[Congressional Record Volume 172, Number 49 (Wednesday, March 18, 2026)]
[Senate]
[Pages S1236-S1237]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 4518. Mr. LUJAN submitted an amendment intended to be proposed by
him to the bill S. 1383, to establish the Veterans Advisory Committee
on Equal Access, and for other purposes; which was ordered to lie on
the table; as follows:
At the appropriate place, insert the following:
SEC. __. 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-12. 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, 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 January 1,
2025, 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-12 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. 727. 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, 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 January 1,
2025, 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. 727. 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. 9827. 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, a group health plan shall provide coverage for
[[Page S1237]]
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 January 1, 2025, 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. 9827. 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, in the case of a vaccine
with respect to which such a recommendation is revoked with
respect to the individual involved on or after January 1,
2025, 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) beginning on the date of the enactment of this
clause, approved vaccines, and the administration of such
vaccines, that were recommended by such advisory committee
with respect to the individual involved as of January 1,
2025, 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) Beginning on the date of the enactment of this
clause, 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 January 1, 2025, 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, beginning on the date of the enactment of
this sentence, the Secretary may not take into account any
revision of such list that occurs on or after January 1,
2025, 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, beginning on the date of
the enactment of this paragraph, 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 January 1, 2025,
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 beginning on the date of
the enactment of such subsection (and the administration of
such vaccines),'' before ``services described in section
1916(a)(2)(G)''.
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