The Inflation Reduction Act Will Help the U.S. Achieve Maximum Vaccine Access and Uptake, but Access Gaps Remain

One of the many achievements in the Inflation Reduction Act (IRA), which President Biden signed into law in August, is aligning Medicare’s vaccine coverage with that of all private health insurance in the United States.

Once implemented, nearly 9 out of 10 of Americans will have access to vaccines with no cost sharing, or what’s known as first-dollar coverage — copays, deductibles, or coinsurance do not apply for receiving any vaccine recommended by the CDC’s Advisory Committee on Immunization Practices.

The Covid-19 pandemic demonstrated both the possibility and the challenges of reaching every American with a vaccine. As the pandemic slowly recedes, new outbreaks like monkeypox emerge, and nearly forgotten diseases like polio reemerge, vaccine advocates should stay vigilant in addressing gaps and strengthening systems so every American has access to seasonal and routine vaccinations. Specifically, the patchwork of publicly financed vaccine procurement and private insurance coverage must be thoughtfully synchronized.

The IRA marks a third major milestone in the advancement of vaccine finance and coverage over the past three decades:

In 1993, the Vaccines for Children Program was established to give first-dollar coverage to children whose families couldn’t pay for vaccinations. Today, it covers at least 40 million low-income children. While school-entry requirement policies drove vaccination uptake in the 20th century, the 1980s saw persistent barriers to vaccine access in low-income and minority children. In addition to providing free vaccine doses to pediatricians, the Vaccines for Children Program also bolstered the national pediatric vaccination infrastructure.

In 2010, the Affordable Care Act guaranteed coverage of vaccines without cost sharing for about 200 million Americans who are either privately insured or newly covered in states that expanded Medicaid. Mandatory coverage of recommended vaccinations and the elimination of cost sharing were major steps toward achieving greater uptake of adult vaccines.

Now the IRA has extended first-dollar coverage to the approximately 50 million older Americans enrolled in Medicare Part D, and it provides states with the incentive to implement the same coverage for adults in traditional Medicaid. The access barriers for these vulnerable older and low-income adults have been well documented and the IRA is a major step toward finally eliminating them.

These three policies align all sources of health coverage in the U.S. to guarantee vaccine coverage for about 300 million Americans. But that leaves 30 million uninsured Americans without guaranteed access to vaccines.

I see several important opportunities to close the gaps and extend vaccine access to every American …