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Teen boy getting vaccine

AAP tracks COVID-19 vaccine commercialization, provides Medicaid ‘unwinding’ resources

April 1, 2023

The Academy is following developments on COVID-19 vaccine commercialization, when commercial markets will play a greater role in purchasing and distributing COVID-19 vaccines, and is in ongoing communication with federal government officials.

Commercialization is expected to take place this fall, when the federal government anticipates it will run out of funding to purchase more vaccines. Notably, the commercialization timeline is separate from the end of the public health emergency in May.

In a message sent to all AAP members in late February, AAP President Sandy L. Chung, M.D., FAAP, outlined two other key points: The Biden administration has stated that its goal is to make available a bivalent vaccine for all ages, and the administration and manufacturers are striving to have single-dose vials available when commercialization begins.

The Academy is pursuing extensive advocacy with the federal government, commercial insurers and vaccine manufacturers to support pediatricians and ensure children can access the vaccine.

These efforts include but are not limited to urging vaccine payment from payers once commercialization begins; flexible ordering policies for COVID-19 vaccines; liberal return policies for expired doses; improved labeling of vaccine vials; and longer invoice and payment schedules so pediatricians are paid for vaccines they purchased before they have to place additional orders.

In addition, the Academy is urging the Centers for Disease Control and Prevention to keep the needs of providers participating in the Vaccines for Children (VFC) program at the forefront as it prepares to include COVID-19 vaccines in the VFC program.

“We will not stop advocating for the changes we know you need to make sure that all eligible children are able to be vaccinated against COVID-19 by their pediatrician,” Dr. Chung said in the message to members.

The AAP will update members on the commercialization process as new information becomes available.

AAP provides resources as Medicaid ‘unwinding’ begins

A policy that kept individuals enrolled in Medicaid during the COVID-19 public health emergency ended on March 31. Over the next 14 months, states must check whether every person enrolled in Medicaid is still eligible for the program and then either renew or terminate that person’s coverage. This process to redetermine eligibility is called the “unwinding.”

States may begin disenrolling individuals who are no longer eligible for Medicaid starting April 1. Families who are no longer eligible may lose their health care coverage or be transitioned to another form of coverage, like the Children’s Health Insurance Program (CHIP) or the health insurance marketplace.  

The Academy is undertaking multifaceted advocacy and education efforts to ensure children do not lose their health care coverage inappropriately or experience disruptions in their health care. A report from the Georgetown University Center for Children and Families showed that Medicaid and CHIP cover 54% of children in the United States.

“As the continuous coverage requirement winds down, it’s critical that state leaders do everything in their power to ensure eligible children and families do not lose their health care coverage,” said Lisa Costello, M.D., M.P.H., FAAP, a member of the AAP Committee on State Government Affairs, during a media call on the report. “And, if a child or family is no longer eligible, we must make sure they’re seamlessly transitioned into another source of health care coverage.”

Studies estimate that as many as 5.3 million children may lose their Medicaid coverage during the unwinding, largely for procedural reasons such as missed paperwork. 

“Families should not face additional layers of burden, like unnecessary paperwork or administrative barriers, that will keep them from getting care they need,” Dr. Costello said.

The Academy has been preparing for the unwinding over the past year and is advocating at the state and federal levels to protect children’s health care coverage.

Myriad resources are available for pediatricians, pediatric practices and AAP state chapters at The webpage includes background information on the unwinding along with tools to help pediatricians spread the word to families, such as flyers with state-specific details and steps families can take to ensure their contact information is up to date with the state. AAP members can continue to check this webpage for the latest resources.

Pediatricians advocate for policies to support Native child health  

Members of the AAP Committee on Native American Child Health (CONACH) recently hosted a congressional briefing in Washington, D.C., to draw attention to the unique health needs of Native children and advocate for policies that will support them.

CONACH hosted the briefing with the National Council of Urban Indian Health and the National Indian Health Board to discuss the barriers this population often faces when trying to access health care and ways to address those challenges. The briefing also focused on the important role of the Indian Health Service (IHS) in improving health care access and quality for Native children.

Committee members and pediatricians from Children’s National Hospital in D.C., also attended meetings with their congressional offices to urge lawmakers to advance policies that support Native children. They called on Congress to continue providing strong funding and advance appropriations for the IHS, support bills that improve recruitment and workforce retention for the agency, and make discussion on the needs of Native children a priority.

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