A child receives a Covid-19 vaccine in Annandale, Virginia, in 2021. Virginia is among the states that have parted ways with fresh federal guidelines limiting access to the vaccine. (Photo: Chip Somodevilla/Getty Images)
Pennsylvania health insurers will be required to cover Covid-19 and other vaccinations through 2026.
All issuers of accident and health insurance policies in the commonwealth will be required to cover vaccinations “without cost-sharing or imposing other administrative barriers,” according to a notice issued Friday by the Pennsylvania Department of Insurance.
This means Pennsylvanians can get the Covid-19 vaccine without copays, deductibles or other costs if it is done by an in-network provider and without insurers having to take additional steps that make it more arduous to get vaccinated. It also enables pharmacists to follow guidance from many trusted medical organizations when administering vaccines.
It also encourages insurers operating employer-sponsored health plans that are not directly regulated by the Commonwealth to ensure continued access to vaccines for insured persons.
The directive responds to changes at the Centers for Disease Control that could make it more arduous to get the vaccine across the country.
“It’s about keeping our promises to Pennsylvanians. Vaccines are one of the best ways to prevent serious disease, and we want every Pennsylvanian to have affordable and easy access to the means to protect themselves and their families,” Insurance Commissioner Michael Humphreys said in a statement. “If your health insurance plan says it covers vaccines, your coverage will last until at least 2026. Getting vaccinated should be easy.”
According to a notice published in Saturday’s issue of the Pennsylvania Bulletin, the agency has received many questions about vaccination coverage related to CDC efforts this year.
The CDC recently withdrew its recommendation for a universal Covid-19 vaccine, as well as other changes to the vaccination schedule that include teenage children receiving the measles-mumps-rubella vaccine separately from the chickenpox vaccine.
“Informed consent is back” decided Acting CDC Director and Deputy Secretary for Health and Human Services Jim O’Neill after the changes were approved on October 6.
The CDC’s 2022 general recommendation for Covid-19 vaccinations “discourages health care providers from talking about the risks and benefits of vaccination for a specific patient or parent,” O’Neill said.
The CDC’s Advisory Committee on Immunization Practices (ACIP) recommended changes to the vaccination schedule in September – months after all 17 committee members were removed and replaced by U.S. Secretary of Health and Human Services Robert F. Kennedy Jr., a longtime and outspoken vaccine skeptic.
Kennedy gutted the commission — a panel of experts that issues guidelines for doctors and pharmacists across the country — shortly after declaring that the CDC would no longer recommend Covid-19 vaccines for robust children and pregnant women. He did not cite any specific research and potentially put the body’s guidance at odds with professional associations representing thousands of pediatricians, gynecologists, family physicians and scientists across the country.
Historically, the Pennsylvania Board of Pharmacy has followed ACIP recommendations. But on Sept. 3, the board unanimously approved a measure allowing the agency to issue vaccine guidelines based on recommendations from three medical associations: the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists, as well as the U.S. Food and Drug Administration.
The commonwealth also joined a coalition of northeastern states to coordinate public health efforts such as emergency preparedness and the creation of vaccination guidelines.
Other states in the Northeast Public Health Collaborative (NEPHC) include Connecticut, Delaware, Massachusetts, New Jersey, New York, Rhode Island and Vermont. All have Democratic governors except Vermont, which is led by Republican Phil Scott.
Gov. Josh Shapiro signed an executive order on Oct. 1 that directs state agencies to protect access to vaccines by establishing a vaccine safety net for children and by aligning policies with medical experts.
The order also launched a central vaccine portal and a vaccine education working group to improve public communication and combat disinformation.
“Importantly, the executive order emphasizes that recommended vaccines should remain covered by both private insurance and Medicaid in Pennsylvania. This step ensures that whether an individual has a public or private plan, their access to vaccinations will be protected and consistent,” the Department of Insurance said.
