Chapter 3 makes recommendations to improve access to vaccines for adults enrolled in Medicaid. Vaccines are important tools to promote public health, yet adult Medicaid beneficiaries have lower vaccination rates than those covered by private insurance for nearly all vaccines. This is due in part to limited coverage of recommended vaccines for beneficiaries who are not enrolled in the new adult group. Vaccine coverage is optional for many adults in Medicaid and varies by state and vaccine, which creates unequal access to cost-effective, preventive care.
In the March report to Congress, the Commission highlighted several policy considerations to improve vaccine access for Medicaid beneficiaries. These considerations include addressing low provider payment, limited provider networks, and inadequate support and education for beneficiaries.
In our June report, the Commission recommends making coverage of recommended vaccines a mandatory benefit for all adult Medicaid beneficiaries. To further improve access, CMS should implement regulations for vaccine payment and encourage the broad use of Medicaid providers in administering vaccines. In addition, the Commission recommends a coordinated effort to improve vaccine outreach and education to Medicaid and State Children’s Health Insurance Program (CHIP) beneficiaries as well as to improve immunization information systems and provide funding to support state-level activities to improve the availability of these services.
From: June 2022 Report to Congress on Medicaid and CHIP