In the wake of the Advisory Committee on Immunization Practices (ACIP) announcing plans to revisit its recommended schedule for childhood vaccinations—a move that has drawn widespread criticism from experts—major insurers have not confirmed whether they’ll continue to cover the full cost of routine shots for children.
For 60 years ACIP has provided vaccine guidance to the Centers for Disease Control and Prevention (CDC), including on the timing and dosage of childhood immunizations. Insurers are required to cover the cost of most jabs on the recommended schedule for children. On Wednesday June 25, ACIP announced it would review the schedule, just weeks after health secretary and longtime anti-vaccine activist Robert F. Kennedy Jr. replaced the entire committee with his own appointees.
When WIRED then asked 21 of the country’s largest health insurance groups whether they would stop providing cost-free coverage of current routine immunizations in the event ACIP stops recommending them, only Blue Shield of California—a company in the Blue Cross Blue Shield Association—confirmed it would continue coverage.
“As a payer our role is to ensure ongoing coverage and access to preventive, evidence-based care, including immunizations,” says company spokesperson Mark Seelig. “Therefore, Blue Shield of California is committed to maintaining coverage of immunizations. The decision on whether to receive a vaccine is between our member and their provider.”
Other large insurers, including UnitedHealthcare (which provides coverage for 50 million people), Cigna, Kaiser Permanente, Anthem, Humana, and Centene Corporation, did not respond to requests for comment. Blue Cross Blue Shield of Michigan said it had no comment.
Most insurers that did respond said they were keeping an eye on developments in Washington, without indicating whether they would or would not cover vaccines dropped from the recommended schedule.
“Vaccines play an important role in the prevention of more serious illnesses,” says Phil Blando, a spokesperson at CVS Health, which owns the insurer Aetna. “We are monitoring any changes the federal government makes to vaccination guidance and eligibility and will evaluate whether coverage adjustments are needed.”
Highmark Inc., part of the Blue Cross Blue Shield Association, operating in Pennsylvania, Delaware, West Virginia, and New York, is also waiting to see what decision ACIP reaches. “We are closely monitoring the evolving vaccine discussions occurring in Washington, DC. Various vaccines and immunizations are covered under Highmark’s member benefits, with any future coverage considerations to be evaluated as more information becomes available,” says spokesperson Aaron Billger.
Bryan Campen, of Health Care Service Corporation—the licensee of Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas—notes that no changes have yet been made to the vaccines ACIP recommends or the company’s vaccine coverage, but says that the company will “continue to monitor any activity that may impact preventive care recommendations and will communicate any changes to recommendations that may impact standard coverage of preventive services.”
Insurers had an eye on changes in ACIP guidance even before the committee announced it would revisit the schedule. “As we navigate an evolving health care landscape, maintaining robust immunization coverage continues to be a top priority for protecting both individual and community health,” the industry’s trade association, AHIP, said in a June 24 statement, the day before ACIP’s announcement.