Sponsors (8)
Introduced April 21, 2026 by Kim Schrier · Last progress April 21, 2026
The bill improves payment rates and formalizes vaccine eligibility for children in Medicaid and CHIP—likely boosting access and provider participation through 2028—while increasing Medicaid costs, imposing state messaging conditions to get a modest FMAP boost, allowing potential fee variability, and creating funding uncertainty after the temporary payment guarantee ends.
Medicaid- and CHIP-enrolled children will have vaccine administration and counseling paid at no less than 100% of Medicare Part B rates from enactment through 12/31/2028, improving provider reimbursement and access to childhood vaccinations.
CHIP-enrolled children are explicitly designated as 'federally vaccine-eligible,' ensuring they receive VFC-related protections and coverage parity with Medicaid for vaccines.
States that meet outreach requirements will receive a modest 1 percentage point FMAP increase starting Q1 2027, giving states additional federal funds to support vaccine outreach and delivery.
Federal and state Medicaid programs (and thus taxpayers) will face higher costs from reimbursing vaccine administration and counseling at Medicare Part B rates through 2028, which could raise budgetary pressure or divert funds from other services.
The payment guarantee is time-limited (through 12/31/2028), creating uncertainty for states and providers about funding after expiration and complicating long-term planning for vaccine delivery programs.
States must include specified vaccine outreach messaging to qualify for the FMAP bump, which may constrain state messaging flexibility and impose administrative implementation costs.
Based on analysis of 2 sections of legislative text.
Adds CHIP enrollees to federally vaccine-eligible children and requires Medicaid/CHIP payments for pediatric vaccine administration and counseling at least equal to Medicare Part B rates through Dec 31, 2028.
Expands which children qualify as federally vaccine-eligible by explicitly including children enrolled in State Children’s Health Insurance Programs (CHIP). Requires Medicaid (including services furnished under the Vaccines for Children program and Medicaid managed care) to pay for pediatric vaccine administration and counseling at no less than 100% of the Medicare Part B payment rate for the same service/provider for services furnished from enactment through December 31, 2028, and extends CHIP vaccine administration coverage through that date.