DOVER – Today the House Economic Development/Banking/Insurance & Commerce Committee voted to advance legislation aimed at protecting access to preventive healthcare services across Delaware.
Sponsored by Rep. Mara Gorman, Rep. Kamela Smith, Sen. Dan Cruce, and Sen. Marie Pinkney, HB 338 would require individual, group, and blanket health insurance carriers to provide coverage for evidence-based preventive services and immunizations that were recommended by the Advisory Committee on Immunization Practices (ACIP) of the Center for Disease Control (CDC) and the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA) that were in effect on January 1, 2025.
The Advisory Committee on Immunization Practices (ACIP) was created in 1964 by the Surgeon General of the U.S. Public Health Service (USPHS) due to advancements in vaccine production, increased federal investments in the immunization resources, and the overall need for more oversight. Prior to that, the USPHS relied on committees that were convened irregularly to address biologics-related issues as they occurred.
For over six decades, the ACIP has advised the CDC on vaccination recommendations for residents of the United States – including specified recommendations based on sex, age, and other factors. The ACIP includes up to 19 voting members responsible for making vaccine recommendations, along with non-voting liaisons from over 30 established health organizations. Voting members are independent medical and public health experts who do not work for CDC, and who serve on the committee voluntarily. Each member serves a 4-year term, though terms are staggered to prevent the entire committee from turning over at once.
Prior to the April 8, 2026 charter change, to meet the criteria to serve as voting members of the ACIP, candidates had to be knowledgeable in the fields of immunization practices and public health, have expertise in the use of vaccines and other immunobiologic agents in clinical practice or preventive medicine, have expertise with clinical or laboratory vaccine research, or have expertise in assessment of vaccine efficacy and safety. The committee also held space for one member who was knowledgeable about consumer perspectives and/or social and community aspects of immunization programs.
Historically, the primary goal of the ACIP has been to provide advice and guidance to the Director of the CDC regarding use of vaccines and related agents for effective control of vaccine-preventable diseases in the civilian population of the United States.
The first major change to the ACIP since its inception came on June 9, 2025, when U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. removed all 17 sitting members of the ACIP. They were replaced with 14 new members, several of whom had been openly critical of vaccines.
Kennedy’s removal of the 17 sitting members came just 2 weeks before the ACIP’s triannual meeting on June 25, 2026, at which time he had only appointed 7 new members. The events of that meeting drew widespread criticism from non-voting liaison members of the ACIP, including the National Association of Pediatric Nurse Practitioners (NAPNAP) and the National Foundation for Infectious Diseases.
On January 5, 2026, the CDC acted on a Presidential Memorandum to make sweeping changes to the U.S. childhood immunization schedule, without the normal, formal review process. Delaware was one of 15 states that filed a lawsuit against HHS over this decision, which reduced the number of diseases children are routinely immunized against to 11 from 17. Over 100 health experts and organizations support the lawsuit.
The most recent change to the United States vaccine recommendations and review practice came just days ago with the introduction of a new ACIP charter, which makes major changes to the structure and overall goals of the longstanding committee.
Based on the new charter, to meet the criteria to serve as voting members of the ACIP, candidates must be knowledgeable in the fields of medicine, vaccines, immunization practices, immunology, toxicology, pediatric neurodevelopment, epidemiology, data science, statistical analysis, health economics, recovery from serious vaccine injuries, or public health; have expertise in the use of vaccines or other immunobiologic agents in clinical practice or preventive medicine, have expertise with clinical or laboratory vaccine research, or have expertise in assessment of vaccine safety and efficacy. Additionally, the charter adds four new non-voting liaison members, including the Independent Medical Alliance and Physicians for Informed Consent, both of which are openly anti-vaccine.
Other changes in the charter redefine the ACIP’s overall mission, allowing for the body to focus on making recommendations for “decreased symptomatology in the civilian population of the United States and gaps in vaccine safety research including adverse effects following vaccination,” rather than primarily aiming to control vaccine-preventable diseases.
The charter change has drawn criticism from more than 130 medical organizations.
A large majority of states across the country have longstanding policies that trigger the automatic adoption of immunization recommendations for routine use in children, adolescents and adults from the ACIP. Meaning, vaccine policy in these states are directly tied to ACIP recommendations.
In Delaware, current law dictates that statewide immunization recommendations, requirements, and vaccine insurance coverage, follow ACIP recommendations and CDC immunization schedules.
The current U.S. childhood immunization schedule, which was implemented on January 5, reduces the number of routine vaccinations for children from 13 to 7, and the number of diseases targeted from 17 to 11.
The six vaccines no longer recommended for routine use by all children in the U.S. include the rotavirus, COVID-19, influenza, hepatitis A, hepatitis B, and meningococcal vaccines.
Due to Delaware’s laws tying vaccine insurance coverage to the federal immunization schedules and ACIP recommendations, those vaccines would no longer be automatically covered by Delaware insurance plans. They would be considered out-of-pocket costs.
HB 338 would address this by making it so Delaware’s vaccine insurance coverage is based off of the ACIP’s comprehensive guidelines and CDC immunization schedule as of January 5, 2025 – which were created prior to the HHS Secretary’s major changes to the CDC and ACIP.
“Since its inception, the Advisory Committee on Immunization Practices had been a well-respected body of medical professionals with the expertise needed to make scientifically-backed decisions for the sake of this nation’s public health. That is no longer the case,” said Rep. Mara Gorman, House Prime Sponsor of HB 338.
“Based on the recent actions from the CDC and the changes to the mission and membership of the ACIP, it is clear that science is not a significant factor in the decision-making process around immunizations. Delawareans deserve access to vaccines, for the health and safety of themselves and those around them. HB 338 ensures that they will continue to be able to receive the ones that a real group of experts recommended.”
29 other states and the District of Columbia are taking similar measures to protect immunization access for their residents. The 9 states in the Northeast Public Health Collaborative, which includes New Jersey, Maryland, and New York, will continue following guidance from the American Academy of Pediatrics instead of the federal government.
In 2025, California enacted a similar bill to HB 338, which bases their insurance coverage off of the ACIP’s comprehensive guidelines and CDC immunization schedule as of January 1, 2025, meaning they are following the same guidance that Delaware would be following under HB 338.
“No patient should have to question whether a recommended vaccine or preventive screening will be covered when their health is at risk,” said Rep. Kamela Smith.
“We know that early intervention saves lives, and when people have consistent access to preventive care, it leads to better outcomes and healthier communities.”
HB 338 was drafted in collaboration with and has the support of Delaware Health and Social Services, the Delaware Department of Insurance, and the Office of the Governor.
“The federal government has shown a blatant disregard for long-established medical guidance on vaccinations, and these reckless decisions – by an administration that relies on pseudoscience – has caused uncertainty for thousands of Delawareans. We must act to ensure our neighbors have access to immunizations that have been proven to work and long been afforded to them,” said Senator Dan Cruce, Senate Prime Sponsor of HB 338.
“This bill is a responsible measure that provides Delawareans access to care that has been widely recommended by expert medical professionals for generations.”
HB 338 now heads to the House floor for consideration.
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