Pennsylvania bill would make insurance companies pay for vaccines not covered at federal level

(WHTM) — Which vaccines should insurance companies be required to cover? That’s a hot topic in Washington, D.C., as there are signs that some of the shots covered today won’t be next week. A Pennsylvania lawmaker is trying to stop that from happening, regardless of what’s decided in D.C.

State Rep. Arvind Venkat (D-Allegheny County) is an E.R. doctor who’s seen it all, but says in 25 years, he has never seen a case of polio, mumps, tetanus, or diphtheria.

“Vaccines work,” said Venkat. “They save lives. These are diseases that have been eradicated, for all intents and purposes, in our country because of vaccines.”

Vaccines covered by insurance companies based on recommendations by the CDC’s Advisory Committee on Immunization Practices, which meets next week and, Rep. Venkat fears, may remove some requirements.

“That has obviously been blown up by (U.S. Health and Human Services Secretary) Robert F. Kennedy Jr. and his anti-vaccine ideology,” said Venkat.

Venkat wants the state to require what the feds may not: Insurance companies are to pay for vaccines as they have been.

“We need to bring it back to the state level to make sure that Pennsylvanians continue to have the assurance that they’ll if they get vaccines, it’ll be covered,” said Venkat.

abc27 spoke with several Republican lawmakers to see if there was pushback against this bill. They said they are not against vaccines; rather, they are against the government requiring someone to get a vaccine.

Venkat has been clear about his bill’s purpose, saying, “There is no vaccine mandate in this bill,” said Rep. Venkat.

The bill would mandate that insurance companies cover the cost of vaccines, even if the federal government does not require them to do so. The Affordable Care Act says states can go beyond CDC recommendations, but when they do, they, not the insurance companies, pick up the tab.

“We are totally dependent on the altruism of the insurance companies, which, you know, I think they understand their bottom line and the benefits of vaccines, but we need the assurance as Pennsylvanians that under law, this is required,” said Venkat.

The doctor insists that vaccines ultimately save insurance companies money with less severe illness. Do the companies agree? We won’t know unless and until those guidelines are changed.