H.R. 8425

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8425 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 8425

To amend title XIX of the Social Security Act to ensure access to 
immunizations under the Medicaid program and the Vaccines for Children 
program, and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

April 21, 2026

Ms. Schrier (for herself and Mr. Joyce of Pennsylvania) introduced the 
following bill; which was referred to the Committee on Energy and 
Commerce

_______________________________________________________________________

A BILL

To amend title XIX of the Social Security Act to ensure access to 
immunizations under the Medicaid program and the Vaccines for Children 
program, and for other purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Strengthening the Vaccines for 
Children Program Act of 2026''.

SEC. 2. ENSURING ACCESS TO IMMUNIZATIONS UNDER THE MEDICAID PROGRAM AND 
THE VACCINES FOR CHILDREN PROGRAM.

(a) Expansion of Definition of Federally Vaccine-Eligible Child.--
Paragraph (2) of section 1928(b) of the Social Security Act (42 U.S.C. 
1396s(b)) is amended--
(1) in subparagraph (A)--
(A) in clause (iii), by striking ``A child who'' 
and all that follows through the period at the end and 
inserting ``A child who is administered a qualified 
pediatric vaccine and is not insured with respect to 
such vaccine.''; and
(B) by adding at the end the following new clause:
``(v) A child who is enrolled for child 
health assistance under a State child health 
plan approved under title XXI.''; and
(2) in subparagraph (B)(ii)(II), by striking ``for purposes 
of subparagraph (A)(iii)(II)'' and inserting ``for purposes of 
subparagraph (A)(iii)''.
(b) Minimum Payment Requirement for Vaccine Administration and 
Counseling Services.--
(1) In general.--Section 1902(a)(13) of the Social Security 
Act (42 U.S.C. 1396a(a)(13)) is amended--
(A) in subparagraph (B), by striking ``and'' at the 
end;
(B) in subparagraph (C), by striking the semicolon 
and inserting ``; and''; and
(C) by adding at the end the following new 
subparagraph:
``(D) for payment for vaccine administration and 
counseling services furnished by a provider during the 
period beginning on the date of the enactment of this 
subparagraph, and ending on December 31, 2028 
(including, notwithstanding subsection (c)(2)(C)(ii) of 
section 1928, any such services furnished with respect 
to a vaccine furnished under the program established by 
the State pursuant to such section to a medicaid-
eligible child (as defined in subsection (b)(2)(B)(i) 
of such section)), at a rate not less than 100 percent 
of the payment rate that applies to such services and 
provider under part B of title XVIII;''.
(2) Managed care plans.--Section 1932(f) of the Social 
Security Act (42 U.S.C. 1396u-2(f)) is amended--
(A) in the header, by striking ``Payment for 
Primary Care Services'' and inserting ``Payments'';
(B) by striking ``section 1902(a)(13)(C)'' and 
inserting ``subparagraph (C) of section 1902(a)(13) and 
vaccine administration and counseling services 
described in subparagraph (D) of such section'';
(C) by striking ``such section'' and inserting 
``such subparagraph (C) or (D), respectively''; and
(D) by adding at the end the following new 
sentence: ``The provisions of the preceding sentence 
shall apply to contracts entered into with, and 
payments made by, other specified entities (as defined 
in section 1903(m)(9)(D)(iii)) in the same manner as 
such provisions apply with respect to contracts entered 
into with, and payments made by, medicaid managed care 
organizations.''.
(3) CHIP.--Section 2103(c) of the Social Security Act (42 
U.S.C. 1397cc(c)) is amended by adding at the end the following 
new paragraph:
``(11) Vaccine administration services.--The child health 
assistance provided to a targeted low-income child shall 
include payment for vaccine administration and counseling 
services furnished by a provider during the period beginning on 
the date of the enactment of this paragraph, and ending on 
December 31, 2028 (including, notwithstanding subsection 
(c)(2)(C)(ii) of section 1928, any such services furnished to 
such child with respect to a vaccine furnished under the 
program established by the State pursuant to such section), at 
a rate not less than 100 percent of the payment rate that 
applies to such services and provider under part B of title 
XVIII.''.
(c) Clarification of Coverage of Pediatric Vaccine Administration 
and Vaccine Counseling and Educational Services Under the Vaccines for 
Children Program.--Section 1928(c)(2)(C) of the Social Security Act (42 
U.S.C. 1396s(c)(2)(C)) is amended--
(1) in clause (ii), by amending such clause to read as 
follows:
``(ii) The provider may impose--
``(I) in the case of a qualified pediatric 
vaccine not described in subclause (II), a fee 
for the administration of and counseling for 
such vaccine (which, in the case of a 
counseling fee, may be so imposed regardless of 
whether such vaccine is actually administered) 
so long as the fee in the case of a federally 
vaccine-eligible child does not exceed the 
costs of such administration and counseling (as 
determined by the Secretary based on actual 
regional costs for such administration and 
counseling and updated as determined 
appropriate by the Secretary to take into 
account changes in such costs, including 
changes attributable to the inclusion of new 
qualified pediatric vaccines in the program 
established under this section); and
``(II) in the case of a qualified pediatric 
vaccine that is a multiple component vaccine, a 
separate charge for the administration of and 
counseling for each component of such vaccine 
(which, in the case of a counseling fee, may be 
so imposed regardless of whether such component 
is actually administered) so long as the charge 
in the case of a federally vaccine-eligible 
child does not exceed--
``(aa) with respect to the first 
component of such vaccine, the costs of 
such administration and counseling for 
such component (as determined by the 
Secretary based on actual regional 
costs for such administration and 
counseling for such first component and 
updated as determined appropriate by 
the Secretary to take into account 
changes in such costs, including 
changes attributable to the inclusion 
of new qualified pediatric vaccines in 
the program established under this 
section); and
``(bb) with respect to a subsequent 
component of such vaccine, the payment 
rate that applies to such 
administration and counseling for such 
component and provider under part B of 
title XVIII.''; and
(2) in clause (iii), by inserting ``or counseling'' after 
``an administration''.
(d) Increase in Federal Medical Assistance Percentage.--
(1) In general.--Subject to paragraph (2), for each 
calendar quarter occurring during the period beginning on or 
after January 1, 2027, the Federal medical assistance 
percentage determined for each State, including the District of 
Columbia, American Samoa, Guam, the Commonwealth of the 
Northern Mariana Islands, Puerto Rico, and the United States 
Virgin Islands, under section 1905(b) of the Social Security 
Act (42 U.S.C. 1396d(b)) shall be increased by 1 percentage 
point.
(2) Requirements.--
(A) In general.--A State described in paragraph (1) 
may not receive the increase described in such 
paragraph in the Federal medical assistance percentage 
for such State, with respect to a quarter, if such 
State does not ensure culturally competent and 
effective messages for vaccination outreach to child 
populations, which may include the dissemination of 
information highlighting--
(i) advancements in research and vaccine 
development that have saved millions of 
individuals from death and disability from now-
preventable diseases;
(ii) information on how individuals across 
the lifespan benefit from immunizations, 
including those who cannot be vaccinated and 
rely on community immunity;
(iii) information on the dangers of not 
being vaccinated, including the potential for 
infectious disease outbreaks within 
communities; and
(iv) information on vaccine safety and the 
systems in place to monitor vaccine safety.
(B) Requirement for certain states.--Section 
1905(cc) of the Social Security Act (42 U.S.C. 
1396d(cc)) is amended--
(i) by inserting ``and section 2(d) of the 
Strengthening the Vaccines for Children Program 
Act of 2026'' before ``, except that in 
applying''; and
(ii) by inserting ``, and in applying such 
treatments to the increases in the Federal 
medical assistance percentage under section 
2(e) of the Strengthening the Vaccines for 
Children Program Act of 2026, the reference to 
`December 31, 2009' shall be deemed to be a 
reference to `December 31, 2025''' before the 
period at the end.
(e) Tribal Epidemiology Center Data Access.--With respect to data 
access for tribal epidemiology centers established under section 214 of 
the Indian Health Care Improvement Act (25 U.S.C. 1621m), the Director 
of the Centers for Disease control and Prevention may create a data 
sharing strategy that ensures such centers have access to data, data 
sets, monitoring systems, delivery systems, and other protected health 
information with respect to health care and public health surveillance 
systems of child and adolescent health necessary to accomplish such 
centers' public health authority responsibilities described in such 
section or section 164.501 of title 45, Code of Federal Regulations.
(f) Reports.--
(1) In general.--For each of fiscal years 2027 and 2028, 
the Director of the Centers for Disease Control and Prevention, 
in coordination with each State that has established a 
pediatric vaccine distribution program under section 1928 of 
the Social Security Act (42 U.S.C. 1396s), shall publish on the 
public internet website of the Centers for Disease Control and 
Prevention, in such manner as determined appropriate by the 
Director, information on vaccination rates under each such 
program during such year, including such rates disaggregated by 
region, age, sex, race, ethnicity, and other demographic 
factors determined appropriate by the Director.
(2) Effects on vaccination rates and program 
participation.--Not later than 2 years after the date of the 
enactment of this Act, the Comptroller General of the United 
States shall submit to Congress a report containing an analysis 
of the effects of the provisions of, and the amendments made 
by, this Act on--
(A) vaccination rates under the pediatric vaccine 
distribution program under section 1928 of the Social 
Security Act (42 U.S.C. 1396s); and
(B) provider participation in such program.
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