NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8824
SPONSOR: Reyes TITLE OF BILL:
An act to amend the insurance law and the social services law, in
relation to insurance reimbursement for vaccination for severe acute
respiratory syndrome coronavirus 2
PURPOSE OR GENERAL IDEA OF BILL::
This bill would include vaccines against SARS CoVID-2 virus on the list
of vaccines which the Commissioner of Insurance must mandate for cover-
age by health insurance providers within the State of New York and
Include vaccines against SARS CoVID-2 virus on on the list of what Medi-
caid must cover for an enrollee who receives such a vaccine at a pharma-
cy
SUMMARY OF PROVISIONS::
Section One. Amends Clause (iii) of subparagraph (B) of paragraph 17 of
subsection (i) of section 3216 of the insurance law, covering for-profit
individual health plans.
Section Two. Amends Clause (iii) of subparagraph (B) of paragraph 8 of
subsection (I) of section 3221 of the insurance law, covering for-profit
group plans.
Section Three. Amends Subparagraph (C) of paragraph 2 of subsection
(j) of section 4303 of the insurance law, covering nonprofit health
plans and health maintenance organizations (HMOs).
Section Four. Amends Paragraph (v) of subdivision 2 of section 365-a of
the social services law, covering Medicaid.
Section Five. Provides for an effective date
JUSTIFICATION::
In light of recent and conflicting guidance from the U.S. Department of
Health and Human Services (HHS)-which has modified its COVID-19 vaccine
recommendations by no longer advising routine vaccination for healthy
children and pregnant individuals-it is imperative for New York State to
enact legislation that ensures health insurance providers continue to
cover the COVID-19 vaccine. This mixed messaging from federal health
authorities risks undermining public confidence and access, making it
all the more essential for the state to step in to safeguard public
health, maintain equitable vaccine access, and uphold its commitment to
preventive care.
Despite the HHS's updated stance, COVID-19 continues to pose significant
health risks. Children, while generally experiencing milder symptoms,
can still suffer severe outcomes and contribute to community trans-
mission. Pregnant individuals face increased risks of complications from
COVID-19, and vaccination has been shown to confer protective benefits
to both mothers and their infants. State-level legislation ensuring
vaccine coverage reinforces New York's proactive approach to mitigating
these risks and protecting vulnerable populations.
The HHS's decision may lead to inconsistencies in vaccine availability
and coverage across states. By proactively legislating insurance cover-
age for the COVID-19 vaccine, New York can preempt potential gaps
resulting from reduced federal support, ensuring continuity in vaccine
access and public health initiatives. State legislation mandating
insurance coverage for COVID-19 vaccines can bolster public confidence
in vaccination programs. It sends a clear message about the state's
trust in the safety and efficacy of vaccines, countering potential
misinformation and hesitancy that may arise from changing federal guide-
lines.
In response to the HHS's revised COVID-19 vaccine recommendations, it is
crucial for New York State to enact legislation that mandates health
insurance coverage for the vaccine. Such action will ensure equitable
access, protect public health, uphold preventive healthcare standards,
address potential federal support gaps, and reinforce public confidence
in vaccination efforts. By taking this step, New York reaffirms its
commitment to the health and well-being of all its residents.
PRIOR LEGISLATIVE HISTORY::
None
FISCAL IMPLICATIONS::
TBD
EFFECTIVE DATE::
This act shall take effect on the first of January after it shall have
become a law
STATE OF NEW YORK
________________________________________________________________________
8824
2025-2026 Regular Sessions
IN ASSEMBLY
June 9, 2025
___________
Introduced by M. of A. REYES -- read once and referred to the Committee
on Insurance
AN ACT to amend the insurance law and the social services law, in
relation to insurance reimbursement for vaccination for severe acute
respiratory syndrome coronavirus 2
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Clause (iii) of subparagraph (B) of paragraph 17 of
2 subsection (i) of section 3216 of the insurance law, as amended by chap-
3 ter 219 of the laws of 2011, is amended to read as follows:
4 (iii) necessary immunizations, as determined by the superintendent in
5 consultation with the commissioner of health, consisting of at least
6 adequate dosages of vaccine against diphtheria, pertussis, severe acute
7 respiratory syndrome coronavirus 2, tetanus, polio, measles, rubella,
8 mumps, haemophilus influenzae type b and hepatitis b, which meet the
9 standards approved by the United States public health service for such
10 biological products.
11 § 2. Clause (iii) of subparagraph (B) of paragraph 8 of subsection (l)
12 of section 3221 of the insurance law, as amended by chapter 219 of the
13 laws of 2011, is amended to read as follows:
14 (iii) necessary immunizations, as determined by the superintendent in
15 consultation with the commissioner of health, consisting of at least
16 adequate dosages of vaccine against diphtheria, pertussis, severe acute
17 respiratory syndrome coronavirus 2, tetanus, polio, measles, rubella,
18 mumps, haemophilus influenzae type b and hepatitis b, which meet the
19 standards approved by the United States public health service for such
20 biological products.
21 § 3. Subparagraph (C) of paragraph 2 of subsection (j) of section 4303
22 of the insurance law, as amended by chapter 219 of the laws of 2011, is
23 amended to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13303-01-5
A. 8824 2
1 (C) necessary immunizations, as determined by the superintendent in
2 consultation with the commissioner of health, consisting of at least
3 adequate dosages of vaccine against diphtheria, pertussis, severe acute
4 respiratory syndrome coronavirus 2, tetanus, polio, measles, rubella,
5 mumps, haemophilus influenzae type b and hepatitis b, which meet the
6 standards approved by the United States public health service for such
7 biological products.
8 § 4. Paragraph (v) of subdivision 2 of section 365-a of the social
9 services law, as added by section 4 of part B of chapter 58 of the laws
10 of 2010, is amended to read as follows:
11 (v) administration of vaccinations, consisting of at least adequate
12 dosages of vaccine against diphtheria, pertussis, severe acute respir-
13 atory syndrome coronavirus 2, tetanus, polio, measles, rubella, mumps,
14 haemophilus influenzae type b and hepatitis b, which meet the standards
15 approved by the United States public health service for such biological
16 products, in a pharmacy by a certified pharmacist within [his or her]
17 their scope of practice.
18 § 5. This act shall take effect on the first of January after it shall
19 have become a law and shall apply to any contract entered into, deliv-
20 ered, amended or modified on or after the date it takes effect.
