Biden announces new vaccine mandates that could cover 100 million Americans

(CNN) President Joe Biden on Thursday imposed stringent new vaccine rules on federal workers, large employers and health care staff in a sweeping attempt to contain the latest surge of Covid-19.

"We've been patient, but our patience is wearing thin, and your refusal has cost all of us," Biden said, his tone hardening toward Americans who still refuse to receive a vaccine despite ample evidence of their safety and full approval of one -- the Pfizer-BioNTech Covid-19 vaccine -- from the US Food and Drug Administration.

He said vaccinated America was growing "frustrated" with the 80 million people who have not received shots and are fueling the spread of the virus. And he acknowledged the new steps would not provide a quick fix.

"While America is in much better shape than it was seven months ago when I took office, I need to tell you a second fact: We're in a tough stretch and it could last for awhile," Biden said in an early evening speech from the White House.

At the center of Biden's new plan is directing the Labor Department to require all businesses with 100 or more employees ensure their workers are either vaccinated or tested once a week, an expansive step the President took after consultation with administration health officials and lawyers. Companies could face thousands of dollars in fines per employee if they don't comply.

Biden also signed an executive order requiring all government employees be vaccinated against Covid-19, with no option of being regularly tested to opt out. The President signed an accompanying order directing the same standard be applied to employees of contractors who do business with the federal government.

He also said 300,000 educators in federal Head Start programs must be vaccinated and called on governors to require vaccinations for schoolteachers and staff.

And Biden announced he would require the 17 million health care workers at facilities receiving funds from Medicare and Medicaid to be fully vaccinated, expanding the mandate to hospitals, home care facilities and dialysis centers around the country.

"We have the tools to combat the virus if we come together to use those tools," Biden said at the outset of what was billed as a major speech to tackle the latest phase of the Covid-19 pandemic.

The new rules amount to the most dramatic steps to date to get more Americans vaccinated. Once cautious of vaccine mandates, the Biden administration is now wholly embracing them as vaccine hesitancy persists among certain groups.

Administration officials acknowledged the requirement for large employers could be challenged in court. But they said their hope was to provide cover of federal rules to businesses who want to require vaccines for employees.

The new rules come as the Delta variant tears through communities across the country, causing upticks in hospitalizations and deaths particularly in areas where vaccination rates remain low.

A potentially massive impact on the US workforce

Wide swaths of the American workforce could be impacted by the new rules, which would take effect over the coming weeks. The new "emergency temporary standard" from the Labor Department will require large employers to give their workers paid time off to get vaccinated. If businesses don't comply, the government will "take enforcement actions," which could include "substantial fines up to nearly $14,000 per violation, according to officials.

Officials said the standard was a "minimum," and some companies may choose to go further, including by mandating the vaccine instead of offering a test-out alternative.

"Each employer will decide exactly what they want to do, but what we're saying through the Department of Labor rule making process is a minimum of testing once a week or full vaccination," a senior administration official said.

The new announcements move beyond what Biden announced earlier this summer, when he required federal workers be vaccinated but allowed for those who opted out to be subject to stringent mitigation measures. Now, federal employees will have 75 days to get vaccinated or risk being fired.

"The expectation is if you want to work in the federal government or want to be a contractor, you need to be vaccinated," press secretary Jen Psaki said, adding the number of unvaccinated federal workers was still being compiled. Officials said limited exemptions would apply to workers claiming medical or religious reasons for not getting vaccinated.

Biden on Thursday also announced a major expansion to free testing, a step public health officials have said is critical to containing the virus, particularly as children return to school and some workers return to offices.

The Defense Production Act, a wartime measure used to compel companies to manufacture essential supplies, will be evoked to accelerate the production of rapid tests and the administration is planning to send 25 million free tests to US health clinics, officials said. Some retailers, like Amazon, Kroger and Walmart, will sell the at-home tests at cost.

In addition, Biden called on large entertainment venues to require proof of vaccination or negative tests for patrons seeking entry. And he said the Transportation Safety Administration would double fines on passengers who refuse to wear masks on planes.

"If you break the rules, be prepared to pay — and by the way, show some respect," he said, chastising recent incidents of "air rage" directed toward hard-working cabin crews.

The six-pronged plan Biden unveiled was finalized by the President and members of his public health team on Wednesday afternoon. He received a briefing in the Oval Office from his Covid-19 response team on the anticipated new steps.

The six pillars of Biden's plan include: vaccinating the unvaccinated; further protecting the vaccinated through booster shots; keeping schools open; increasing testing and requiring masks; protecting the economic recovery; and improving care for those with Covid-19.

Biden's approval on handling of Covid is slipping

Officials said they hope the new approach will provide Americans a clearer view of how the pandemic will end after 18 months of Covid-dampened life. The White House has watched as the President's approval ratings on Covid have slipped, and feel part of the problem is the backward motion felt this summer: a spike in cases led to a return to masks and continued working from home.

An ABC News/Washington Post poll conducted at the end of August found 52% of respondents approve of how Biden is handling the pandemic, a 10-point drop from June. Still, more respondents said they approved of his handling of Covid than disapproved.

At the same time, Biden's overall approval has slipped into negative territory amid a chaotic withdrawal from Afghanistan and the Delta variant's drag on the economic recovery. The President's aides view combating the pandemic as the single most important issue of his presidency, and the one that will determine his political fate.

This story has been updated with additional reporting and developments from Biden's speech.