Table 2.

Recommended steps to improve the effects of preemption on public health and equity.

Provide a foundation from which to evaluate impact of preemption

Invest in research to gather empirical data on the public health effects of preemption [2]

Develop a robust evidence base regarding preemption (from various content areas and diverse approaches) to inform preemption policy considerations

Include savings clauses (explicit statement that the law does not preempt lower levels of government from enacting stronger legislation to protect public health)

Establish best practices for preventing exacerbations of health inequities

Emphasize that preemptive clauses in legislation should draw on established evidence base

Ensure that core to all policies is consideration of those most likely to be disproportionately impacted by the policy

Involve representation of those most disproportionately impacted in all phases of policy drafting

Obtain input from the public health science community to determine whether preemption could have positive or negative public health benefits

Policy considerations

Do not enact preemptive public health laws that are not supported by scientific evidence

Consider providing waiver provisions in preemptive laws

Remove existing state preemption of more protective local laws related to COVID-19

Strengthen the “home rule” to promote local authority to regulate in their own communities

Consider federal preemptive intervention to combat the misuse of state preemption

Enact preemptive legislation that serves as a regulatory floor rather than a regulatory ceiling to reserve the power of local authorities to enact stricter laws

Disallow regulatory vacuums