OAN Staff Brooke Mallory
1:44 PM – Friday, January 2, 2026
In an encouraging start to 2026, the Trump administration has delivered Centers for Medicare and Medicaid Services (CMS) policy changes that dial back federal pressure on vaccination rate tracking, reducing how much federal healthcare programs push and incentivize high vaccination rates among patients through quality tracking and reporting.
“Government bureaucracies should never coerce doctors or families into accepting vaccines or penalize physicians for respecting patient choice. That practice ends now. Under the Trump administration, HHS will protect informed consent, respect religious liberty, and uphold medical freedom. Thank you @DrOzCMS + @CMSGov for your leadership on this issue,” Kennedy stated on Wednesday.
However, immunization registries and surveillance systems still remain in place, and providers can report vaccination data through other channels. The change reduces mandatory state-level tracking and reporting of vaccination rates in Medicaid and CHIP populations, easing indirect pressure on doctors serving these patients.
Although the government hasn’t “deleted” the data systems, it has removed the mandatory reporting and financial pressure that previously forced states and doctors to meet specific quotas.
In a State Health Official letter (SHO #25-005) issued this week, CMS announced updates to the 2026 and 2027 Core Sets of quality measures for Medicaid and the Children’s Health Insurance Program (CHIP).
Effective for 2026, four immunization-related measures were removed from the mandatory Child and Adult Core Sets:
- Childhood Immunization Status (CIS-CH)
- Immunizations for Adolescents (IMA-CH)
- Prenatal Immunization Status: Under Age 21 (PRS-CH)
- Prenatal Immunization Status: Age 21 and Older (PRS-AD)
These measures are now voluntary for states to report, and CMS stated that there are no federal payment ties or penalties linked to performance on immunization measures in Medicaid/CHIP.
While Medicaid and CHIP both provide behavioral health services, Medicaid serves a broader demographic, including adults and those with disabilities, while CHIP focuses on children and, in some cases, pregnant women from middle-income families.
Additionally, the agency strongly discourages Democrat-led states from using these measures in their own value-based purchasing or payment incentive programs. In states like California and New York, value-based purchasing ties provider pay to state-chosen health targets — using financial penalties and bonuses to pressure compliance rather than relying on voluntary clinical judgment.
Going forward, CMS also plans to collaborate with stakeholders to develop new vaccine measures that better account for informed patient and family choices, discussions about vaccine safety and side effects, alternative schedules, and religious exemptions.
Separately, in the Calendar Year 2026 Medicare Physician Fee Schedule final rule, CMS removed one vaccination-related quality measure from the Merit-based Incentive Payment System (MIPS): Quality ID #508 (Adult COVID-19 Vaccination Status). This process measure, which tracked the percentage of adult patients up to date on COVID-19 vaccinations, will no longer factor into MIPS quality scores.
MIPS also allows providers to document patient refusals for religious, personal, medical, or other reasons as denominator exceptions. Individual patient declines do not negatively impact the provider’s score for those cases.
Meanwhile, the updates align with broader priorities under the Trump administration’s “Make America Healthy Again” (MAHA) initiative, led by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., which emphasizes personal health choices and reducing coercive federal mandates.
Dr. Mehmet Oz, Administrator of the CMS, is a central figure in the MAHA movement. He oversees the “financial engine” of the MAHA initiative, working directly under Kennedy to transform how the U.S. government pays for health and nutrition. While RFK Jr. focuses on the science and safety of food and medicine, Dr. Oz is responsible for the policy and payment shifts required to execute the MAHA agenda.
Administration health officials have described the new changes as an important step toward greater medical autonomy, while CMS frames them as refinements to quality measures in response to evolving public health priorities.
The 2026 rules do not remove vaccine coverage. Under the federal One Big Beautiful Bill Act (OBBBA), all CDC-recommended vaccines remain available to Medicare beneficiaries with zero out-of-pocket costs.
However, by removing the financial “stick,” the administration hopes to restore trust in the doctor-patient relationship, allowing for individualized care rather than a one-size-fits-all mandate.
The pharmaceutical industry is one of the most powerful and well-funded interest groups in Washington. In early 2026, the industry has reached record levels of political spending, largely in a defensive reaction to the Trump administration’s health policy changes. The pharmaceutical and health products industry is consistently the #1 spender on federal lobbying in the U.S., outspending even the oil and defense industries. In the first half of 2025, the industry spent a record $227 million on federal lobbying.
Social media users chimed in to express their opinions on the matter.
“I worked for a major insurance company for 16 years. They gave $40k incentive bonuses to pediatric groups who had vaccination rates at 95% of patients. The year they started doing this, my unvaccinated children were discharged as patients from the pediatrician that had been seeing them since birth. This is why it’s so hard to get care for unvaccinated children. We switched to a Family Medicine doctor and haven’t had problems since,” said one online user on X.
“When I was pregnant and trying to find a pediatrician 12 years ago, I had to interview at least 7 before I found one who would even entertain the idea of allowing an alternative vax schedule, and even then he made me keep up with her vaccines because I refused to go by the CDC schedule,” said another.
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