Enhancing Access to Routine Vaccines for Adults in Medicaid

By: Helen R. Pfister | Julian Polaris | Matthew C. Itzkowitz
– Health Affairs

Manatt Health Partners Julian Polaris and Helen Pfister and Associate Matthew Itzkowitz co-authored an article with Merck’s Alexandra Bhatti, Amanda L. Eiden and Anthony DiFranzo for Health Affairs on how policymakers can increase access to routine vaccinations for adults enrolled in Medicaid.  

In the article, the authors discuss how the Inflation Reduction Act addresses longstanding vaccination barriers by guaranteeing coverage for routine vaccinations, without cost sharing, to individuals enrolled in Medicaid and Medicare. The article notes that while the Inflation Reduction Act is an important step towards greater access to routine vaccinations, additional barriers to vaccination – which can be especially severe for low-income or historically underrepresented communities – continue to present challenges. The article explains that while insurance coverage of vaccines is necessary, it is not sufficient to ensure the greatest possible access and uptake.  

The authors propose a number of state-level policy reforms – including enhancing vaccination authority under state licensure laws for alternative vaccinators as well as reviewing reimbursement for vaccines and administration – in order to “expand the pool of potential vaccinators and ensure that Medicaid reimbursement is adequate to cover providers’ costs of acquiring vaccines and administering them to Medicaid enrollees.” Though important steps have been taken, the authors conclude that thoughtful adjustments to state policies are essential to continue improving vaccine access and uptake for these communities. 

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