Financing the HPV vaccine under medicaid: Access for low-income women

HPV vaccine represents a major advance in cancer prevention. Its introduction into the market highlights significant gaps in vaccine access, particularly among adult Medicaid beneficiaries. Federal rules require each Medicaid program to cover all recommended vaccines for pediatric beneficiaries. However, coverage for adults who qualify for Medicaid is provided as an optional benefit only. Thus, coverage of immunizations for adults varies from state to state. These differences could create significant barriers to access to the HPV vaccine and places this population at unnecessary risk for cervical cancer.

This presentation will identify states whose Medicaid programs provide HPV vaccine coverage for adults, determine how each state categorizes the service and describe how coverage decisions are made. Factors that influenced decisions include: social policy, regional political climate, consumer demand, availability of established funding streams, and provider reimbursement and replacement policy.