Ensuring Vaccination and Treatment Affordability Act

To amend titles XIX and XXI of the Social Security Act to require coverage under the Medicaid program and Children’s Health Insurance Program for vaccines and treatment for COVID–19 without the imposition of cost sharing requirements, and for other purposes. 1. Short title This Act may be cited as the Ensuring Vaccination and Treatment Affordability Act 2. Coverage at no cost sharing of COVID–19 vaccine and treatment (a) Medicaid (1) In general Section 1905(a)(4) of the Social Security Act ( 42 U.S.C. 1396d(a)(4) (A) by striking and (D) (D) (B) by striking the semicolon at the end and inserting ; (E) a COVID–19 vaccine licensed under section 351 of the Public Health Service Act and the administration of such vaccine; and (F) items and services furnished for the treatment of COVID–19 or a condition that may complicate the treatment of COVID–19; (2) Prohibition of cost sharing (A) In general Subsections (a)(2) and (b)(2) of section 1916 of the Social Security Act ( 42 U.S.C. 1396o (i) in subparagraph (F), by striking or (ii) in subparagraph (G), by striking ; and , or (iii) by adding at the end the following subparagraphs: (H) a COVID–19 vaccine licensed under section 351 of the Public Health Service Act and the administration of such vaccine, or (I) any item or service furnished for the treatment of COVID–19 or a condition that may complicate the treatment of COVID–19; and . (B) Application to alternative cost sharing Section 1916A(b)(3)(B) of the Social Security Act ( 42 U.S.C. 1396o–1(b)(3)(B) (i) in clause (xi), by striking any visit any service (ii) by adding at the end the following clauses: (xii) A COVID–19 vaccine licensed under section 351 of the Public Health Service Act and the administration of such vaccine. (xiii) An item or service furnished for the treatment of COVID–19 or a condition that may complicate the treatment of COVID–19. . (C) Clarification The amendments made in this subsection shall apply with respect to a State plan of a territory in the same manner as a State plan of one of the 50 States. (b) State pediatric vaccine distribution program Section 1928 of the Social Security Act ( 42 U.S.C. 1396s (1) in subsection (a)(1)— (A) in subparagraph (A), by striking ; and (B) in subparagraph (B), by striking the period and inserting ; and (C) by adding at the end the following subparagraph: (C) each vaccine-eligible child (as defined in subsection (b)) is entitled to receive a COVID–19 vaccine from a program-registered provider (as defined in subsection (h)(8)) without charge for— (i) the cost of such vaccine; or (ii) the administration of such vaccine. ; (2) in subsection (c)(2)— (A) in subparagraph (C)(ii), by inserting , but may not impose a fee for the administration of a COVID–19 vaccine (B) by adding at the end the following subparagraph: (D) The provider will provide and administer an approved COVID–19 vaccine to a vaccine-eligible child in accordance with the same requirements as apply under the preceding subparagraphs to the provision and administration of a qualified pediatric vaccine to such a child. ; and (3) in subsection (d)(1), in the first sentence, by inserting , including with respect to a COVID–19 vaccine licensed under section 351 of the Public Health Service Act (c) CHIP (1) In general Section 2103(c) of the Social Security Act ( 42 U.S.C. 1397cc(c) (11) Coverage of COVID–19 vaccines and treatment The child health assistance provided to a targeted low-income child shall include coverage of— (A) any COVID–19 vaccine licensed under section 351 of the Public Health Service Act and the administration of such vaccine; and (B) any item or service furnished for the treatment of COVID–19 or a condition that may complicate the treatment of COVID–19. . (2) Prohibition of cost sharing Section 2103(e)(2) of the Social Security Act ( 42 U.S.C. 1397cc(e)(2) (A) in the paragraph header, by inserting a COVID–19 vaccine, COVID–19 treatment, or pregnancy-related assistance (B) by striking visits described in section 1916(a)(2)(G), or services described in section 1916(a)(2)(G), vaccines described in section 1916(a)(2)(H), items or services described in section 1916(a)(2)(I), or (d) Conforming amendments Section 1937 of the Social Security Act ( 42 U.S.C. 1396u–7 (1) in subsection (a)(1)(B), by inserting , under subclause (XXIII) of section 1902(a)(10)(A)(ii), section 1902(a)(10)(A)(i) (2) in subsection (b)(5), by adding before the period the following: , and, effective on the date of the enactment of the Ensuring Vaccination and Treatment Affordability Act, must comply with subparagraphs (F) through (I) of subsections (a)(2) and (b)(2) of sections 1916 and 1916A (e) Effective date The amendments made by this section shall take effect on the date of enactment of this Act and shall apply with respect to a COVID–19 vaccine beginning on the date that such vaccine is licensed under section 351 of the Public Health Service Act ( 42 U.S.C. 262

Summary: Ensuring Vaccination and Treatment Affordability Act This bill requires COVID-19 (i.e., coronavirus disease 2019) vaccines and treatment, as well as treatment for conditions that may complicate COVID-19 treatment, to be covered without cost-sharing under the Children's Health Insurance Program (CHIP) and Medicaid. Additionally, the bill includes vaccines for COVID-19 in the Vaccines for Children (VFC) Program. The VFC Program provides free vaccinations to individuals 18 years of age or younger who are uninsured or underinsured (i.e., with limited or no insurance for vaccines), are eligible for Medicaid, or are American Indians or Alaskan Natives.