In March 2024, Utah’s legislature took away the state health officer’s power to order isolation or quarantine. Local health officials kept it, but only for a narrow set of conditions. The one exception is a new, drug-resistant or reemerging pathogen likely to cause high death or illness rates, and then only if the local legislative body agrees it needs containing.
Utah was one of many states rewriting who gets to act in a health emergency. The Association of State and Territorial Health Officials (ASTHO) counted at least 28 state legislatures that considered bills in 2024 to reshape public health legal authority for infectious disease. Earlier, during the 2020 and 2021 sessions, lawmakers in 25 states enacted at least 70 such bills.
Curbing the pandemic powers
Most of that early wave cut officials’ powers. Some limited how long an emergency order could last. Others demanded legislative oversight of public health emergencies, or barred health measures from restricting gatherings in places of worship.
NBC News reported in 2021 that the National Conference of State Legislatures was tracking more than 300 bills in 47 states and territories on legislative oversight of executive power during Covid-19. At least 15 legislatures had passed or introduced bills to weaken governors’ or local governments’ health authority, according to a report from the Network for Public Health Law and the National Association of County and City Health Officials. Nearly all were controlled by large Republican majorities.
Ohio showed how it played out. Gov. Mike DeWine won early bipartisan praise for his aggressive health orders, then drew protesters. In March 2021 the Republican legislature overrode his veto and gave itself more power to reject his decisions. State Sen. Niraj Antani, a Republican who voted to curb DeWine, said masks and shutdowns “became, frankly, very partisan.” He added: “Nowhere in our history do we let an executive have unchecked limitless power for longer than the time to deal with an emergency.”
Indiana’s Republican governor, Eric Holcomb, vetoed two bills, and lawmakers overrode both. He sued over one that would let the legislature call itself into special session and cancel his emergency orders, saying it usurped his exclusive power to do that.
It was not purely a party fight. New York’s Democratic legislature stripped Democratic Gov. Andrew Cuomo of his pandemic emergency powers, in a bill he signed. Lori Freeman, who leads the national association of county and city health officials, told NBC: “To use the politicization of Covid to drive legislative changes doesn’t bode well for our government or for our public health system.”
2023 and 2024
Texas passed SB 29 in 2023. It limits the government’s authority to close private businesses or require face coverings or vaccines to stop Covid-19 from spreading.
South Carolina considered two 2024 bills that would have narrowed quarantine authority. One, S 975, would have confined quarantine orders to people diagnosed with, or exposed to, the disease named in an emergency. It did not pass the Senate, but parts of it were folded into S 915, a bill to restructure the state’s health agencies. Another amendment to S 915 would have required the health department to get the governor’s approval before acting to control infectious disease. That bill also failed to pass the chamber by the end of session.
Kansas has weighed bills for at least three years in a row to remove its state health officer’s quarantine power. In February 2024 the Senate passed SB 391, which would also have stopped the officer from directing law enforcement to help enforce health measures. It died in the House in April.
At least four states, Idaho, New Hampshire, Oklahoma and Wyoming, considered bills declaring that the World Health Organization has no jurisdiction there. Oklahoma enacted SB 426 in July 2024, barring state officials from enforcing WHO requirements. ASTHO noted that the law’s validity is unclear, because WHO only makes recommendations and cannot dictate health policy.
Expanding access
Two states went the other way in 2024. Washington’s SB 6095, enacted in March, lets the state health official issue prescriptions or standing orders for any biological product, device or drug used to control, prevent or treat disease. Hawaii’s SB 3122, enacted in June, gives its health official broad authority to issue standing orders for adults 18 and older to receive services recommended by the US Preventive Services Task Force, including HIV preexposure prophylaxis.
North Carolina did something similar in 2021 with HB 96, which let certain pharmacists give vaccines to people six and older.
ASTHO said it expects legislatures to keep reshaping these authorities, and has published a technical package to help health leaders keep enough legal power to protect the public.
Sources
- Legislatures Reshape Public Health Legal Authority
- Growing number of GOP-led states seek to limit officials’ power to respond to next pandemic
