[Congressional Record Volume 146, Number 47 (Thursday, April 13, 2000)]
[Senate]
[Pages S2763-S2764]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself and Mr. Reed):
  S. 2444. A bill to amend title I of the Employee Retirement Income 
Security Act of 1974, the Public Health Service Act, and the Internal 
Revenue Code of 1986 to require comprehensive health insurance coverage 
for childhood immunization; to the Committee on Health, Education, 
Labor, and Pensions.


   the state immunization funding and infrastructure act of 2000 and 
 comprehensive insurance coverage of childhood immunization act of 2000

  Mr. DURBIN. Mr. President, as National Immunization Week approaches, 
I rise today to introduce legislation addressing childhood 
immunizations. National Immunization Week (April 17-21) recognizes one 
of the most powerful health care and public health achievements in this 
century. Remarkable advances in the science of vaccine development and 
widespread immunization efforts have led to a substantial reduction in 
the incidence of infectious disease. Today, vaccination coverage is at 
record high levels. Smallpox has been eradicated; polio has been 
eliminated from the Western Hemisphere; and measles and Hib invasive 
disease, the leading cause of childhood meningitis and postnatal 
retardation, have been reduced to record lows.
  The two bills I introduce today build on these successes. One 
proposal, ``The State Immunization Funding and Infrastructure Act of 
2000,'' ensures that state and local health departments are adequately 
funded to continue successful efforts to immunize children and improve 
their ability to reach pockets of underimmunized populations. The 
other, ``The Comprehensive Insurance Coverage of Childhood Immunization 
Act of 2000,'' requires all health plans to cover recommended childhood 
and adolescent immunizations.
  In spite of our successes, we must remain vigilant. Every day, nearly 
11,000 infants are born and each baby will need up to 19 doses of 
vaccine by age two. New vaccines continue to enter the market. Although 
a significant proportion of the general population may be fully 
immunized at a given time, coverage rates in the United States are 
uneven and life-threatening disease outbreaks do occur. In fact, in 
many of the Nation's urban and rural areas, rates are unacceptably low 
and are actually declining.
  Unfortunately, one of the areas most in need of attention is in my 
own home State of Illinois. Childhood immunization coverage rates in 
Chicago have dropped each year since 1996 when they peaked at 76 
percent. The most recent National Immunization Survey indicates that 
Chicago's coverage rate is now 66.7 percent--one of the lowest rates in 
the United States. Coverage rates for African American children in 
Chicago are the worst in the Nation.
  It is notable, however, that during this same period when Chicago has 
struggled to improve vaccination rates, Federal financial assistance to 
state and local health departments for immunization outreach activities 
has been significantly reduced. In 1999, Chicago received a 38 percent 
reduction in Federal funds for the operation of their immunization 
program. In 2000, Chicago suffered another 37.5 percent reduction. The 
State of Illinois suffered a 58 percent reduction in 1999 and a further 
16 percent reduction in the year 2000. And the story in my State is not 
that different from other areas of the country. Federal support for 
vaccine delivery activities has declined by more than 30 percent since 
1995.
  Purchasing vaccines is not enough. The Section 317 immunization 
program administered by the Centers for Disease Control and Prevention 
provides grants to state and local public health departments for 
``operations and infrastructure'' activities. These grants are a 
critical source of support, indeed the sole source of Federal support, 
for essential efforts to get children immunized. They fund immunization 
registries, provider education programs, outreach initiatives to 
parents, outbreak control, and linkages with other public health and 
welfare services. These grants get the vaccine from the warehouse to 
our children.
  The State Immunization Funding And Infrastructure Act of 2000 
authorizes an increase in Federal support for Section 317 grants to 
states by $75 million for a total of $214 in FY2001. This restores 
funding to the levels States and localities received in the mid-1990's 
and will help to stabilize many of the key functions that have been cut 
back in the face of steep funding reductions. In the past few years, 
many states have already had to reduce clinic hours, cancel contracts 
with providers, suspend registry development and implementation, limit 
outreach efforts and discontinue performance monitoring. The bill also 
provides a $20 million increase over last year's funding level ($10 
million over the President's budget) for vaccine purchase. This will 
ensure that States are able to purchase adequate amounts of all 
currently licensed and recommended vaccines.
  The other proposal I am introducing today, The Comprehensive 
Insurance Coverage of Childhood Immunization Act of 2000, will require 
that all health plans cover all immunizations in accordance with the 
most recent version of the Recommended Childhood Immunization Schedule 
issued by the Centers for Disease Control and Prevention. These 
vaccinations must be provided without deductibles, coinsurance or other 
cost-sharing for all children and adolescents under the age of 19.
  I was shocked to learn that, according to a recent survey of 
employer-sponsored health plans conducted by William M. Mercer, Inc. 
and Partnership for Prevention, one out of five employer-sponsored 
plans do not cover childhood immunizations and one out of four fail to 
cover adolescent immunizations. Not only is this a significant gap in 
our health system, but it is simply financially illogical. Childhood 
and adolescent immunizations have been proven to save money. They 
decrease the direct medical costs due to vaccine-preventable illnesses 
and reduce the time parents spend off the job, tending sick children.
  I invite my colleagues to join me in these efforts to maintain and 
improve our nation's national immunization record and to ensure that 
all areas of the country and all populations benefit from the advances 
we have made over the last century. Despite remarkable progress, many 
challenges still face the U.S. vaccine delivery system. Approximately 
one million children are still not adequately immunized. Our 
infrastructure must be capable of successfully implementing an 
increasingly complex vaccination schedule. Pockets

[[Page S2764]]

of underserved children still leave us vulnerable to deadly disease 
outbreaks.
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