RICHMOND, Va. (WRIC) — Virginia Gov. Glenn Youngkin asked the federal government to waive its COVID-19 vaccine mandate for health care workers at rural and state-run hospitals.

Youngkin and West Virginia Gov. Jim Justice sent a letter to the Centers for Medicare and Medicaid Services (CMS) on Monday requesting a “limited waiver” to the federal rule requiring most health care workers in the U.S. to be vaccinated.

The Republican governors wrote that “an urgent staffing crisis” has constrained rural and state facilities and the federal rule compounds the issue. They expressed concerns the mandate could lead to thousands of workers being fired for not complying while some hospitals face “a breaking point.”

“This relief could take multiple forms, including broader conscience exemptions, flexibility on enforcement, or simply a six month delay of the rule,” the governors wrote.

President Joe Biden imposed vaccine mandates for businesses and health care workers that were challenged in court by Republican administrations. Before taking office, Youngkin and Attorney General Jason Miyares vowed to join the fight but the U.S. Supreme Court ruled on both cases.

The Supreme Court stopped the Biden administration’s vaccine and testing rules for large employers but allowed the federal mandate for health care workers to remain in place. The rule covers 10.4 million workers at 76,000 health care facilities.

The mandate issued by CMS requires employees at facilities that receive federal government funding to be fully vaccinated or be tested. Workers at nursing homes, hospitals and certain other facilities must be vaccinated under the mandate.

“Our objections to the rule itself have been well noted, but we recognize the legal process has left this interim rule in place,” Youngkin and Justice wrote in the letter. “However, rural and state health care facilities in our states are facing an urgent staffing crisis that we believe necessitates relief from the rule.”

Virginia Hospital & Healthcare Association spokesman Julian Walker said Tuesday that VHHA backed COVID-19 vaccine requirements for hospital and health system employees in July, but the 110 hospitals in its alliance are independent, have different needs and should be able to develop rules that are best for their staff.

Walker said VHHA appreciates Youngkin’s focus on “real staffing issues” that Virginia hospitals faced before the pandemic and during spikes in hospitalizations.

“The pandemic has magnified them [staffing shortages] significantly,” Walker said, citing an increase in demand for travel nurses and workers sidelined with COVID-19 amid the omicron surge.

More than 750 workers at Ballad Health, a system serving Southwest Virginia and eastern Tennessee, missed work on Jan. 19.

“We support vaccines. It’s important to really isolate the fundamental issue, not the broader debate about vaccine rules but about the pressing issues, the impact on staffing… that’s what we have,” Walker added.

While noting the impact staffing concerns have had at rural hospitals, Walker said facilities across Virginia have faced their own issues.