NEW YORK, Aug 28 (Reuters) - Broad U.S. health insurance
coverage of the COVID-19 vaccine is not likely to change this
fall even after the Food and Drug Administration limited the
shot to people 65 and older or those with health conditions,
sources at two insurance trade organizations said.
Coverage could change starting in January 2026 when health
plans offer new annual benefits and depending on the type of
recommendations made in the coming months by the U.S. Centers
for Disease Control and Prevention's outside committee of
advisers, they added.
U.S. insurers currently provide broad coverage at no cost
for the initial shots and annual COVID boosters based on
recommendations from that committee, known as the Advisory
Committee on Immunization Practices, as required by the
Affordable Care Act.
Health Secretary Robert F. Kennedy Jr., a vaccine skeptic,
has questioned the safety of vaccines used against COVID and
changed who is eligible for the shots. He replaced all 17
advisory committee members with those who share his views and
announced the CDC would stop recommending the COVID vaccine for
pregnant women and healthy children.
Kennedy's pick for CDC director, Susan Monarez, was
fired on Wednesday, a move she attributed to the agency's
vaccine policy changes, a close associate said.
Kennedy also brought in FDA Commissioner Marty Makary, who
led the FDA in narrowing its approval to people aged 65 and
older or those aged 6 months to 64 years at risk of severe
disease. The U.S. Department of Health and Human Services has
said others can get the shots in consultation with their
doctors.
"Individual health plans and plan sponsors will be prepared
to make coverage decisions informed by science, the latest
medical evidence and data," a spokesperson for industry trade
association America's Health Insurance Plans said.
The spokesperson said that determinations will be
evidence-based and will consider recommendations made by the
CDC's committee of outside advisers.
A spokesperson for CVS Health's ( CVS ) insurer Aetna said
that for plans it operates and funds, the company will continue
to provide coverage for COVID vaccines with no cost sharing.
UnitedHealth Group ( UNH ) and Cigna ( CI ) did not
immediately respond to requests for comment.