed as the delta variant of the coronavirus threatens to upend fall plans.
“I do think compassion for the unvaccinated is starting to wear out,” said Arthur Caplan, director of the division of medical ethics at the New York University Grossman School of Medicine. “Seeing more and more people vaccinated, seeing schools reopen with kids going back who can’t be vaccinated, and watching the complete mess that’s sweeping through the Southern states that were obstinate about masking and vaccinated — those factors are really fueling this rise in less tolerance for the unvaccinated position.”
Delta CEO Ed Bastian said the average hospital stay for COVID-19 has cost the company $50,000 per person, necessitating the fee.
“This surcharge will be necessary to address the financial risk the decision to not vaccinate is creating for our company. In recent weeks since the rise of the B.1.617.2 variant, all Delta employees who have been hospitalized with COVID were not fully vaccinated,” he said, using the technical term for the delta variant that happens to share a name with the company.
Also Wednesday, the Pentagon said active troops must get vaccinated for COVID-19 because a licensed vaccine is now available. A memo from Defense Secretary Lloyd Austin did not detail penalties for noncompliance, but experts say troops who do not qualify for an exemption and refuse to comply could face legal jeopardy.
The memo says military departments should work along “ambitious” timelines and “may promulgate appropriate guidance to carry out the requirements.”
United Airlines has been clearer about its expectations: Upload proof of full vaccination by Sept. 27 or get out.
“Employees who fail to obtain their vaccination prior to this date will be separated from the company,” the airline told The Washington Times.
Mr. Caplan said it is not surprising that airlines and other corporations use punishment instead of rewards in the face of a resurgent virus.
“We’re going to the stick because in order to run our business, we’ve got to have customer confidence,” he said. “The travel business is highly vulnerable to COVID and COVID fears. That’s really racked the cruise business.”
Meanwhile, health insurers that once absorbed out-of-pocket costs for COVID-19 treatment are changing their policies.
Earlier in the pandemic, 88% of insurance companies waived co-pays for COVID-19 treatment. They were sympathetic to the patients and generated higher profits because the use of other health care services was lower than expected, according to a brief from the Kaiser Family Foundation.
The environment has shifted in the past few months. Researchers have found that “72% of the two largest insurers in each state and D.C. are no longer waiving these costs, and another 10% of plans are phasing out waivers by the end of October.”
“As vaccines have become widely available to adults in the U.S. and health care utilization has rebounded more generally, health insurers may no longer face political or public relations pressure to continue waiving costs for COVID-19 treatment,” the Kaiser Family Foundation found. “As more waivers expire, more people hospitalized for COVID-19 — the vast majority of whom are unvaccinated — will likely receive significant medical bills for their treatment.”
The Harris Poll, meanwhile, found that 51% of Americans oppose higher insurance premiums for unvaccinated employees to cover potential costs from contracting COVID-19, while 49% like the idea.
The get-tough trend has divided government leaders, typically along partisan lines. Leaders in Washington state and New York City require teachers and other public employees to get vaccinated. Governors of red states have resisted mandates, though that hasn’t stopped some entities within their borders from imposing rules.
The Houston Methodist hospital system said more than 150 employees were fired or resigned after a judge tossed an employee lawsuit against the system’s vaccine mandate this summer.
Jason Valentine, a doctor in Mobile, Alabama, recently posted a Facebook photo of him pointing to a new policy on his office door.
“Dr. Valentine will no longer see patients that are not vaccinated against COVID-19, ” the sign said, sparking national attention and debate about whether the policy is ethical.
News reports quoted Dr. Valentine as saying, “COVID is a miserable way to die, and I can’t watch them die like that.”
Mr. Caplan and J. Russell Teagarden, a member of the Working Group on Compassionate Use and Preapproval Access, argue in an NBC News op-ed that it is unethical for medical professionals to refuse treatment because of anger, resentment or frustration, including over vaccination status.
For that reason, Dr. Valentine’s stance, which revolves around emotional pain, might not be on strong ethical grounds, they wrote.
However, they added: “When actions that cause anger and frustration do interfere with doctors’ ability to meet their obligations to provide safe and effective treatment, refusing services can be ethical. For example, taking vaccination status into account is ethical when it’s intended to protect health care staff members and patients and to select patients for scarce ICU beds who have the best chances for survival.”
Georgia Gov. Brian Kemp, a Republican, has signed an executive order that prohibits local governments from imposing COVID-19 rules on private businesses, though it allows them to require masks or vaccinations.
At Delta, Mr. Bastian said 75% of the Atlanta-based company’s 75,000 employees are fully vaccinated and new hires are required to get the shots. As of Sept. 30, the airline will offer special pay protection only to vaccinated employees who experience “breakthrough” infections and not those who are unvaccinated and get sick.
“I know some of you may be taking a wait-and-see approach or waiting for full FDA approval,” Mr. Bastian wrote. “With this week’s announcement that the FDA has granted full approval for the Pfizer vaccine, the time for you to get vaccinated is now.”
• Mike Glenn contributed to this report.