Insurance coverage of hepatitis B vaccine won’t change, industry and officials say

By Tami Luhby, CNN

(CNN) — Parents will still be able to get the hepatitis B vaccine for their children at no cost even though the US Centers for Disease and Control Prevention’s vaccine advisers recommended a major change to the immunization practice.

The CDC’s Advisory Committee on Immunization Practices, whose members were chosen by US Health and Human Services Secretary Robert F. Kennedy Jr., voted Friday to end universal hepatitis B vaccination recommendations for newborns.

The revised recommendation calls for mothers who test negative for the virus to consult with a doctor or other health care provider before having their babies vaccinated. This could create confusion and place additional hurdles in front of parents and result in fewer children being immunized.

The advisers also voted in favor of recommending that babies who don’t receive a dose at birth should wait at least two months before being immunized.

Two major health insurance industry groups, the Blue Cross Blue Shield Association and AHIP, reiterated Thursday that they will continue to cover all vaccines recommended by the committee as of earlier this year, with no cost-sharing, through 2026.

BCBS companies will cover all immunizations recommended by ACIP as of January 1, 2025, while operating within federal and state laws and meeting program and customer requirements, a spokesperson told CNN. AHIP members will do so for all vaccines recommended by ACIP as of September 1, 2025, a spokesperson said.

Both groups released these statements earlier in the fall, before ACIP announced changes to recommendations for the Covid-19 vaccine and the combined measles, mumps, rubella and varicella (MMRV) vaccine.

The CDC committee members recommended in September that patients consult with a health care provider for a Covid-19 vaccine, a process known as shared clinical decision-making, but do not need to have a prescription. And the members voted to recommend against using the combined MMRV vaccine for young children.

The change to requiring a consultation with a doctor has raised concerns that insurers would no longer be required to cover the full cost of the immunization. The Affordable Care Act mandates that most private insurers cover vaccines recommended by ACIP at no cost, and Medicaid’s no-cost coverage of vaccines is tied to the committee’s recommendations.

The shift to shared clinical decision-making will not affect the ACA’s mandate for insurers, said Jen Kates, senior vice president of global and public health policy for KFF, an independent health policy research organization.

“The change today will have an impact, but not on insurance coverage,” Kates said Friday. Rather, she said, the effect will be that fewer newborns will receive the vaccine.

ACIP also voted to recommend shared clinical decision-making on the hepatitis B shot for parents who get free vaccines through the federal Vaccines for Children program. The program provides a variety of immunizations at no cost to children who are eligible for Medicaid, are uninsured or are underinsured.

Dr. Georgina Peacock, director of the CDC’s Immunization Services Division, said Thursday that if that recommendation was approved, those immunizations would be covered by Vaccines for Children.

Also Thursday, a Centers for Medicare and Medicaid Services official said the inclusion of individual-based decision-making language would not affect coverage of the vaccine without any cost-sharing.

The CDC makes the final decision on vaccine recommendations but typically aligns with the advisory panel’s vote.

The-CNN-Wire
™ & © 2025 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.