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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2857 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 2857
To require coverage of certain immunizations recommended by the
Advisory Committee on Immunization Practices under the Medicare
program, the Medicaid program, the Children's Health Insurance Program,
group health plans, and health insurance coverage.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 18 (legislative day, September 16), 2025
Mr. Wyden (for himself and Mr. Sanders) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To require coverage of certain immunizations recommended by the
Advisory Committee on Immunization Practices under the Medicare
program, the Medicaid program, the Children's Health Insurance Program,
group health plans, and health insurance coverage.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protecting Free Vaccines Act of
2025''.
SEC. 2. REQUIRING COVERAGE OF CERTAIN IMMUNIZATIONS RECOMMENDED BY THE
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES.
(a) Group Health Plans and Health Insurance Coverage.--
(1) PHSA.--
(A) In general.--Part D of title XXVII of the
Public Health Service Act (42 U.S.C. 300gg-111 et seq.)
is amended by adding at the end the following new
section:
``SEC. 2799A-11. COVERAGE OF CERTAIN IMMUNIZATIONS RECOMMENDED BY THE
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES.
``(a) In General.--With respect to plan years occurring during the
date of the enactment of this section, or beginning on or after the
date of the enactment of this section and before January 1, 2030, a
group health plan and a health insurance issuer offering group or
individual health insurance coverage shall provide coverage for and
shall not impose any cost sharing requirements for immunizations that
had in effect a recommendation from the Advisory Committee on
Immunization Practices of the Centers for Disease Control and
Prevention with respect to the individual involved as of October 25,
2024, including such an immunization involving a vaccine as updated or
changed after such date under an approved supplemental application to a
biological product licensed under section 351 on or before such date.
``(b) Special Rule.--Subsection (a) shall not apply in the case of
an immunization administered during the minimum interval established
under section 2713(b) with respect to such immunization.''.
(B) Conforming amendment.--Section 1302(e)(1)(B)(i)
of the Patient Protection and Affordable Care Act (42
U.S.C. 18022(e)(1)(B)(i)) is amended by striking
``section 2713'' and inserting ``sections 2713 and
2799A-11 of the Public Health Service Act''.
(2) ERISA.--
(A) In general.--Subpart B of part 7 of subtitle B
of title I of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1185 et seq.) is amended by
adding at the end the following new section:
``SEC. 726. COVERAGE OF CERTAIN IMMUNIZATIONS RECOMMENDED BY THE
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES.
``(a) In General.--With respect to plan years occurring during the
date of the enactment of this section, or beginning on or after the
date of the enactment of this section and before January 1, 2030, a
group health plan and a health insurance issuer offering group health
insurance coverage shall provide coverage for and shall not impose any
cost sharing requirements for immunizations that had in effect a
recommendation from the Advisory Committee on Immunization Practices of
the Centers for Disease Control and Prevention with respect to the
individual involved as of October 25, 2024, including such an
immunization involving a vaccine as updated or changed after such date
under an approved supplemental application to a biological product
licensed under section 351 of the Public Health Service Act (42 U.S.C.
262) on or before such date.
``(b) Special Rule.--Subsection (a) shall not apply in the case of
an immunization administered during the minimum interval established
under section 2713(b) of the Public Health Service Act (42 U.S.C.
300gg-13(b)) with respect to such immunization.''.
(B) Clerical amendment.--The table of contents in
section 1 of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1001 note) is amended by
inserting after the item relating to section 725 the
following new item:
``Sec. 726. Coverage of certain immunizations recommended by the
Advisory Committee on Immunization
Practices.''.
(3) IRC.--
(A) In general.--Subchapter B of chapter 100 of the
Internal Revenue Code of 1986 is amended by adding at
the end the following new section:
``SEC. 9826. COVERAGE OF CERTAIN IMMUNIZATIONS RECOMMENDED BY THE
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES.
``(a) In General.--With respect to plan years occurring during the
date of the enactment of this section, or beginning on or after the
date of the enactment of this section and before January 1, 2030, a
group health plan shall provide coverage for and shall not impose any
cost sharing requirements for immunizations that had in effect a
recommendation from the Advisory Committee on Immunization Practices of
the Centers for Disease Control and Prevention with respect to the
individual involved as of October 25, 2024, including such an
immunization involving a vaccine as updated or changed after such date
under an approved supplemental application to a biological product
licensed under section 351 of the Public Health Service Act (42 U.S.C.
262) on or before such date.
``(b) Special Rule.--Subsection (a) shall not apply in the case of
an immunization administered during the minimum interval established
under section 2713(b) of the Public Health Service Act (42 U.S.C.
300gg-13(b)) with respect to such immunization.''.
(B) Clerical amendment.--The table of sections for
subchapter B of chapter 100 of the Internal Revenue
Code of 1986 is amended by adding at the end the
following new item:
``Sec. 9826. Coverage of certain immunizations recommended by the
Advisory Committee on Immunization
Practices.''.
(b) Medicare.--Section 1860D-2(b)(8)(B) of the Social Security Act
(42 U.S.C. 1395w-102(b)(8)(B)) is amended--
(1) by striking ``with recommendations'' and inserting
``with--
``(i) recommendations'';
(2) by striking the period at the end and inserting ``;
or''; and
(3) by adding at the end the following new clause:
``(ii) for plan years occurring during the
date of the enactment of this clause, or
beginning on or after the date of the enactment
of this clause and before January 1, 2030, in
the case of a vaccine with respect to which
such a recommendation is revoked with respect
to the individual involved on or after October
25, 2024, including such a vaccine as updated
or changed after such date under an approved
supplemental application to a biological
product licensed under section 351 of the
Public Health Service Act on or before such
date, the most recent recommendation that was
in effect with respect to such vaccine and such
individual prior to such revocation.''.
(c) Medicaid.--
(1) In general.--Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended--
(A) in subsection (a)(13)(B)--
(i) by striking ``individual, approved''
and inserting ``individual--
``(i) approved''; and
(ii) by adding at the end the following new
clause:
``(ii) for the period beginning on the date
of the enactment of this clause and ending on
December 31, 2029, approved vaccines, and the
administration of such vaccines, that were
recommended by such advisory committee with
respect to the individual involved as of
October 25, 2024, including such a vaccine as
updated or changed after such date under an
approved supplemental application to a
biological product licensed under section 351
of the Public Health Service Act on or before
such date; and''; and
(B) in subsection (r)(1)(B)(iii), by--
(i) striking ``section 1928(c)(2)(B)(i)''
and inserting ``clause (i) of section
1928(c)(2)(B)''; and
(ii) inserting ``, subject to the
limitation described in clause (iii) of such
section'' after ``pediatric vaccines''.
(2) Coverage for pregnant individuals.--Section 1902(a)(10)
of the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended
in the matter following subparagraph (G) by inserting ``medical
assistance for vaccines described in section 1905(a)(13)(B) and
the administration of such vaccines,'' after ``complicate
pregnancy,''.
(3) Program for distribution of pediatric vaccines.--
Section 1928 of the Social Security Act (42 U.S.C. 1396s) is
amended--
(A) in subsection (c)(2)(B)--
(i) in clause (i), by striking ``clause
(ii)'' and inserting ``clauses (ii) and
(iii)''; and
(ii) by adding at the end the following new
clause:
``(iii) For the period beginning on the date of the
enactment of this clause and ending on December 31,
2029, the provider will not take into account any
change in the schedule described in clause (i) that
removes the recommendation to administer a pediatric
vaccine with respect to the vaccine-eligible child
involved if such pediatric vaccine was recommended with
respect to such child under such schedule as of October
25, 2024, including with respect to such pediatric
vaccine as updated or changed after such date under an
approved supplemental application to a biological
product licensed under section 351 of the Public Health
Service Act on or before such date.''; and
(B) in subsection (e), by inserting ``For purposes
of the preceding sentence, during the period beginning
on the date of the enactment of this sentence and
ending on December 31, 2029, the Secretary may not take
into account any revision of such list that occurs on
or after October 25, 2024, that removes a pediatric
vaccine from such list if such vaccine was included in
such list as of such date, including with respect to
such vaccine as updated or changed after such date
under an approved supplemental application to a
biological product licensed under section 351 of the
Public Health Service Act on or before such date.''
after the period at the end.
(4) State flexibility in benefit packages.--Section 1937(b)
of the Social Security Act (42 U.S.C. 1396u-7(b)) is amended by
adding at the end the following new paragraph:
``(9) Coverage of adult vaccines.--Notwithstanding the
previous provisions of this section, a State may not provide
for medical assistance through enrollment of an individual with
benchmark coverage or benchmark-equivalent coverage under this
section unless such coverage includes (and does not impose any
deduction, cost sharing, or similar charge for) the medical
assistance described in section 1905(a)(13)(B).''.
(d) CHIP.--Section 2103 of the Social Security Act (42 U.S.C.
1397cc) is amended--
(1) in subsection (c), by adding at the end the following
new paragraph:
``(13) Required coverage of certain vaccines recommended by
the advisory committee on immunization practices.--Regardless
of the type of coverage elected by a State under subsection
(a), the child health assistance provided for a targeted low-
income child shall include coverage, during the period
beginning on the date of the enactment of this paragraph and
ending on December 31, 2029, of vaccines, and the
administration of such vaccines, that had in effect a
recommendation from the Advisory Committee on Immunization
Practices of the Centers for Disease Control and Prevention
with respect to the child involved as of October 25, 2024,
including such a vaccine as updated or changed after such date
under an approved supplemental application to a biological
product licensed under section 351 of the Public Health Service
Act on or before such date.''; and
(2) in subsection (e)(2), by inserting ``vaccines described
in subsection (c)(13) administered during the period beginning
on the date of the enactment of such subsection and ending on
December 31, 2029 (and the administration of such vaccines),''
before ``services described in section 1916(a)(2)(G)''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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