Sponsors (9)
The bill increases short-term access and provider payment for vaccines for Medicaid and CHIP children and boosts transparency, at the cost of higher Medicaid spending, potential out-of-pocket/billing variability, state administrative requirements, and uncertainty when the temporary payment boosts expire.
Medicaid- and CHIP-enrolled children will have vaccine administration and counseling reimbursed at no less than 100% of Medicare Part B rates through 12/31/2028, improving provider reimbursement and likely increasing access to childhood vaccines.
CHIP-enrolled children are explicitly designated as federally vaccine-eligible, ensuring Vaccines for Children (VFC)-related protections and coverage parity between Medicaid and CHIP.
CDC publication of state pediatric vaccination rates (FY2027-2028) and a GAO study within two years increase transparency on program performance and provider participation, aiding oversight and program improvement.
Reimbursing vaccine administration and counseling at Medicare Part B rates through 2028 increases federal and state Medicaid costs, potentially creating budgetary pressure or diverting funds from other services.
Allowing providers to charge administration/counseling fees up to cost could produce variability in out-of-pocket charges or billing complexity for families (especially for multi-component vaccines) if not uniformly monitored.
Short-term payment guarantees (through 12/31/2028) create uncertainty for providers and states after expiration, complicating long-term planning for vaccine delivery programs.
Based on analysis of 2 sections of legislative text.
Adds CHIP enrollees to federally vaccine-eligible children and requires Medicaid/CHIP to pay vaccine administration and counseling at no less than 100% of Medicare Part B through Dec 31, 2028.
Introduced April 21, 2026 by Kim Schrier · Last progress April 21, 2026
Expands which children qualify for federal vaccine programs by adding children enrolled in State Children’s Health Insurance Programs (CHIP) as "federally vaccine-eligible" and clarifies VFC rules about who is insured for a vaccine. Requires Medicaid and CHIP to pay for pediatric vaccine administration and counseling at no less than 100% of the Medicare Part B payment rate for those services and providers, with that payment parity in effect from enactment through December 31, 2028. Updates related Medicaid managed care and program references to reflect these changes.