By Amina Niasse
NEW YORK (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 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 and Cigna did not immediately respond to requests for comment.
(Reporting by Amina Niasse; Editing by Caroline Humer and Jamie Freed)
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