The COVID-19 pandemic has focused attention on the important role the federal government plays in the development and distribution of vaccines. Although it is likely that all state Mediciad programs will cover the COVID-19 vaccine, the Medicaid statute does not mandate vaccine coverage for all Medicaid beneficiaries. Vaccine coverage for Medicaid enrollees varies by population. Children enrolled in Medicaid receive vaccines through the Vaccines for Children program (VFC); however, vaccines are considered an optional benefit for some adults but mandatory for others.
In this presentation, we provide background on Medicaid coverage of vaccines and how coverage is different depending on age and eligibility pathway. It reviews how Medicaid pays for vaccines and presents results from a recent study from the Centers for Disease Control and Prevention. It then discusses how differences in Medicaid coverage and payment rates may be barriers to access and contribute to lower vaccination rates. Finally, this presentation includes some strategies and potential policy options that could help improve vaccination coverage and access for Medicaid-enrolled adults.