What Not To Do About the Unvaccinated

Image by Gerd Altmann from Pixabay

Covid-19 is perhaps one of the most frustrating things in recent American history. It has shut down our lives in ways that we could never have imagined, killing hundreds of thousands of people in the United States and millions worldwide. And with that destructive yield, debates about Covid-19 inevitably evoke intense emotions across society, both here and abroad. But with the recent attempt by the Illinois legislature to increase medical costs for unvaccinated people, it is important to consider the consequences and limitations of the state’s response to unvaccinated people.


Before I begin, I would like to preface myself. Under no circumstances does my current position on healthcare costs remove the obligation of eligible people to get vaccinated. I have always been, and always will be, in favor of vaccination programs and mandates to achieve herd immunity.

Since I stepped into this topic, I consistently maintained that anti-vaxxers are the bane of our collective experience in this pandemic and were a problem for society even before Covid-19. I have always felt that mandatory vaccination is necessary to public health, and I maintain that position to this day. Nobody has the right to threaten herd immunity and the well-being of immunocompromised people. Nobody.

Similarly, I have consistently maintained my intense disdain for anti-vaccine sentiments, and I make no apologies for my unmitigated disdain for the entire movement that identifies itself as so-called “free thinkers.” I have written multiple articles reiterating that anti-vaxxers are, by and large, self-destructive and ignorant and that they regularly exemplify the worst elements of our past.

But with all of that under consideration, I also can’t support laws that will deny healthcare, which is a human right, to people because it is more profitable for a hospital to do so.


The current bill under consideration was proposed by Illinois state Rep. Jonathan Carroll and comes after the state has seen all 102 of its counties hit with a rise in Covid cases. With the cases rising, the state has done all that it can to increase vaccination rates, increasing their population’s vaccination percentage, meaning the percentage of people with more than one shot, to a tantalizing 66.6 percent. Not quite the 70 percent that some medical professionals are hoping for, but significantly better than where it once was.

With this context in mind, it would seem odd to oppose the proposal by Rep. Carroll, but consider what policies have not been enacted the cost to the people’s well-being, and it will become clear why this approach is untenable and unjustifiable.

Under Rep. Carroll’s proposal, “a person who is eligible to receive a COVID-19 vaccine and chooses not to be vaccinated shall pay for health care expenses out-of-pocket if the person becomes hospitalized because of COVID-19 symptoms.” While on its face, it appears that this would only affect those who refuse to get vaccinated, what it does not consider is the possibility that people who are eligible to get vaccinated and don’t have access. If the law fails to consider unequal levels of transportation, it could end up punishing people who are willing to get vaccinated but don’t always have the means to get to their appointment.

Even before Covid-19, transportation remained a significant problem for people in urban and suburban areas to getting vaccinated. A 2012 study found that nearly a quarter of respondents had difficulty getting transportation. And further analysis has shown that 61 studies have determined that transportation is a barrier to treatment for other illness, including chronic ones. Needless to say, this challenge intersects with the influence of racism and infrastructure policy.

Since the approval of the Federal-Aid Highway Act, infrastructure policy has cut through black communities and established a form of de-facto segregation. Entire black neighborhoods were demolished to build highways and roads that led to the suburbanization, which primarily benefited white Americans leaving the cities. It was so destructive to black communities that it was derisively called “the negro removal act.” And though the language is certainly outdated, it is an apt description of the policy’s impact.

The end result of this racial re-entrenchment was the modern American transportation system. Dependent on private cars and poorly funded public transportation, it continued to serve white Americans fine, but left black Americans reeling as their communities were destroyed with little compensation. The withdrawal of wealth out of the cities also meant that black residents had less funding to alter infrastructure in their communities, and thus, found themselves cut off yet again.

Of course, the inevitable response to this is “why can’t they just buy a car?” But that also ignores the racism that underlies American society, as black Americans are, on average, charged more than their white counterparts when buying a car. Whether it is in their markups or autoloans, black Americans face higher charges. And with incomes nearly twice as low as their white counterparts, this burden makes disparities in access even more pronounced.

With this in mind, raising costs for healthcare by making an unnvaccinated pay out of pocket for treatment would likely do more to hurt black Americans, who already die at a higher rate, by forcing an expense on them that may not even be justified by supposed refusal to get vaccinated. Remember, the law clearly states “a person who is eligible to receive a COVID-19 vaccine and chooses not to be vaccinated shall pay for health care expenses out-of-pocket if the person becomes hospitalized because of COVID-19 symptoms.” It does not address persons who unable to get access while also being eligible, so if you missed an appointment or were unable to make one, and were hospitalized for Covid-19, then you would be subject to a massive expense that you probably couldn’t afford.

And considering that black Americans’ lack of access is almost certainly due to federal and state policies, it is completely inappropriate to enact this poorly thought-out policy. There were plenty of alternatives, but the current proposal chooses the most harmful path possible with vaccine enforcement.


While it is tempting to suggest that all mandates will fall into this trap, that is not the case. The Biden administration’s vaccine mandate for employers, while currently challenged in court, could avoid the problems related to healthcare. If the states want to, it could enact a mandate that not only requires employers to get their employees to get vaccinated, but also provides for a state-supported transportation outreach program for those unable to get to vaccination sites on their own.

Moreover, the state should endeavor to avoid general fines against unvaccinated and distinguish between the willfully unvaccinated and those unable to receive it. Under current precedent, the states do have the power to mandate vaccination if they see fit to do so, and if states like Illinois enact such policies while also considering and planning for inequities in access, then they can avoid the problems mentioned above and save lives.

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