I 
111TH CONGRESS 
1ST SESSION 
H. R. 323 
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 
JANUARY 8, 2009 
Mr. GENE GREEN of Texas introduced the following bill; which was referred 
to the Committee on Energy and Commerce, and in addition to the Com-
mittee on Education and Labor, for a period to be subsequently deter-
mined 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 com-
prehensive coverage for childhood immunization. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Comprehensive Insur-
ance Coverage of Childhood Immunization Act of 2009’’. 
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SEC. 2. COMPREHENSIVE COVERAGE FOR CHILDHOOD IM-
MUNIZATION BY GROUP HEALTH PLANS AND 
HEALTH INSURANCE ISSUERS. 
(a) GROUP HEALTH PLANS.— 
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENTS.—Subpart 2 of part A of title XXVII of the 
Public Health Service Act is amended by adding at 
the end the following new section: 
‘‘SEC. 2708. STANDARD RELATING TO COVERAGE OF CHILD-
HOOD IMMUNIZATION. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage, shall provide for each plan year comprehensive 
coverage for routine immunizations for each individual 
who is a dependent of a participant or beneficiary under 
the plan and is under 19 years of age. 
‘‘(b) COMPREHENSIVE COVERAGE.—For purposes of 
this section, comprehensive coverage for routine immuni-
zations for a plan year consists of coverage, without 
deductibles, coinsurance, or other cost-sharing, for immu-
nizations (including the vaccine itself) in accordance with 
the most recent version of the Recommended Childhood 
Immunization Schedule issued prior to such plan year by 
the Advisory Committee on Immunization Practices of the 
Centers for Disease Control and Prevention.’’. 
(2) ERISA AMENDMENTS.— 
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(A) IN GENERAL.—Subpart B of part 7 of 
subtitle B of title I of the Employee Retirement 
Income Security Act of 1974 is amended by 
adding at the end the following new section: 
‘‘SEC. 715. STANDARD RELATING TO COVERAGE OF CHILD-
HOOD IMMUNIZATION. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage, shall provide for each plan year comprehensive 
coverage for routine immunizations for each individual 
who is a dependent of a participant or beneficiary under 
the plan and is under 19 years of age. 
‘‘(b) COMPREHENSIVE COVERAGE.—For purposes of 
this section, comprehensive coverage for routine immuni-
zations for a plan year consists of coverage, without 
deductibles, coinsurance, or other cost-sharing, for immu-
nizations (including the vaccine itself) in accordance with 
the most recent version of the Recommended Childhood 
Immunization Schedule issued prior to such plan year by 
the Advisory Committee on Immunization Practices of the 
Centers for Disease Control and Prevention.’’. 
(B) CLERICAL AMENDMENT.—The table of 
contents in section 1 of such Act is amended by 
inserting after the item relating to section 714 
the following new item: 
‘‘715. Standard relating to coverage of childhood immunization.’’. 
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(b) INDIVIDUAL HEALTH INSURANCE.—Part B of 
title XXVII of the Public Health Service Act is amended 
by inserting after section 2753 the following new section: 
‘‘SEC. 2754. STANDARD RELATING TO COVERAGE OF CHILD-
HOOD IMMUNIZATION. 
‘‘The provisions of section 2708 shall apply to health 
insurance coverage offered by a health insurance issuer 
in the individual market in the same manner as they apply 
to health insurance coverage offered by a health insurance 
issuer in connection with a group health plan in the small 
or large group market.’’. 
SEC. 3. COORDINATION OF ADMINISTRATION. 
The Secretary of Health and Human Services and the 
Secretary of Labor shall ensure, through the execution of 
an interagency memorandum of understanding among 
such Secretaries, that— 
(1) regulations, rulings, and interpretations 
issued by such Secretaries relating to the same mat-
ter over which both such Secretaries have responsi-
bility under the provisions of this Act (and the 
amendments made thereby) are administered so as 
to have the same effect at all times; and 
(2) coordination of policies relating to enforcing 
the same requirements through such Secretaries in 
order to have a coordinated enforcement strategy 
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