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By Jasmine Laws
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The Trump administration has announced a major change to how health care provision will be assessed in 2026, particularly in relation to immunization.
In the official announcement, which was shared on December 30, the Centers for Medicare and Medicaid Services (CMS) stated that it is removing four measures relating to pediatric and prenatal immunization status from the 2026 Child and Adult Core Sets.
Health and Human Services (HHS) Secretary Robert F. Kennedy Jr wrote in a post on the social media platform X: "Government bureaucracies should never coerce doctors or families into accepting vaccines or penalize physicians for respecting patient choice."
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He added: "That practice ends now. Under the Trump administration, HHS will protect informed consent, respect religious liberty, and uphold medical freedom."
Why It Matters
The move follows a series of others made by the Trump administration against the recommendation of vaccines.
The Centers for Disease Control and Prevention (CDC) changed its recommendations for the COVID-19 vaccine in October, 2025, from urging nearly all Americans aged six months and older to get updated vaccines to leaving the decision up to individuals and their doctors.
In regard to the debate around vaccines and autism, the CDC also changed its website page on vaccine safety, to say: "The claim 'vaccines do not cause autism' is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism," according to The Associated Press.
Kennedy Jr also ended the longstanding recommendation that all U.S. newborns receive a hepatitis B shot on the day they are born, among many other policies that have sought to roll back vaccine development, recommendations and requirements.
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What To Know
The four measures that are being removed from the Child and Adult Core Sets include childhood immunization status, immunizations for adolescents, and prenatal immunization status for both those under age 21, and age 21 and older, according to the official announcement report.
The Child and Adult Core Sets refer to the set of standardized health care quality measures for children and adults used to determine the quality of the care provided to those using Medicaid and the Children's Health Insurance Program (CHIP).
The briefing states measures regarding childhood immunization status and immunizations for adolescents will be "removed from 2026 mandatory stratification requirements," and are instead listed as measures that can be voluntarily reported.
This means that immunization coverage will no longer be included in the assessment of health care provision quality to those using Medicaid and CHIP, signaling another shift of the Trump administration to make immunization a personal choice, rather than a recommended or required aspect of health care provision.
Studies have previously suggested that the inclusion of immunization in quality measures can "drive vaccine uptake" by providing data on vaccination rates.
This move comes as vaccination rates across the country are declining, which has been thought to be the reason why certain vaccine-preventable diseases like measles, whooping cough, and others have been on the rise in America.
However, supporters of the change have said that it will mean doctors are no longer "financially punished if patients decline vaccines, including for religious reasons."
Robby Starbuck, a conservative American social media activist who has more than 860,000 followers on X, wrote in a post that the move means "Medicaid and CHIP payments will no longer be tied to prenatal and childhood vaccine numbers."
"In the past, some providers avoided patients with religious objections to vaccines because it could hurt their ratings and payments. That perverse incentive is now gone," Starbuck added. His post was shared by Kennedy, who thanked him for "bringing attention to this update."
Postpartum and prenatal depression screening and follow-up are other measures also being changed to a voluntary reporting measure instead of a requirement for the assessment of health care provision quality, according to the CMS announcement.
What People Are Saying
CMS said in the announcement: "In 2026 and beyond, CMS will explore options to facilitate the development of new vaccine
measures that capture information about whether parents and families were informed about vaccine choices, vaccine safety and side effects, and alternative vaccine schedules. CMS plans to engage with stakeholders, including states, quality measure stewards, immunization registry managers, providers, and electronic health record vendors to learn how new measures could
capture person and family preferences related to vaccines. CMS will also explore how religious exemptions for vaccinations can be accounted for in the data and the subsequent measures.
"CMS does not tie payment to performance on immunization quality measures in Medicaid and CHIP at the federal level. While states have flexibility and discretion to use quality measures in state developed value-based purchasing and payment incentive fee for service or managed care programs, CMS strongly discourages states from using immunization measures in payment
arrangements."
What Happens Next
The announcement also includes a series of changes set to come into action in 2027. These include evaluations regarding hepatitis B and C testing, and oval evaluations for diabetes among adults being changed from required data collection to voluntary reporting measures.
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