I 

108TH CONGRESS 

1ST SESSION H. R. 2095

To amend title XXVII of the Public Health Service Act and title I of 

the Employee Retirement Income Security Act of 1974 to require that 

group and individual health insurance coverage and group health plans 

provide comprehensive coverage for childhood immunization. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 14, 2003

Mr. GREEN of Texas (for himself, Mr. QUINN, Mr. PALLONE, Mr. BERMAN, 

Mr. MCDERMOTT, Mr. SANDLIN, Mr. EVANS, Mr. BROWN of Ohio, Mr. 

WAXMAN, Mr. GEORGE MILLER of California, Mr. GUTIERREZ, Mr. 

FROST, Mr. GORDON, and Mr. BELL) introduced the following bill; which 

was referred to the Committee on Energy and Commerce, and in addition 

to the Committee on Education and the Workforce, for a period to be 

subsequently determined by the Speaker, in each case for consideration 

of such provisions as fall within the jurisdiction of the committee concerned 

A BILL

To amend title XXVII of the Public Health Service Act 

and title I of the Employee Retirement Income Security 

Act of 1974 to require that group and individual health 

insurance coverage and group health plans provide comprehensive coverage for childhood immunization.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Comprehensive Insur3 ance Coverage of Childhood Immunization Act of 2003’’. 

4 SEC. 2. COMPREHENSIVE COVERAGE FOR CHILDHOOD IM5 MUNIZATION BY GROUP HEALTH PLANS AND 

6 HEALTH INSURANCE ISSUERS. 

7 (a) GROUP HEALTH PLANS.—

8 (1) PUBLIC HEALTH SERVICE ACT AMEND9 MENTS.—Subpart 2 of part A of title XXVII of the 

10 Public Health Service Act is amended by adding at 

11 the end the following new section: 

12 ‘‘SEC. 2707. STANDARD RELATING TO COVERAGE OF CHILD13 HOOD IMMUNIZATION. 

14 ‘‘(a) IN GENERAL.—A group health plan, and a 

15 health insurance issuer offering group health insurance 

16 coverage, shall provide for each plan year comprehensive 

17 coverage for routine immunizations for each individual 

18 who is a dependent of a participant or beneficiary under 

19 the plan and is under 19 years of age. 

20 ‘‘(b) COMPREHENSIVE COVERAGE.—For purposes of 

21 this section, comprehensive coverage for routine immuni22 zations for a plan year consists of coverage, without 

23 deductibles, coinsurance, or other cost-sharing, for immu24 nizations (including the vaccine itself) in accordance with 

25 the most recent version of the Recommended Childhood 

26 Immunization Schedule issued prior to such plan year by 
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1 the Advisory Committee on Immunization Practices of the 

2 Centers for Disease Control and Prevention.’’. 

3 (2) ERISA AMENDMENTS.—

4 (A) IN GENERAL.—Subpart B of part 7 of 

5 subtitle B of title I of the Employee Retirement 

6 Income Security Act of 1974 is amended by 

7 adding at the end the following new section: 

8 ‘‘SEC. 714. STANDARD RELATING TO COVERAGE OF CHILD9 HOOD IMMUNIZATION. 

10 ‘‘(a) IN GENERAL.—A group health plan, and a 

11 health insurance issuer offering group health insurance 

12 coverage, shall provide for each plan year comprehensive 

13 coverage for routine immunizations for each individual 

14 who is a dependent of a participant or beneficiary under 

15 the plan and is under 19 years of age. 

16 ‘‘(b) COMPREHENSIVE COVERAGE.—For purposes of 

17 this section, comprehensive coverage for routine immuni18 zations for a plan year consists of coverage, without 

19 deductibles, coinsurance, or other cost-sharing, for immu20 nizations (including the vaccine itself) in accordance with 

21 the most recent version of the Recommended Childhood 

22 Immunization Schedule issued prior to such plan year by 

23 the Advisory Committee on Immunization Practices of the 

24 Centers for Disease Control and Prevention.’’. 
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1 (B) CLERICAL AMENDMENT.—The table of 

2 contents in section 1 of such Act is amended by 

3 inserting after the item relating to section 713 

4 the following new item:

‘‘Sec. 714. Standard relating to coverage of childhood immunization.’’.

5 (b) INDIVIDUAL HEALTH INSURANCE.—Part B of 

6 title XXVII of the Public Health Service Act is amended 

7 by inserting after section 2752 the following new section: 

8 ‘‘SEC. 2753. STANDARD RELATING TO COVERAGE OF CHILD9 HOOD IMMUNIZATION. 

10 ‘‘The provisions of section 2707 shall apply to health 

11 insurance coverage offered by a health insurance issuer 

12 in the individual market in the same manner as they apply 

13 to health insurance coverage offered by a health insurance 

14 issuer in connection with a group health plan in the small 

15 or large group market.’’. 

16 SEC. 3. COORDINATION OF ADMINISTRATION. 

17 The Secretary of Health and Human Services and the 

18 Secretary of Labor shall ensure, through the execution of 

19 an interagency memorandum of understanding among 

20 such Secretaries, that—

21 (1) regulations, rulings, and interpretations 

22 issued by such Secretaries relating to the same mat23 ter over which both such Secretaries have responsi24 bility under the provisions of this Act (and the 
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1 amendments made thereby) are administered so as 

2 to have the same effect at all times; and 

3 (2) coordination of policies relating to enforcing 

4 the same requirements through such Secretaries in 

5 order to have a coordinated enforcement strategy 

6 that avoids duplication of enforcement efforts and 

7 assigns priorities in enforcement. 

8 SEC. 4. EFFECTIVE DATES. 

9 (a) GROUP HEALTH PLANS AND GROUP HEALTH IN10 SURANCE COVERAGE.—Subject to subsection (c), the 

11 amendments made by section 2(a) apply with respect to 

12 group health plans for plan years beginning on or after 

13 January 1, 2004. 

14 (b) INDIVIDUAL HEALTH INSURANCE COVERAGE.—

15 The amendment made by section 2(b) applies with respect 

16 to health insurance coverage offered, sold, issued, re17 newed, in effect, or operated in the individual market on 

18 or after such date. 

19 (c) COLLECTIVE BARGAINING EXCEPTION.—In the 

20 case of a group health plan maintained pursuant to 1 or 

21 more collective bargaining agreements between employee 

22 representatives and 1 or more employers ratified before 

23 the date of enactment of this Act, the amendments made 

24 by section 2(a) shall not apply to plan years beginning 

25 before the later of—
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1 (1) the earliest date as of which all such collec2 tive bargaining agreements relating to the plan have 

3 terminated (determined without regard to any exten4 sion thereof agreed to after the date of enactment of 

5 this Act), or 

6 (2) January 1, 2004. 

7 For purposes of paragraph (1), any plan amendment made 

8 pursuant to a collective bargaining agreement relating to 

9 the plan which amends the plan solely to conform to any 

10 requirement added by section 2(a) shall not be treated as 

11 a termination of such collective bargaining agreement.

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