,,ii  #aai? ,,congress  #a/ ,session    
,s4 #bheg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ah          
7legislative day1 ,septemb] #af71       
#bjbe,mr4 ,wyd5 7= himself & ,mr4 ,s&]s7
 introduc$ ! foll[+ bill2 :i* 0 read    
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to require cov]age ( c]ta9  
immunizations recomm5d$ by ! ,advisory  
,committee on ,immunization ,practices  
"u ! ,m$ic>e program1 ! ,m$icaid        
program1 ! ,*ildr5's ,heal? ,insurance  
,program1 gr\p heal? plans1 & heal?     
insurance cov]age4  #a4 ,%ort title ,?is
 ,act may be cit$ z ! ,protect+ ,free   
,vacc9es ,act ( #bjbe4  #b4 ,requir+    
cov]age ( c]ta9 immunizations recomm5d$ 
by ! ,advisory ,committee on            
,immunization ,practices  7a7 ,gr\p     
heal? plans & heal? insurance cov]age   
7#a7 ,,phsa  7,a7 ,9 g5]al ,"p ,d (     
title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa et    
seq47 is am5d$ by add+ at ! end ! foll[+

 new section3  #bgii;,a-#aa4 ,cov]age ( 
c]ta9 immunizations recomm5d$ by !      
,advisory ,committee on ,immunization   
,practices  7a7 ,9 g5]al ,) respect to  
plan ye>s occurr+ dur+ ! date ( !       
enactm5t ( ?is section1 or beg9n+ on or 
aft] ! date ( ! enactm5t ( ?is section &
 be=e ,janu>y #a1 #bjcj1 a gr\p heal?   
plan & a heal? insurance issu] (f]+ gr\p
 or individual heal? insurance cov]age  
%all provide cov]age = & %all n impose  
any co/ %>+ requirem5ts = immunizations 
t _h 9 effect a recomm5dation f !       
,advisory ,committee on ,immunization   
,practices ( ! ,c5t]s = ,disease        
,control & ,prev5tion ) respect to !    
individual involv$ z ( ,octob] #be1     
#bjbd1 includ+ su* an immunization      
involv+ a vacc9e z updat$ or *ang$ aft] 
su* date "u an approv$ supplem5tal      
application to a biological product     
lic5s$ "u section #cea on or be=e su*   
date4  7b7 ,special rule ,subsection 7a7
 %all n apply 9 ! case ( an immunization
 adm9i/]$ dur+ ! m9imum int]val e/abli%$

 "u section #bgac7;b7 ) respect to su*  
immunization4  4  7,b7 ,con=m+ am5dm5t  
,section #acjb7;e77#a77;,b77i7 ( !      
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4                     
#ahjbb7;e77#a77;,b77i77 is am5d$ by     
/rik+ section #bgac & ins]t+ sections   
#bgac & #bgii;,a-#aa ( ! ,public ,heal? 
,s]vice ,act4  7#b7 ,,erisa  7,a7 ,9    
g5]al ,subp>t ,b ( "p #g ( subtitle ,b (
 title ,i ( ! ,employee ,retirem5t      
,income ,security ,act ( #aigd 7#bi     
,u4,s4,c4 #aahe et seq47 is am5d$ by    
add+ at ! end ! foll[+ new section3     
#gbf4 ,cov]age ( c]ta9 immunizations    
recomm5d$ by ! ,advisory ,committee on  
,immunization ,practices  7a7 ,9 g5]al  
,) respect to plan ye>s occurr+ dur+ !  
date ( ! enactm5t ( ?is section1 or     
beg9n+ on or aft] ! date ( ! enactm5t ( 
?is section & be=e ,janu>y #a1 #bjcj1 a 
gr\p heal? plan & a heal? insurance     
issu] (f]+ gr\p heal? insurance cov]age 
%all provide cov]age = & %all n impose  
any co/ %>+ requirem5ts = immunizations 

t _h 9 effect a recomm5dation f !       
,advisory ,committee on ,immunization   
,practices ( ! ,c5t]s = ,disease        
,control & ,prev5tion ) respect to !    
individual involv$ z ( ,octob] #be1     
#bjbd1 includ+ su* an immunization      
involv+ a vacc9e z updat$ or *ang$ aft] 
su* date "u an approv$ supplem5tal      
application to a biological product     
lic5s$ "u section #cea ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bfb7
 on or be=e su* date4  7b7 ,special rule
 ,subsection 7a7 %all n apply 9 ! case (
 an immunization adm9i/]$ dur+ ! m9imum 
int]val e/abli%$ "u section #bgac7;b7 ( 
! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #cjj;gg-#ac7;b77 ) respect to 
su* immunization4  4  7,b7 ,cl]ical     
am5dm5t ,! table ( cont5ts 9 section #a 
( ! ,employee ,retirem5t ,income        
,security ,act ( #aigd 7#bi ,u4,s4,c4   
#ajja note7 is am5d$ by ins]t+ aft] !   
item relat+ to section #gbe ! foll[+ new
 item3  ,sec4 #gbf4 ,cov]age ( c]ta9    
immunizations recomm5d$ by ! ,advisory  

,committee on ,immunization ,practices4 
4  7#c7 ,,irc  7,a7 ,9 g5]al ,sub*apt]  
,b ( *apt] #ajj ( ! ,int]nal ,rev5ue    
,code ( #aihf is am5d$ by add+ at ! end 
! foll[+ new section3  #ihbf4 ,cov]age (
 c]ta9 immunizations recomm5d$ by !     
,advisory ,committee on ,immunization   
,practices  7a7 ,9 g5]al ,) respect to  
plan ye>s occurr+ dur+ ! date ( !       
enactm5t ( ?is section1 or beg9n+ on or 
aft] ! date ( ! enactm5t ( ?is section &
 be=e ,janu>y #a1 #bjcj1 a gr\p heal?   
plan %all provide cov]age = & %all n    
impose any co/ %>+ requirem5ts =        
immunizations t _h 9 effect a           
recomm5dation f ! ,advisory ,committee  
on ,immunization ,practices ( ! ,c5t]s =
 ,disease ,control & ,prev5tion )       
respect to ! individual involv$ z (     
,octob] #be1 #bjbd1 includ+ su* an      
immunization involv+ a vacc9e z updat$  
or *ang$ aft] su* date "u an approv$    
supplem5tal application to a biological 
product lic5s$ "u section #cea ( !      
,public ,heal? ,s]vice ,act 7#db        

,u4,s4,c4 #bfb7 on or be=e su* date4    
7b7 ,special rule ,subsection 7a7 %all n
 apply 9 ! case ( an immunization       
adm9i/]$ dur+ ! m9imum int]val e/abli%$ 
"u section #bgac7;b7 ( ! ,public ,heal? 
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;gg-#ac7;b77 ) respect to su*       
immunization4  4  7,b7 ,cl]ical am5dm5t 
,! table ( sections = sub*apt] ,b (     
*apt] #ajj ( ! ,int]nal ,rev5ue ,code ( 
#aihf is am5d$ by add+ at ! end ! foll[+
 new item3  ,sec4 #ihbf4 ,cov]age (     
c]ta9 immunizations recomm5d$ by !      
,advisory ,committee on ,immunization   
,practices4  4  7b7 ,m$ic>e ,section    
#ahfj;,d-#b7;b77#h77;,b7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7;b77#h77;,b77 is am5d$--    
7#a7 by /rik+ ) recomm5dations & ins]t+ 
)-- 7i7 recomm5dations  2  7#b7 by /rik+
 ! p]iod at ! end & ins]t+ 2 or2 &  7#c7
 by add+ at ! end ! foll[+ new clause3  
7ii7 = plan ye>s occurr+ dur+ ! date ( !
 enactm5t ( ?is clause1 or beg9n+ on or 
aft] ! date ( ! enactm5t ( ?is clause & 

be=e ,janu>y #a1 #bjcj1 9 ! case ( a    
vacc9e ) respect to :i* su* a           
recomm5dation is revok$ ) respect to !  
individual involv$ on or aft] ,octob]   
#be1 #bjbd1 includ+ su* a vacc9e z      
updat$ or *ang$ aft] su* date "u an     
approv$ supplem5tal application to a    
biological product lic5s$ "u section    
#cea ( ! ,public ,heal? ,s]vice ,act on 
or be=e su* date1 ! mo/ rec5t           
recomm5dation t 0 9 effect ) respect to 
su* vacc9e & su* individual prior to su*
 revocation4  4  7c7 ,m$icaid  7#a7 ,9  
g5]al ,section #aije ( ! ,social        
,security ,act 7#db ,u4,s4,c4 #acif;d7  
is am5d$-- 7,a7 9 subsection            
7a77#ac77;,b7-- 7i7 by /rik+ individual1
 approv$ & ins]t+ individual-- 7i7      
approv$  2 &  7ii7 by add+ at ! end !   
foll[+ new clause3  7ii7 = ! p]iod      
beg9n+ on ! date ( ! enactm5t ( ?is     
clause & end+ on ,decemb] #ca1 #bjbi1   
approv$ vacc9es1 & ! adm9i/ration ( su* 
vacc9es1 t 7 recomm5d$ by su* advisory  
committee ) respect to ! individual     

involv$ z ( ,octob] #be1 #bjbd1 includ+ 
su* a vacc9e z updat$ or *ang$ aft] su* 
date "u an approv$ supplem5tal          
application to a biological product     
lic5s$ "u section #cea ( ! ,public      
,heal? ,s]vice ,act on or be=e su* date2
 &  2 &  7,b7 9 subsection              
7r77#a77;,b77iii71 by-- 7i7 /rik+       
section #aibh7;c77#b77;,b77i7 & ins]t+  
clause 7i7 ( section #aibh7;c77#b77;,b72
 &  7ii7 ins]t+ 1 subject to !          
limitation describ$ 9 clause 7iii7 ( su*
 section aft] p$iatric vacc9es4  7#b7   
,cov]age = pregnant individuals ,section
 #aijb7;a77#aj7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #acif;a7a77#aj77 is 
am5d$ 9 ! matt] foll[+ subp>agraph 7,g7 
by ins]t+ m$ical assi/ance = vacc9es    
describ$ 9 section #aije7;a77#ac77;,b7 &
 ! adm9i/ration ( su* vacc9es1 aft]     
complicate pregnancy14  7#c7 ,program = 
di/ribution ( p$iatric vacc9es ,section 
#aibh ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acifs7 is am5d$-- 7,a7 9     
subsection 7c77#b77;,b7-- 7i7 9 clause  

7i71 by /rik+ clause 7ii7 & ins]t+      
clauses 7ii7 & 7iii72 &  7ii7 by add+ at
 ! end ! foll[+ new clause3  7iii7 ,= ! 
p]iod beg9n+ on ! date ( ! enactm5t (   
?is clause & end+ on ,decemb] #ca1      
#bjbi1 ! provid] w n take into acc\nt   
any *ange 9 ! s*$ule describ$ 9 clause  
7i7 t removes ! recomm5dation to adm9i/]
 a p$iatric vacc9e ) respect to !       
vacc9e-eligible *ild involv$ if su*     
p$iatric vacc9e 0 recomm5d$ ) respect to
 su* *ild "u su* s*$ule z ( ,octob] #be1
 #bjbd1 includ+ ) respect to su*        
p$iatric vacc9e z updat$ or *ang$ aft]  
su* date "u an approv$ supplem5tal      
application to a biological product     
lic5s$ "u section #cea ( ! ,public      
,heal? ,s]vice ,act on or be=e su* date4
  2 &  7,b7 9 subsection 7e71 by ins]t+ 
,= purposes ( ! prec$+ s5t5ce1 dur+ !   
p]iod beg9n+ on ! date ( ! enactm5t (   
?is s5t5ce & end+ on ,decemb] #ca1      
#bjbi1 ! ,secret>y may n take into      
acc\nt any revision ( su* li/ t occurs  
on or aft] ,octob] #be1 #bjbd1 t removes

 a p$iatric vacc9e f su* li/ if su*     
vacc9e 0 includ$ 9 su* li/ z ( su* date1
 includ+ ) respect to su* vacc9e z      
updat$ or *ang$ aft] su* date "u an     
approv$ supplem5tal application to a    
biological product lic5s$ "u section    
#cea ( ! ,public ,heal? ,s]vice ,act on 
or be=e su* date4 aft] ! p]iod at ! end4
  7#d7 ,/ate flexibility 9 b5efit       
packages ,section #aicg7;b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acifu-#g7;b77 is am5d$ by add+ at ! end
 ! foll[+ new p>agraph3  7#i7 ,cov]age (
 adult vacc9es ,not)/&+ ! previ\s       
provisions ( ?is section1 a ,/ate may n 
provide = m$ical assi/ance ?r\gh        
enrollm5t ( an individual ) b5*m>k      
cov]age or b5*m>k-equival5t cov]age "u  
?is section unless su* cov]age includes 
7& does n impose any d$uction1 co/ %>+1 
or simil> *>ge =7 ! m$ical assi/ance    
describ$ 9 section #aije7;a77#ac77;,b74 
4  7d7 ,,*ip ,section #bajc ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #acig;cc7 
is am5d$-- 7#a7 9 subsection 7c71 by    

add+ at ! end ! foll[+ new p>agraph3    
7#ac7 ,requir$ cov]age ( c]ta9 vacc9es  
recomm5d$ by ! ,advisory ,committee on  
,immunization ,practices ,reg>dless ( ! 
type ( cov]age elect$ by a ,/ate "u     
subsection 7a71 ! *ild heal? assi/ance  
provid$ = a t>get$ l[-income *ild %all  
include cov]age1 dur+ ! p]iod beg9n+ on 
! date ( ! enactm5t ( ?is p>agraph &    
end+ on ,decemb] #ca1 #bjbi1 ( vacc9es1 
& ! adm9i/ration ( su* vacc9es1 t _h 9  
effect a recomm5dation f ! ,advisory    
,committee on ,immunization ,practices (
 ! ,c5t]s = ,disease ,control &         
,prev5tion ) respect to ! *ild involv$ z
 ( ,octob] #be1 #bjbd1 includ+ su* a    
vacc9e z updat$ or *ang$ aft] su* date  
"u an approv$ supplem5tal application to
 a biological product lic5s$ "u section 
#cea ( ! ,public ,heal? ,s]vice ,act on 
or be=e su* date4  2 &  7#b7 9          
subsection 7e77#b71 by ins]t+ vacc9es   
describ$ 9 subsection 7c77#ac7 adm9i/]$ 
dur+ ! p]iod beg9n+ on ! date ( !       
enactm5t ( su* subsection & end+ on     

,decemb] #ca1 #bjbi 7& ! adm9i/ration ( 
su* vacc9es71 be=e s]vices describ$ 9   
section #aiaf7;a77#b77;,g74