Sponsors (3)
The bill temporarily eliminates cost-sharing for ACIP-recommended vaccines for many insured and Medicaid/CHIP enrollees through 12/31/2029—likely increasing vaccination and reducing illness in the near term—at the expense of higher short-term costs for payers, added administrative burdens, and uncertainty when the policy sunsets.
People with private group or individual health plans will receive ACIP-recommended vaccines without copay or deductible through December 31, 2029.
Medicaid and CHIP enrollees, including targeted low-income children, will receive covered vaccines and administration without cost-sharing through December 31, 2029.
Removing cost-sharing for many vaccines is likely to increase vaccination rates and reduce vaccine-preventable illness and related healthcare costs.
Insurers, employers, and state programs may face higher short-term costs to cover vaccines without cost-sharing, potentially leading to higher premiums, increased employer plan contributions, or state budget pressures that require offsets.
The policy is temporary (sunsets 12/31/2029), creating potential coverage uncertainty for patients and providers after that date.
The federal mandate will impose administrative compliance and coordination burdens on plans, states, and providers to implement the temporary coverage across programs.
Based on analysis of 2 sections of legislative text.
Requires group plans and applicable issuers to cover, without cost-sharing, vaccines ACIP-recommended as of Oct 25, 2024 (including select supplemental BLAs) through Dec 31, 2029.
Introduced September 18, 2025 by Ronald Lee Wyden · Last progress September 18, 2025
Requires group health plans and applicable health insurers to cover, with no cost-sharing, vaccines that had an ACIP recommendation for the covered individual as of October 25, 2024 (including certain supplemental biologics license updates filed by that date). The requirement is temporary: it applies to plan years that begin on or after enactment through December 31, 2029, and excludes doses given during a shorter-than-recommended interval.