II 

114TH CONGRESS 

1ST SESSION S. 1921 

To amend title XIX of the Social Security Act to encourage States to 

adopt administrative procedures with respect to nonmedical exemptions 

for State immunization requirements. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 4, 2015 

Mr. MURPHY introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to encourage 

States to adopt administrative procedures with respect 

to nonmedical exemptions for State immunization requirements. 

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 ‘‘Vaccinate America’s 

5 Children through Complete Information & Education Act 

6 of 2015’’. 


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1 SEC. 2. ENCOURAGING STATES TO STRENGTHEN ADMINIS2 TRATIVE PROCEDURES RELATED TO NON3 MEDICAL EXEMPTIONS FROM STATE VAC4 CINATION REQUIREMENTS. 

5 (a) IN GENERAL.—Section 1928 of the Social Secu6 rity Act (42 U.S.C. 1396s) is amended— 

7 (1) by redesignating subsection (h) as sub8 section (i); and 

9 (2) by inserting after subsection (g) the fol10 lowing new subsection: 

11 ‘‘(h) ADMINISTRATIVE PROCEDURES FOR GRANTING

12 NONMEDICAL EXEMPTIONS.— 

13 ‘‘(1) CERTIFICATION OF ADOPTION OF PROCE14 DURES.— 

15 ‘‘(A) IN GENERAL.—A State program 

16 under this section does not comply with the re17 quirements of this section unless the State cer18 tifies to the Secretary that the State has estab19 lished administrative procedures for granting 

20 nonmedical exemptions from State immuniza21 tion requirements (as defined in subparagraph 

22 (B)) that include at least 2 of the prerequisites 

23 described in paragraph (2). 

24 ‘‘(B) NONMEDICAL EXEMPTION FROM

25 STATE IMMUNIZATION REQUIREMENT.—For 

26 purposes of this subsection, the term ‘nonmedVerDate Sep 11 2014 06:09 Aug 05, 2015 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1921.IS S1921

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1 ical exemption from State immunization re2 quirements’ means any exemption from a State 

3 law that requires a child to receive a pediatric 

4 vaccine (including school immunization require5 ments) that is not based on a medical reason. 

6 ‘‘(2) NONMEDICAL EXEMPTION PRE7 REQUISITES.—The prerequisites for granting a non8 medical exemption from State immunization require9 ments described in this paragraph are the following: 

10 ‘‘(A) The State requires that prior to the 

11 exemption being granted, a parent or guardian 

12 seeking a nonmedical exemption from State im13 munization requirements for a child shall dis14 cuss the consequences of nonvaccination with 

15 the child’s pediatrician or other primary care 

16 provider and that the discussion is noted in the 

17 child’s medical record. 

18 ‘‘(B) The State requires that prior to the 

19 exemption being granted, a parent or guardian 

20 seeking a nonmedical exemption from State im21 munization requirements for a child read and 

22 sign a form that discusses the risks of nonvac23 cination and submits the form to the State. 

24 ‘‘(C) The State requires that prior to the 

25 exemption being granted, a parent or guardian 


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1 seeking a nonmedical exemption from State im2 munization requirements for a child submits to 

3 the State a notarized letter describing the par4 ent’s or guardian’s reasons for seeking the ex5 emption. 

6 ‘‘(D) The State requires that all nonmed7 ical exemptions from State immunization re8 quirements shall only be granted for a 1-year 

9 period and shall be required to be renewed an10 nually if a parent or guardian of a child wants 

11 the exemption to continue for another year. 

12 ‘‘(3) PENALTY.— 

13 ‘‘(A) IN GENERAL.—With respect to a fis14 cal year, if a State fails to submit the certifi15 cation required under paragraph (1) or if the 

16 administrative procedures established by the 

17 State for granting nonmedical exemptions from 

18 State immunization requirements do not include 

19 at least 2 of the prerequisites described in para20 graph (2), the State shall pay the Secretary an 

21 amount equal to— 

22 ‘‘(i) in the case of a State that is not 

23 a manufacturer of pediatric vaccines, 5 

24 percent of the value (as determined by the 

25 Secretary) of the vaccines provided to the 


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1 State under subsection (b)(2)(A) for that 

2 fiscal year; and 

3 ‘‘(ii) in the case of a State that is a 

4 manufacturer of pediatric vaccines, 5 per5 cent of the sum of— 

6 ‘‘(I) the value (as determined by 

7 the Secretary) of any vaccines pro8 vided to the State under subsection 

9 (b)(2)(A) for that fiscal year; and 

10 ‘‘(II) the amount paid to the 

11 State for the fiscal year under sub12 section (b)(2)(C). 

13 ‘‘(B) TREATMENT AS AN OVERPAYMENT.— 

14 A State payment required to be made to the 

15 Secretary under subparagraph (A) shall be 

16 deemed an overpayment to the State under this 

17 title to be disallowed against the State’s regular 

18 quarterly draw for all spending under section 

19 1903(d)(2). Such a disallowance is not subject 

20 to a reconsideration under section 1116(e).’’. 

21 (b) CONFORMING AMENDMENTS.— 

22 (1) Section 1928 of the Social Security Act (42 

23 U.S.C. 1396s), as amended by subsection (a), is fur24 ther amended— 


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1 (A) in subsection (a)(1)(A), by striking 

2 ‘‘subsection (h)(8)’’ and inserting ‘‘subsection 

3 (i)(8)’’; and 

4 (B) in subsection (b)(2)(A)(iv), by striking 

5 ‘‘subsection (h)(3)’’ and inserting ‘‘subsection 

6 (i)(3)’’. 

7 (2) Section 609(d) of the Employee Retirement 

8 Income Security Act of 1974 (42 U.S.C. 1169(d)) is 

9 amended by striking ‘‘section 1928(h)(6)’’ and in10 serting ‘‘section 1928(i)(6)’’. 

11 (c) EFFECTIVE DATE.—The amendments made by 

12 this Act shall take effect on the date that is 1 year after 

13 the date of the enactment of this Act. 

Æ 


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