HR5448-119

1. Short title This Act may be cited as the Protecting Free Vaccines Act.

2. Requiring coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices 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: 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. 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. 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. 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: 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. 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. 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: Subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by adding at the end the following new section: 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. 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. 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: Section 1860D–2(b)(8)(B) of the Social Security Act (42 U.S.C. 1395w–102(b)(8)(B)) is amended— by striking with recommendations and inserting with— recommendations by striking the period at the end and inserting ; or; and by adding at the end the following new clause: 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. Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended— in subsection (a)(13)(B)— by striking individual, approved and inserting individual— approved by adding at the end the following new clause: 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. in subsection (r)(1)(B)(iii), by— striking section 1928(c)(2)(B)(i) and inserting clause (i) of section 1928(c)(2)(B); and inserting , subject to the limitation described in clause (iii) of such section after pediatric vaccines. 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,. Section 1928 of the Social Security Act (42 U.S.C. 1396s) is amended— in subsection (c)(2)(B)— in clause (i), by striking clause (ii) and inserting clauses (ii) and (iii); and by adding at the end the following new clause: 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. 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. 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: 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). Section 2103 of the Social Security Act (42 U.S.C. 1397cc) is amended— in subsection (c), by adding at the end the following new paragraph: 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. 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). 2799A–11.Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices (a)In generalWith 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 ruleSubsection (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.. 726.Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices (a)In generalWith 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 ruleSubsection (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.. Sec. 726. Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices.. 9826.Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices (a)In generalWith 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 ruleSubsection (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.. Sec. 9826. Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices.. with— (i)recommendations; (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.. individual— (i)approved; and (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 (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 (9)Coverage of adult vaccinesNotwithstanding 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).. (13)Required coverage of certain vaccines recommended by the Advisory Committee on Immunization PracticesRegardless 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

2799A–11. Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices 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. 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.

726. Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices 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. 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.

9826. Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices 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. 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.