15 states sue RFK Jr. over vaccines, fear changes will affect private insurance
Federal officials and insurance company executives have stated that U.S. health plan coverage for childhood vaccines will stay the same, even if the U.S. Department of Health and Human Services changes its vaccine recommendations.
Officials in 15 states are questioning that prediction in a new suit over HHS vaccine policy recommendation changes.
HHS recently moved seven vaccines, on what the plaintiffs call the “Kennedy schedule,” from the routine childhood vaccination category to a category for vaccines that a child might get after a parent or guardian engages in “shared clinical decisionmaking” with a doctor or other health care provider. The Kennedy schedule includes the vaccines against COVID-19, hepatitis A, hepatitis B, influenza, meningococcal disease, rotavirus and respiratory syncytial virus.
The Kennedy schedule is forcing cash-strapped states to spend money to counter increased resistance to vaccines and encourage children to get vaccines that protect them against potentially deadly, expensive-to-treat conditions, according to a complaint filed Tuesday in the U.S. District Court for the Northern District of California.
The “defendants’ assurances that all vaccines on the Kennedy schedule will remain covered by private insurance companies as required by the Affordable Care Act are similarly open to suspicion,” the plaintiff states told the court.
The plaintiff states are asking the court to declare that the Kennedy schedule “arbitrary and capricious and contrary to law” and to set aside the Kennedy schedule and any implementation of the Kennedy schedule.
The list of plaintiffs in the case, State of California Justice Departments v. Kennedy, includes Arizona, Colorado, Connecticut, Delaware, Maine, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island and Wisconsin, as well as California. The list also includes Josh Shapiro, the governor of Pennsylvania.
The defendants are HHS Secretary Robert F. Kennedy Jr.; Jayanta Bhattacharya, who’s the acting director of the Centers for Disease Control and Prevention; HHS; and the CDC.
The parties could not immediately be reached for comment.
What it means: The plaintiffs in the new case are correct, employer health plans may eventually be able to stop covering vaccinations for COVID-19, hepatitis B and other conditions on the Kennedy schedule.
The backdrop: The Affordable Care Act requires all major medical plans, including self-insured plans and high-deductible health plans that are compatible with health savings accounts, to cover a package of preventive services, including childhood vaccinations, without imposing deductibles, co-payments or other cost-sharing obligations on the patients.
Health insurers said in response to proposed HHS vaccination policy changes that they would continue to keep the vaccinations on the Kennedy list in the ACA preventive services package, even if the vaccinations moved to the shared clinical decisionmaking category.
Federal officials said that the changes would give families more flexibility and have no effect on vaccine coverage.