Vaccine coverage mandate passes Pa. House in narrow vote

HARRISBURG — A narrow vote of approval advanced legislation out of the Pennsylvania House on Wednesday, intended by its supporters to protect vaccine access.

State representatives voted 104-99 with two Republicans joining all 102 Democrats in the lower chamber to approve House Bill 1828. It now moves to the Republican-majority Senate for further consideration.

The bill looks to mandate insurance coverage of vaccines without charging out-of-pocket costs to patients and also maintain vaccine schedules recommended by professional medical societies.

It's a direct response to policy changes at the federal level under the Trump administration, including an overhaul of the Advisory Committee on Immunization Practices. ACIP, which is within the Centers for Disease Control and Prevention and is responsible for approving vaccine guidance in the U.S.

"I hope it means something when the three of us, the three health care providers here in this caucus, come and speak to you on behalf of vaccines. Vaccines are incredibly important, especially scheduled vaccines, especially for children," Rep. Bridget Kosierowski, D-Lackawanna, said during floor remarks. "Vaccines are the safest and most effective way to prevent the spread of disease, including measles, whooping cough and polio."

Kosierowski and Rep. Tarik Khan, D-Philadelphia, each are nurses. Rep. Arvind Venkat, D-Allegheny, is an emergency physician. All sponsored the bill.

The bill would authorize the Pennsylvania Department of Health to recommend vaccine schedules and could choose to do so, though it wouldn't be required, with the support of the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, the American Academy of Family Physicians, the Infectious Diseases Society of America and the Society for Maternal-Fetal Medicine.

Vaccines recommended by the Department of Health would be required for coverage by health insurance companies. Violations would risk the insurer's license and also fines of up to $500,000 within a calendar year.

Coverage would also be required under Medicaid for vaccines approved by the Food and Drug Administration. A religious exemption is included in the bill.

Gov. Josh Shapiro signed an executive order on Oct. 1 directing the Department of Health to pursue much of what the proposed bill would require under the law — maintain vaccine access for children without cost-sharing using the vaccine schedule in place before President Donald Trump's inauguration, base vaccine schedule recommendations on that of medical societies, create www.pa.gov/vaccines to review guidance and seek other information, establish a vaccine workgroup of in-state medical professionals, parents and community leaders to "combat misinformation."

Rep. Brian Munroe, D-Bucks, spoke of his Non-Hodgkin Lymphoma diagnosis in 2019. He said he underwent six rounds of chemotherapy treatments and told of how the therapy weakens the immune system.

"They literally obliterate your immune system. Do you know what happens to you if you have absolutely no immune system?" Munroe asked, telling of how he had been hospitalized with fever during one round.

The COVID-19 pandemic broke out months after his diagnosis. He said he isolated to protect himself. In 2023, cancer returned and a different therapy had the same impact — a weakened immune system. Today, he said he's cancer-free. And, he said, he needs vaccines.

"Easy access to vaccines for those of us who wish to keep them is crucial for many in our communities and for families like mine," Munroe said.

Rep. Tim O'Neal, R-Washington, House minority whip, said the bill isn't about access, it's about mandating insurance coverage.

"This bill has nothing to do with access to vaccines. If you want the vaccine, you can go get it now, you can get it whether or not we pass this legislation," O'Neal said. "The federal government under the direction of the CDC and the Affordable Care Act already has this essential mandate."

Venkat countered O'Neal's remarks, saying changes in federal policies are "jeopardizing insurance coverage for vaccines." He said out-of-pocket costs could approach $4,000 for the full childhood vaccine schedule if they weren't covered.

"In the here and now, there is a financial cost and insurance coverage is a fundamental part of that, and that's why I think this legislation is absolutely necessary," Venkat said.