119-hr5448

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5448 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 5448

 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 HOUSE OF REPRESENTATIVES

 September 18, 2025

 Mr. Pallone (for himself, Mr. Neal, and Mr. Scott of Virginia) 
 introduced the following bill; which was referred to the Committee on 
 Energy and Commerce, and in addition to the Committees on Ways and 
 Means, and Education and Workforce, for a period to be subsequently 
 determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

 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''.

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 as updated or changed after that 
date under a supplement to a biologics license application approved by 
the Food and Drug Administration.
 ``

    (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 as updated or changed after that date under a supplement 
to a biologics license application approved by the Food and Drug 
Administration.
 ``

    (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 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 as updated or changed after that date under a supplement 
to a biologics license application approved by the Food and Drug 
Administration.
 ``

    (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 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 that date under a supplement 
 to a biologics license application approved by 
 the Food and Drug Administration, 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 that date under a 
 supplement to a biologics license application 
 approved by the Food and Drug 
 Administration.''; 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 that date under a 
 supplement to a biologics license application approved 
 by the Food and Drug Administration.''; 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 that date 
 under a supplement to a biologics license application 
 approved by the Food and Drug Administration.'' 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 that date 
 under a supplement to a biologics license application approved 
 by the Food and Drug Administration.''; 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) ''.
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