H.R. 9877

Health Equity and Accountability Act of 2026

Sponsor: Raul Ruiz

26 cosponsors
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I Data collection and reporting

II Culturally and linguistically appropriate health and health care

III Health workforce diversity

A Diversifying the health care workplace

B Substance Use Disorder Treatment and Behavioral and Mental Health Workforce

C ACCESS in Mental Health Act

D Developing the Community Health Workforce Act

IV Improving Health Care Access and Quality

A Reducing Barriers to Accessing Care

B Improvement of Coverage

C Expansion of Access

1 General Provisions

2 Rural

3 Indian Communities

4 Providers

5 Dental

D Advancing Health Equity Through Payment and Delivery Reform

Sec. 4305. Improving access to care for Medicare and Medicaid beneficiaries

Section 1115A of the Social Security Act (42 U.S.C. 1315a) is amended—

(1) in subsection (a)—

(A) in the last sentence of paragraph (1), by inserting advance health equity and before improve the coordination; and

(B) in the first sentence of paragraph (3)—

(i) by inserting (including the Office of Minority Health of the Centers for Medicare & Medicaid Services, the Office of Rural Health Policy of the Health Resources and Services Administration, and the Office on Women’s Health of the Department of Health and Human Services) after relevant Federal agencies; and

(ii) by striking experts with expertise in medicine and inserting experts with expertise in medicine, the causes of health disparities and the social determinants of health, and;

(2) in subsection (b)—

(A) in paragraph (2)—

(i) in subparagraph (A)—

(I) by inserting the following after the first sentence: Prior to selecting a model under this paragraph, the Secretary shall consult with the Office of Minority Health of the Centers for Medicare & Medicaid Services, the Office of Rural Health Policy of the Health Resources and Services Administration, and the Office on Women’s Health of the Department of Health and Human Services to ensure that models under consideration address health disparities and social determinants of health as appropriate for populations to be cared for under the model.;

(II) by inserting and, for models for which testing begins on or after January 1, 2027, address health equity as well as improving access to care received by individuals receiving benefits under such title after applicable title; and

(III) by adding at the end the following: The models selected under this subparagraph shall include the social determinants of health payment model described in subsection (h), the testing of which shall begin not later than December 31, 2027.; and

(ii) in subparagraph (C), by adding at the end the following new clauses:

Text this section adds to the law

(ix) Whether the model will affect access to care from providers and suppliers caring for high risk patients or operating in underserved areas.

(x) Whether the model has the potential to reduce health disparities, including minority and rural health disparities.

(B) in paragraph (3)(B)—

(i) in clause (i), by inserting or health equity after quality of care;

(ii) in clause (ii), by inserting or increasing health inequities after quality of care; and

(iii) in clause (iii), by inserting or health equity after quality of care; and

(C) in paragraph (4)(A)—

(i) in clause (i), by striking ; and and inserting a semicolon;

(ii) in clause (ii), by striking the period and inserting ; and; and

(iii) by adding at the end the following new clause:

Text this section adds to the law

(iii) for models for which testing begins on or after January 1, 2027, the extent to which the model improves health equity.

(3) in subsection (c)—

(A) in paragraph (1)—

(i) in subparagraph (A), by inserting or, beginning on or after January 1, 2027, increasing health inequities before the semicolon; and

(ii) in subparagraph (B), by inserting or, beginning on or after January 1, 2027, health equity after patient care; and

(B) in paragraph (3), by inserting or increase health disparities experienced by beneficiaries, including low-income, minority, or rural beneficiaries, or that such expansion would improve health equity before the period;

(4) in subsection (g), by adding at the end the following:

Text this section adds to the law

For reports submitted after the date of enactment of the Health Equity and Accountability Act of 2026, each such report shall include information on the following:

(1) The interventions that address social determinants of health, health disparities, or health equity in payment models selected by the CMI for testing under this section.

(2) Estimated Federal savings achieved through reducing disparities, including rural and minority health disparities, improving health equity, or addressing social determinants of health.

(3) The effectiveness of interventions in mitigating negative health outcomes and higher costs associated with social determinants of health within models selected by the Center for Medicare and Medicaid Innovation for testing.

(4) Other areas determined appropriate by the Secretary.

; and

(5) by adding at the end the following new subsection:

Text this section adds to the law

(h) Social determinants of health payment model

(1) In general. The social determinants of health payment model described in this subsection is a payment model that tests each of the payment and service delivery innovations described in paragraph (2) in a region determined appropriate by the Secretary.

(2) Payment and service delivery innovations described. For purposes of paragraph (1), the payment and service delivery innovations described in this clause are the following:

(A) Payment and service delivery innovations for behavioral health services, focusing on gathering actionable data to address the higher costs associated with beneficiaries with diagnosed behavioral conditions.

(B) Payment and service delivery innovations targeting conditions or comorbidities of individuals entitled or enrolled under the Medicare program under title XVIII and enrolled under a State plan under the Medicaid program under title XIX to increase capacity in underserved areas.

(C) Payment and service delivery innovations targeting conditions or comorbidities of applicable individuals to increase capacity in underserved areas.

(D) Payment and service delivery innovations targeted on Medicaid eligible pregnant and postpartum women, up to 1 year after delivery.

E Health Empowerment Zones

F Equitable Health Care for All

G Investing in Equity

H Miscellaneous

I Territories Health Equity

1 Medicare

A Part A

B Part B

C Medicare Advantage (Part C)

D Part D

2 Miscellaneous

V Improving health outcomes for women, gender-diverse people, children, and families

A Underserved communities

B Pregnancy screening

C Pregnancy-Related care

D Federal agency coordination on maternal health

E Reproductive and Sexual Health

F Children’s Health

G Elder Care

H Miscellaneous provisions

VI Mental health and substance use disorders

A Access to care and funding streams

B Interprofessional care

C Workforce development

D Children’s mental health

E Community-Based care

F Reports

G Miscellaneous provisions

VII Addressing high-impact minority diseases

A Cancer

B Viral hepatitis and liver cancer control and prevention

C Acquired bone marrow failure diseases

D Cardiovascular disease, chronic disease, obesity, and other disease issues

E HIV/AIDS

F Diabetes

G Lung disease

H Tuberculosis

I Osteoarthritis and Musculoskeletal Diseases

J Sleep and circadian rhythm disorders

K Kidney disease research, surveillance, prevention, and treatment

L Diversity in clinical trials

M Additional provisions addressing high-impact minority diseases

N Health Equity and Rare Disease Act

O Asunción Valdivia Heat Illness, Injury, and Fatality Prevention

P New Era of Preventing End-Stage Kidney Disease

VIII Health Information Technology

A Reducing Health Disparities Through Health IT

B Modifications To Achieve Parity in Existing Programs

C Additional Research and Studies

D Closing Gaps in Funding To Adopt Certified EHRs

E Expanding Access to Telehealth Services

IX Accountability and Evaluation

X Addressing Social Determinants and Improving Environmental Justice

A In General

B Gun Violence

C Nutrition for women, children, families

1 Senior hunger prevention

2 Closing the meal gap

D Universal school meals

1 School breakfast program

2 School lunch program

3 Elementary and secondary education data

4 Amendments to other programs and laws

XI Protections to combat regulatory harm to health equity