difficult to track vaccine administration fees as a separate cost indicator because such fees now are generally included in the capitated payments.

The U.S. federal government currently spends more than $1 billion annually to purchase vaccines for disadvantaged children and adults and to support immunization programs within the 64 grantees, which include the 50 states, 6 municipal regions,3 and 8 U.S. political jurisdictions (see Table 1–4).4 These funds are allocated primarily by two federal agencies: CDC, which administers the National Immunization Program, established by Section 317 of the Public Health Service Act (see Appendix A); and the Health Care Financing Administration (HCFA), which administers the Medicaid and Medicare programs and the new State Children’s Health Insurance Program (SCHIP) in collaboration with the states. In addition, the Vaccines for Children (VFC) program, created in 1993 through an amendment to the Social Security Act, is financed through HCFA and administered by CDC. CDC supplies VFC vaccines and provides Section 317 vaccines and financial assistance awards to the states annually in response to state requests for assistance and estimates of vaccine need (see Boxes 1–1 and 1–2).

In fiscal year (FY) 1998, the VFC program, which provides federally financed vaccines for four categories of disadvantaged children, spent $437 million in federal funds for vaccines and operational costs; Medicaid program expenditures for immunization in this same year were an additional $127 million, $70 million of which was federal. In addition, CDC provided $418 million in support of vaccine purchase for the states, financial assistance for state immunization programs, and CDC program

TABLE 1–4 Total Federal Immunization Funding, FY 1999 ($ in millions)

Program

Federal

State

Total

Section 317a

448

Unknown

448

VFCb

467

Not applicable

467

Medicaid

70

57

127

Medicare

115

Not applicable

115

TOTAL

1,100

57

1,157

aTotal Section 317 federal immunization funding, FY 1999 (actual) as reported in the Department of Health and Human Services FY 2001 Centers for Disease Control and Prevention Justification of Estimates for Appropriations Committees.

bTotal VFC federal immunization funding, FY 1999 (enacted), as reported in the Department of Health and Human Services FY 2001 Centers for Disease Control and Prevention Justification of Estimates for Appropriations Committees.

SOURCE: Information provided by CDC.



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