II
119th CONGRESS
1st Session
S. 2857
IN THE SENATE OF THE UNITED STATES
September 18 (legislative day, September 16), 2025
Mr. Wyden (for himself and Mr. Sanders) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions
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.
Short title
This Act may be cited as the Protecting Free Vaccines Act of 2025
.
Requiring coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices
Group health plans and health insurance coverage
PHSA
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:
Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices
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 involving a vaccine as updated or changed after such date under an approved supplemental application to a biological product licensed under section 351 on or before such date.
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.
.
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
.
ERISA
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:
Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices
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 involving a vaccine as updated or changed after such date under an approved supplemental application to a biological product licensed under section 351 of the Public Health Service Act (42 U.S.C. 262) on or before such date.
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 (42 U.S.C. 300gg–13(b)) with respect to such immunization.
.
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.
.
IRC
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:
Coverage of certain immunizations recommended by the Advisory Committee on Immunization Practices
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 involving a vaccine as updated or changed after such date under an approved supplemental application to a biological product licensed under section 351 of the Public Health Service Act (42 U.S.C. 262) on or before such date.
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 (42 U.S.C. 300gg–13(b)) with respect to such immunization.
.
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.
.
Medicare
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 such date under an approved supplemental application to a biological product licensed under section 351 of the Public Health Service Act on or before such date, the most recent recommendation that was in effect with respect to such vaccine and such individual prior to such revocation.
.
Medicaid
In general
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
; 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, 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 such date under an approved supplemental application to a biological product licensed under section 351 of the Public Health Service Act on or before such date; and
; and
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
.
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,
.
Program for distribution of pediatric vaccines
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 such date under an approved supplemental application to a biological product licensed under section 351 of the Public Health Service Act on or before such date.
; and
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 such date under an approved supplemental application to a biological product licensed under section 351 of the Public Health Service Act on or before such date.
after the period at the end.
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:
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).
.
CHIP
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:
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 such date under an approved supplemental application to a biological product licensed under section 351 of the Public Health Service Act on or before such date.
; and
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)
.