The Biden administration’s proposal to mandate minimum staffing requirements for nursing homes across America is expected to touch off what could be an epic political battle pitting labor unions and Democrats against nursing homes unable to meet the requirements. 

President Biden’s proposed rules for nursing homes, issued through the Centers for Medicare and Medicaid Services, are winning praise from Big Labor. The president of the Service Employees International Union, Mary Kay Henry, is already calling the proposal a “historic first step.”

Yet nursing homes, 95 percent of which already say they face hiring difficulties, are warning that it will be impossible to staff up their facilities to the levels Mr. Biden is proposing to require. The measure would mandate that a registered nurse be on duty at all times, increase hours of care for every patient, and is estimated to cost nursing homes $40.6 billion over 10 years.

Mr. Biden’s proposal for the nursing homes is a first-of-its-kind nationwide mandate. It would bring a widely scattered industry of small businesses under national rule. Plus, it can be seen as a kind of template for other industries that have largely been able to prosper without federal staffing mandates. In this sense, it’s a radical step at the beginning of an election year.

“This once again shows the neglect of a federal regulatory agency and an administration — which is clearly taking advice from special interest groups — to bring all stakeholders to the table and make a rational decision that works for everyone,” the president and chief executive of the Pennsylvania Health Care Association, Zach Shamberg, told The New York Sun. 

“We’re not surprised that the Biden administration is making decisions based on the advice of workers unions. This agenda-driven decision is an attack on the access to care of seniors and adults with disabilities. The proposal is unfunded and in no way supports workforce development to attain the amount of caregivers needed,” Mr. Shamberg said. 

In Mr. Biden’s op-ed in USA Today announcing the proposed regulations, he wrote that the new standards would be part of building “a pipeline of health care workers into good-paying jobs — that include the free and fair choice to join a union.” 

As of 2021, 16 percent of nursing home workers were represented by labor unions. That could change as the Biden administration works with labor unions. The proposed standards, currently in a 60-day public comment period, are estimated to affect 75 percent of nursing homes across the country.

The proposed federal mandate came as several states had already introduced their own nursing home staffing requirements. Pennsylvania implemented new staffing ratios on July 1 and increased the required hours of care for every resident. The requirements are set to increase again in July 2024.

Mr. Shamberg told the Sun the federal mandate will create a “‘dumpster fire’ for providers in states like Pennsylvania that have already implemented higher staffing standards and ratios. This convoluted mess lacks thought and consideration for states like ours and undermines the work we have already done to enhance care.”

In 2022, New York mandated a minimum staffing requirement and increased daily hours of direct care for every resident. A year later, 75 percent of New York nursing homes did not meet the requirements. Despite labor union praise, there’s little evidence the federal mandates will fare any better.