Freedom to die where you want because you have no insurance....

DeSantis is championing medical freedom. GOP state lawmakers like what they see.

The Florida governor and likely presidential candidate has secured a place for the movement in the conservative mainstream.

By MEGAN MESSERLY, KRISTA MAHR and AREK SARKISSIAN

The “medical freedom” movement, mostly known for its opposition to vaccine requirements, was long consigned to the fringes of libertarian and left-wing politics. Then came Ron DeSantis.

The Florida governor and likely presidential candidate has secured a place for the movement in the conservative mainstream. And as a sitting governor, he has the opportunity to distinguish himself from other declared and potential candidates by putting his vision into practice.

DeSantis, who this week begins a media tour to promote his new book “The Courage to Be Free,” launched a “Prescribe Freedom” campaign in January that proposes permanently limiting Covid-19 vaccination and mask requirements and giving cover to physicians whose medical views depart from scientific consensus. He also plans to set up a panel to review recommendations from the Centers for Disease Control and Prevention and called for a grand jury to “investigate crimes and wrongdoing committed against Floridians” related to the Covid vaccine.

DeSantis’ attention to the issue is having real-world impact — and not just in Florida. GOP lawmakers across the country, in some cases emboldened by DeSantis’ ramped-up rhetoric, have introduced hundreds of bills this year under the medical freedom banner, including proposals to put lawmakers in charge of immunization requirements, ban the government from creating non-school-based vaccine mandates and allow citizens to challenge public health disaster declarations.

“Governor DeSantis has been leading the way,” said Texas state Rep. Matt Schaefer, chair of the Texas Freedom Caucus, who sponsored his state’s public health disaster declaration bill. “A lot of people are looking to DeSantis to see what he’s doing at this point, and it gives cover to other governors, I think, to step out there.”

DeSantis’ spotlight on medical freedom, which grew in popularity during the pandemic, comes as routine childhood vaccine rates are dropping and trust in government and science is low. Public health experts fear the entrenched political polarization around vaccinations and public health will lead to eliminated diseases, such as polio and measles, gaining footholds in communities and diminish the nation’s ability to respond effectively to future health crises.

The momentum also highlights one of DeSantis’ biggest strengths heading into the 2024 election cycle: his handling of Covid-19 in the third-most populous state. Conservatives across the country have praised DeSantis’ rejection of vaccine mandates and masking students in schools, fueling the governor’s popularity.

“If he runs, it’s just going to bring more prominence to this ideology, and that’s my concern,” said Rupali Limaye, an associate professor at the Johns Hopkins Bloomberg School of Public Health. “This idea of — we are going to reject, essentially, anything that is science-based because that’s part of our identity. The government can’t tell us what’s true, what’s not true. We make our own decisions. We make our own truth.”

Most of the medical freedom bills introduced in statehouses this year aren’t likely to go anywhere, observers say, but their volume speaks to the backlash federal pandemic policies engendered and how DeSantis’ proposals could be the inevitable result of so many Americans losing trust in local, state and federal health officials.

“I think he’s presenting an alternative. Is the alternative being presented in a political way? Yes. That doesn’t make it less valid,” said Brian Miller, a non-resident fellow at the American Enterprise Institute. “Taking a different approach in public health requires a lot of guts. The public health community has historically not done a good job in integrating centrist, conservative and libertarian viewpoints.”

Jeremy Redfern, DeSantis’ deputy press secretary, said that recent research raising questions about the efficacy of masks in preventing infection indicates that when it comes to getting rid of mask mandates, “Governor DeSantis was right all along.”

And while state lawmakers around the country who have been committed to medical freedom since before the pandemic see DeSantis as a relative newcomer to the movement, they welcome the national attention he brings.

“I definitely appreciate his effort to do that,” said Indiana GOP state Rep. Becky Cash. “Quite honestly, if he’s going to run for president, I like what I see.”

DeSantis’ adroitness at positioning himself as a national leader in a series of high-profile culture war issues has helped secure him a spot as one of the country’s most popular governors — and most powerful Republicans.

He’s used funds linked to Covid-19 relief to transport migrants on airplanes from Texas to the liberal enclave of Martha’s Vineyard, traveled to blue states to talk about rising crime, undermined Disney’s special tax status after the company rebuked Florida’s “Don’t Say Gay” bill, restricted abortion rights, targeted gender-affirming care and barred high school students from taking a new advanced placement course on African American studies.

The stance that DeSantis, a leading skeptic of masks and lockdowns, has taken on “protecting Floridians from the biomedical security state” and his attacks on former White House chief medical adviser Anthony Fauci, have earned him wide acclaim on the right and plenty of leeway from Florida’s GOP supermajority legislature which, during a 2021 special session, passed a law banning Covid vaccine mandates.

“He’s never been wrong,” said Florida House Health and Human Services Committee Chair Randy Fine, a Republican. He added that DeSantis’ policy will have no problem clearing the Republican-controlled House. “What would make anyone think he’s wrong now?”

Some Florida physicians worry DeSantis’ efforts are putting Floridians at risk. Routine vaccinations among Florida kindergartners have been dropping, with fewer kids being immunized against measles, polio, chickenpox and diphtheria, tetanus and pertussis.

“We have an incredible amount of vaccine hesitancy that has only grown worse,” said Greg Savel, a pediatrician in Clearwater, Fla. “Whatever Governor DeSantis says goes around here.”

And while DeSantis is garnering most of the attention, the positions he espouses have been quietly gaining ground outside of Florida.

Between January 2021 and May 2022, legislators enacted 65 laws in 25 states that now limit public health authorities’ power to react during an emergency, according to research by Temple University.

This year, state lawmakers have introduced more than 400 bills promoting a small-government vision for public health, according to the National Academy for State Health Policy. Some are Covid-specific, such as a bill in Indiana that would prohibit employers from requiring routine testing for the virus, and a bill in Idaho that would prevent the government from mandating the Covid vaccine to receive government services, enter a government venue or work for the state.

Other proposals would make significant changes to the mandate-driven approach to public health.

Schaefer’s bill in Texas, for instance, would allow individuals to challenge any disaster, public health disaster, public health emergency or control measure order issued by the governor “if the provision is alleged to cause injury to the person or burden a right of the person that is protected by the state or federal constitution or by a state or federal law.”

“It is the historical legal tradition of the United States of America that when your rights are infringed, there’s some way to get into a court and get a hearing, even a preliminary hearing. There’s some due processes that’s involved. But in Texas, and I’m sure in many other states as well, no one could get standing,” Schaefer said. “A lot of this is just simply restoring due process.”

Two bills in Mississippi, meanwhile, would require state health officer orders to be approved by the governor. Legislation in Iowa would prohibit health officials from conducting contact tracing; a proposal in Wyoming would prohibit the use of CDC and WHO requirements, mandates, recommendations, instructions or guidance to justify mask, vaccine or medical testing requirements and a bill in Idaho would make it a misdemeanor to administer any mRNA-based vaccine.

Several states — Indiana, Missouri, New Hampshire, Oklahoma, South Dakota and Texas — have also introduced bills that would take the power to set school-based immunization requirements away from state health officials and put it in the hands of the legislature.

Lawmakers who have long been involved with the medical freedom movement say they’re starting to see more interest from their GOP colleagues in embracing the issue.

“We’re trying to do what Governor DeSantis is doing there,” Cash said. “God bless Governor DeSantis for what he’s doing, but it’s coming from the executive branch, and we really need legislative branches, that are elected by the people, to make the laws to do this.”

The question of individual freedom versus federal and state power to impose measures to protect the public’s health has also shown up in court. In most cases, public health authorities were upheld, but there were a series of high-profile and potentially influential wins for supporters of religious liberty and those who seek to limit the scope of health authorities, including in the 11th U.S. Circuit Court of Appeals, which covers Florida, and the U.S. Supreme Court.

Those wins would not have escaped DeSantis’ attention, said Wendy Parmet, faculty co-director at the Center for Health Policy and Law at Northeastern University. But, she added, he’s playing “a precarious game.”

“You don’t know how serious the next problem is going to be,” she said. “You don’t know how it’s going to be transmitted. You don’t know the groups who will be most affected. You want to say the health department can’t close schools, but what if the next pandemic has a 50 percent fatality rate for kids, but adults are fine?”