II

107TH CONGRESS

1ST SESSION S. 1297

To require comprehensive health insurance coverage for childhood

immunization.

IN THE SENATE OF THE UNITED STATES

AUGUST 1, 2001

Mr. DURBIN (for himself and Mr. REED) introduced the following bill; which

was read twice and referred to the Committee on Health, Education,

Labor, and Pensions

A BILL

To require comprehensive health insurance 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,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Comprehensive Insur5 ance Coverage of Childhood Immunization Act of 2001’’.

6 SEC. 2. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN7 COME SECURITY ACT OF 1974.

8 (a) IN GENERAL.—Subpart B of part 7 of subtitle

9 B of title I of the Employee Retirement Income Security
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1 Act of 1974 (29 U.S.C. 1185 et seq.) is amended by add2 ing at the end the following:

3 ‘‘SEC. 714. STANDARD RELATING TO COVERAGE OF CHILD4 HOOD IMMUNIZATION.

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

6 health insurance issuer offering health insurance coverage

7 in connection with a group health plan, shall provide for

8 each plan year comprehensive coverage for routine immu9 nizations for each individual who is a dependent of a par10 ticipant or beneficiary under the plan and is under 19

11 years of age.

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

13 this section, comprehensive coverage for routine immuni14 zations for a plan year consists of coverage, without

15 deductibles, coinsurance, or other cost-sharing, for immu16 nizations (including the vaccine itself) in accordance with

17 the most recent version of the Recommended Childhood

18 Immunization Schedule issued prior to such plan year by

19 the Advisory Committee on Immunization Practices of the

20 Centers for Disease Control and Prevention.’’.

21 (b) CONFORMING AMENDMENT.—The table of con22 tents in section 1 of such Act is amended by inserting

23 after the item relating to section 713 the following new

24 item:

‘‘Sec. 714. Standard relating to coverage of childhood immunization.’’.
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1 SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE

2 ACT.

3 (a) GROUP MARKET.—Subpart 2 of part A of title

4 XXVII of the Public Health Service Act (42 U.S.C.

5 300gg–4 et seq.) is amended by adding at the end the

6 following new section:

7 ‘‘SEC. 2707. STANDARD RELATING TO COVERAGE OF CHILD8 HOOD IMMUNIZATION.

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

10 health insurance issuer offering health insurance coverage

11 in connection with a group health plan, shall provide for

12 each plan year comprehensive coverage for routine immu13 nizations for each individual who is a dependent of a par14 ticipant or beneficiary under the plan and is under 19

15 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.’’.

25 (b) INDIVIDUAL MARKET.—The first subpart 3 of

26 part B of title XXVII of the Public Health Service Act
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1 (42 U.S.C. 300gg–51 et seq.) (relating to other require2 ments) (42 U.S.C. 300gg–51 et seq.) is amended—

3 (1) by redesignating such subpart as subpart 2;

4 and

5 (2) by adding at the end the following:

6 ‘‘SEC. 2753. STANDARD RELATING TO COVERAGE OF CHILD7 HOOD IMMUNIZATION.

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

9 insurance coverage offered by a health insurance issuer

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

11 to health insurance coverage offered by a health insurance

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

13 or large group market.’’.

14 SEC. 4. AMENDMENTS TO THE INTERNAL REVENUE CODE

15 OF 1986.

16 Subchapter B of chapter 100 of the Internal Revenue

17 Code of 1986 is further amended—

18 (1) in the table of sections, by inserting after

19 the item relating to section 9812 the following new

20 item:

‘‘Sec. 9813. Standard relating to coverage of childhood immunization.’’;

21 and

22 (2) by inserting after section 9812 the fol23 lowing:
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1 ‘‘SEC. 9813. STANDARD RELATING TO COVERAGE OF CHILD2 HOOD IMMUNIZATION.

3 ‘‘(a) IN GENERAL.—A group health plan shall pro4 vide for each plan year comprehensive coverage for routine

5 immunizations for each individual who is a dependent of

6 a participant or beneficiary under the plan and is under

7 19 years of age.

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

9 this section, comprehensive coverage for routine immuni10 zations for a plan year consists of coverage, without

11 deductibles, coinsurance, or other cost-sharing, for immu12 nizations (including the vaccine itself) in accordance with

13 the most recent version of the Recommended Childhood

14 Immunization Schedule issued prior to such plan year by

15 the Advisory Committee on Immunization Practices of the

16 Centers for Disease Control and Prevention.’’.

17 SEC. 5. EFFECTIVE DATES.

18 (a) GROUP HEALTH INSURANCE COVERAGE.—Sub19 ject to subsection (c), the amendments made by sections

20 2, 3(a), and 4 apply with respect to group health plans

21 for plan years beginning on or after January 1, 2002.

22 (b) INDIVIDUAL HEALTH INSURANCE COVERAGE.—

23 The amendment made by section 3(b) applies with respect

24 to health insurance coverage offered, sold, issued, re25 newed, in effect, or operated in the individual market on

26 or after such date.
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1 (c) COLLECTIVE BARGAINING EXCEPTION.—In the

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

3 more collective bargaining agreements between employee

4 representatives and 1 or more employers ratified before

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

6 sections 2, 3(a), and 4 shall not apply to plan years begin7 ning before the later of—

8 (1) the earliest date as of which all such collec9 tive bargaining agreements relating to the plan have

10 terminated (determined without regard to any exten11 sion thereof agreed to after the date of the enact12 ment of this Act), or

13 (2) January 1, 2002.

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

15 pursuant to a collective bargaining agreement relating to

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

17 requirement added by sections 2, 3(a), and 4 shall not be

18 treated as a termination of such collective bargaining

19 agreement.

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