Massachusetts Mandates Insurance Coverage for Vaccines

Massachusetts has become the first state to mandate that health insurance companies cover vaccines recommended by the state’s Department of Public Health. This new law diverges from the previous practice of solely following guidelines set by the Centers for Disease Control and Prevention (CDC), especially amid recent changes in vaccine recommendations from the federal government.

The decision comes as the Food and Drug Administration (FDA) recently narrowed its recommendations for the COVID-19 vaccine, a move that has faced scrutiny. During a Senate hearing, Health and Human Services Secretary Robert F. Kennedy Jr. was questioned about this and other controversial decisions. In response to these developments, Massachusetts Governor Maura Healey emphasized her commitment to ensuring that residents have access to necessary vaccinations.

“Massachusetts has the best health care in the world,” Healey stated on September 5, 2023. “We won’t let Donald Trump and Robert Kennedy get between patients and their doctors. When the federal government fails to protect public health, Massachusetts will step up.” She added that the state’s actions would ensure that residents can continue to receive the vaccines they need.

In a coordinated effort, several states with Democratic governors, including California, Oregon, and Washington, have announced plans to form a public health alliance to provide “evidence-based immunization guidance.” Healey indicated that Massachusetts would join other Northeastern states in creating a similar coalition aimed at establishing robust vaccine policies.

Support for the new mandate has come from significant health organizations. Both Blue Cross Blue Shield of Massachusetts and the Massachusetts Association of Health Plans have expressed their backing for Healey’s initiative. “Today’s action ensures that everyone who should get a vaccine will get one, and their insurance will cover it,” said Insurance Commissioner Michael Caljouw. He emphasized the importance of collaboration between state government and health insurance companies as the fall season approaches.

Governor Healey’s press release detailed a three-step plan to implement the new law effectively. Firstly, the Division of Insurance and Department of Public Health issued a bulletin mandating that insurance carriers in Massachusetts continue to cover vaccines recommended by the Massachusetts Department of Public Health. Secondly, the governor has initiated measures to guarantee that residents seeking the COVID-19 vaccine can access it through local pharmacies. Lastly, Massachusetts is taking a leadership role in fostering a public health collaboration with neighboring states in New England and across the Northeast, all focused on enhancing public health safeguards.

This proactive approach by Massachusetts not only sets a precedent for health policy in the state but also highlights the ongoing commitment to prioritizing public health amid changing federal guidelines.