Bill,

>>I think Bernie's point is that there are tens of millions of people in the US who can't afford any medical treatment or insurance but at least in the states where I've lived, poor kids, including my brother and myself way back, could be vaccinated at no cost.

Here's Medicaid coverage of vaccination: https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/quality-of-care-vaccines/index.html

Vaccination is fully covered for kids of financially disadvantaged families to the age of 21. In addition, CDC bulk purchases vaccines and distributes them to state and other agencies for the VCP program that "provides vaccines at no cost to children who are ... uninsured, underinsured, or an American Indian or Alaska Native through age 18." As the page notes, "CMS is currently collaborating with other Department of Health and Human Services (HHS) officials on the ACIP to identify gaps in adult immunization activities and to develop recommendations to improve vaccination rates in adults."

I don't think it's a realistic bogeyman that the poor won't have access to vaccines... not least since the Medicaid legislation specifically disallows Medicaid providers refusing care or services to any beneficiary due to their inability to pay any portion of a cost sharing arrangement.

Military families are fully covered for vaccination under TRICARE to CDC's recommended schedule.

Insured adults: "All Health Insurance Marketplace plans and most other private insurance plans must cover CDC's recommended vaccinations without charging a copayment or coinsurance when provided by an in-network provider. This is true even for patients who have not met a yearly deductible."

Medicare B covers the usual vaccination (flu, hepatitis, rabies after injury etc) with Medicare D covering most immunizations that prevent illness e.g. shingles, Tdap.

So if anybody who wants vaccine is going to miss out, it sounds like middle class people who have elected to self-insure... but my pick is that in the interest of immunity, CDC will bulk purchase vaccine so cost is limited to the administration fee at most. My expectation is that if this develops into a serious pandemic inside US borders, the administration will offer mass vaccination including for legal and illegal aliens as a public health measure. We shall see.

BTW, I see that SCOTUS has agreed to hear a claim that the ACA is invalid because it failed to maintain "individual mandate" without which complainants say the scheme cannot succeed. The argument is one you have heard here before (!) but the requested decision (to strike down ACA) would be a big problem in view of current Congress dysfunction.