,,ii  #aadth ,,congress  #ast ,session  
,s4 #aiba  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,august #d1    
#bjae ,mr4 ,murphy introduced the       
following bill2 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      
requirements4  #a4 ,short title  ,this  
,act may be cited as the ,vaccinate     
,america's ,children through ,complete  
,information  ,education ,act of #bjae4 
#b4 ,encouraging ,states to strengthen  
administrative procedures related to    
nonmedical exemptions from ,state       
vaccination requirements  7a7 ,in       
general ,section #aibh of the ,social   
,security ,act 7#db ,u4,s4,c4 #acifs7 is
 amended-- 7#a7 by redesignating        
subsection 7h7 as subsection 7i72 and   
7#b7 by inserting after subsection 7g7  
the following new subsection3  7h7      

,administrative procedures for granting 
nonmedical exemptions  7#a7             
,certification of adoption of procedures
  7,a7 ,in general ,a ,state program    
under this section does not comply with 
the requirements of this section unless 
the ,state certifies to the ,secretary  
that the ,state has established         
administrative procedures for granting  
nonmedical exemptions from ,state       
immunization requirements 7as defined in
 subparagraph 7,b77 that include at     
least #b of the prerequisites described 
in paragraph 7#b74  7,b7 ,nonmedical    
exemption from ,state immunization      
requirement ,for purposes of this       
subsection1 the term nonmedical         
exemption from ,state immunization      
requirements means any exemption from a 
,state law that requires a child to     
receive a pediatric vaccine 7including  
school immunization requirements7 that  
is not based on a medical reason4  7#b7 
,nonmedical exemption prerequisites ,the
 prerequisites for granting a nonmedical

 exemption from ,state immunization     
requirements described in this paragraph
 are the following3  7,a7 ,the ,state   
requires that prior to the exemption    
being granted1 a parent or guardian     
seeking a nonmedical exemption from     
,state immunization requirements for a  
child shall discuss the consequences of 
nonvaccination with the child's         
pediatrician or other primary care      
provider and that the discussion is     
noted in the child's medical record4    
7,b7 ,the ,state requires that prior to 
the exemption being granted1 a parent or
 guardian seeking a nonmedical exemption
 from ,state immunization requirements  
for a child read and sign a form that   
discusses the risks of nonvaccination   
and submits the form to the ,state4     
7,c7 ,the ,state requires that prior to 
the exemption being granted1 a parent or
 guardian seeking a nonmedical exemption
 from ,state immunization requirements  
for a child submits to the ,state a     
notarized letter describing the parent's

 or guardian's reasons for seeking the  
exemption4  7,d7 ,the ,state requires   
that all nonmedical exemptions from     
,state immunization requirements shall  
only be granted for a #a-year period and
 shall be required to be renewed        
annually if a parent or guardian of a   
child wants the exemption to continue   
for another year4  7#c7 ,penalty  7,a7  
,in general ,with respect to a fiscal   
year1 if a ,state fails to submit the   
certification required under paragraph  
7#a7 or if the administrative procedures
 established by the ,state for granting 
nonmedical exemptions from ,state       
immunization requirements do not include
 at least #b of the prerequisites       
described in paragraph 7#b71 the ,state 
shall pay the ,secretary an amount equal
 to--  7i7 in the case of a ,state that 
is not a manufacturer of pediatric      
vaccines1 #e percent of the value 7as   
determined by the ,secretary7 of the    
vaccines provided to the ,state under   
subsection 7b77#b77;,a7 for that fiscal 

year2 and  7ii7 in the case of a ,state 
that is a manufacturer of pediatric     
vaccines1 #e percent of the sum of--    
7,i7 the value 7as determined by the    
,secretary7 of any vaccines provided to 
the ,state under subsection 7b77#b77;,a7
 for that fiscal year2 and  7,,ii7 the  
amount paid to the ,state for the fiscal
 year under subsection 7b77#b77;,c74    
7,b7 ,treatment as an overpayment ,a    
,state payment required to be made to   
the ,secretary under subparagraph 7,a7  
shall be deemed an overpayment to the   
,state under this title to be disallowed
 against the ,state's regular quarterly 
draw for all spending under section     
#aijc7;d77#b74 ,such a disallowance is  
not subject to a reconsideration under  
section #aaaf7;e74  4  7b7 ,conforming  
amendments  7#a7 ,section #aibh of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acifs71 as amended by subsection 7a71  
is further amended--  7,a7 in subsection
 7a77#a77;,a71 by striking subsection   
7h77#h7 and inserting subsection        

7i77#h72 and  7,b7 in subsection        
7b77#b77;,a77iv71 by striking subsection
 7h77#c7 and inserting subsection       
7i77#c74  7#b7 ,section #fji7;d7 of the 
,employee ,retirement ,income ,security 
,act of #aigd 7#db ,u4,s4,c4 #aafi7;d77 
is amended by striking section          
#aibh7;h77#f7 and inserting section     
#aibh7;i77#f74  7c7 ,effective date ,the
 amendments made by this ,act shall take
 effect on the date that is #a year     
after the date of the enactment of this 
,act4