[Congressional Record Volume 150, Number 44 (Thursday, April 1, 2004)]
[Senate]
[Pages S3571-S3572]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself and Mr. Smith):
  S. 2272. A bill to amend title XIX of the Social Security Act to 
expand the pediatric vaccine distribution program to include coverage 
for children administered a vaccine at a public health clinic or Indian 
clinic, and for other purposes; to the Committee on Finance.
  Mr. BINGAMAN. Mr. President, in conjunction with Senator Smith, I am 
introducing the ``Children's Vaccine Access Act of 2004.'' This 
legislation makes three changes to the Vaccines for Children program 
with the intent of expanding access and the delivery of vaccines to our 
Nation's children. This legislation is supported by the Administration 
and included in the Administration's budget as recommended by the 
Centers for Disease Control and Prevention, or CDC.
  First, the legislation expands access to the Vaccines for Children, 
or VFC, program for children whose private health insurance does not 
cover immunizations by allowing children to receive their VFC vaccines 
at State and local public health clinics. Currently, underinsured 
children must go to specially designated Federal Qualified Health 
Centers or rural health centers to receive VFC vaccines. Consequently, 
our bill expands the number of access points at which children can get 
the vaccines they need.
  According to the CDC, there are approximately 3,000 Federally 
Qualified Health Centers enrolled in VFC, compared with approximately 
7,000 health department clinics. As the CDC notes, ``Increasing access 
points for VFC eligible underinsured children will allow those who may 
have been previously denied immunizations at public health clinics to 
be vaccinated with the full series of routinely administered 
vaccines.''
  Second, the bill seeks to restore the tetanus and diphtheria vaccines 
to the VFC program by lifting the 1993 price caps that were in use 
prior to enactment of the VFC program. The price caps are so low that, 
for example, the tetanus booster vaccine was unfortunately dropped from 
VFC coverage when no vaccine manufacturer would bid on the contract at 
the 1993-imposed price cap levels.
  CDC estimates that over 200,000 additional children would be served 
through VFC with these two changes.
  And finally, the bill includes new authorizing language to allow the 
CDC to sell the VFC purchased stockpile vaccines to its grantees or 
back to manufacturers for use in the private sector in the event that 
the stockpiled vaccines are needed by non VFC-eligible children.
  Immunizations are critical to both children's health and the public 
health care system. The VFC program began on October 1, 1994, to 
improve vaccine availability to children nationwide by providing 
vaccines free-of-charge to Medicaid-eligible, uninsured, underinsured, 
American Indian, or Alaska Native children through both public and 
private providers. The VFC program automatically covers vaccines 
recommended by the Advisory Committee on Immunization Practices, or 
ACIP, and approved by the CDC.
  VFC has had an enormous impact on improving the immunization rates 
among our Nation's children. According to the Children's Defense Fund, 
``Between 1993 and 1999, there was nearly a 20 percent increase in the 
number of fully immunized two year-olds.''
  However, the goal of achieving a 90 percent immunization coverage 
rate, with the complete series of recommended vaccines, has still not 
been achieved. According to the National Immunization Survey (NIS), the 
nationwide vaccination coverage levels

[[Page S3572]]

among children 19-35 months of age for the 4:3:1:3:3 series of 
childhood immunizations was 74.8 percent in 2002. Unfortunately, the 
immunization rate in New Mexico was just 64.6 percent in 2002 and 
second worst in the Nation to only Colorado. To address that problem, 
in December 2001, I requested the CDC to work with the State of New 
Mexico on improving its immunization rate and a number of positive 
developments have taken place, including the creation of an 
Immunization Task Force at the state level and the passage of 
legislation to create an immunization registry by the New Mexico 
Legislature this past month.
  It is my belief that the strides the Nation and New Mexico continue 
to make to further improve the childhood immunization rate is assisted 
by this legislation. I would like to thank the CDC for their fine work 
on the VFC program and their assistance with this legislation and in 
its assistance directly to the State of New Mexico. I would also like 
to thank Senator Smith for his dedication and support for this 
initiative to improve the health of our Nation's children.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2272

       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 ``Children's Vaccine Access 
     Act of 2004''.

     SEC. 2. EXPANSION OF DEFINITION OF FEDERALLY VACCINE-ELIGIBLE 
                   CHILD.

       (a) In General.--Section 1928(b)(2)(A)(iii)(I) of the 
     Social Security Act (42 U.S.C. 1396s(b)(2)(A)(iii)(I)) is 
     amended by striking ``or a rural health clinic (as defined in 
     section 1905(l)(1))'' and inserting ``, a rural health clinic 
     (as defined in section 1905(l)(1)), or a State or local 
     public health clinic''.
       (b) Conforming Amendment.--Section 1928(h)(3) of the Social 
     Security Act (42 U.S.C. 1396s(h)(3)) is amended by striking 
     ``and `tribal organization' '' and inserting ``, `tribal 
     organization', and `urban Indian organization' ''.

     SEC. 3. REPEAL OF PRICE CAP FOR PRE-1993 VACCINES.

       (a) In General.--Section 1928(d)(3)(B) of the Social 
     Security Act (42 U.S.C. 1396s(d)(3)(B)) is repealed.
       (b) Conforming Amendment.--Section 1928(d)(3) of such Act 
     (42 U.S.C. 1396s(d)(3)) is amended by striking subparagraph 
     (C) and inserting the following:
       ``(B) Negotiation of discounted price.--With respect to 
     contracts entered into for a pediatric vaccine described in 
     this section, the price for the purchase of such vaccine 
     shall be a discounted price negotiated by the Secretary.''.

     SEC. 4. SIMPLIFIED ADMINISTRATION OF VACCINE SUPPLY.

       Section 1928(d)(6) of the Social Security Act (42 U.S.C. 
     1396s(d)(6)) is amended by inserting after the second 
     sentence the following: ``The Secretary may sell such 
     quantities of vaccines from such supply to public health 
     departments or back to the vaccine manufacturer as the 
     Secretary determines appropriate. Proceeds received from such 
     sales shall be available to the Secretary only for the 
     purpose of procuring pediatric vaccines stockpiles under this 
     section and shall remain available until expended.''.

     SEC. 5. EFFECTIVE DATE.

       The amendments made by this Act take effect on October 1, 
     2004.
                                 ______