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

E Health Empowerment Zones

F Equitable Health Care for All

G Investing in Equity

H Miscellaneous

Sec. 4704. Women Expansion of Learning and Labor Safety (WELLS) Act

(a) Requiring hospitals participating in Medicare To develop discharge plans for pregnant individuals. Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is amended—

(1) in subsection (a)(1)—

(A) in subparagraph (X), by striking and at the end;

(B) in subparagraph (Y), by striking the period at the end and inserting , and; and

(C) by inserting after subparagraph (Y) the following new subparagraph:

Text this section adds to the law

(Z) beginning January 1, 2027, in the case of a hospital, critical access hospital, or rural emergency hospital, to comply with the requirements described in subsection (l)(1).

; and

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

Text this section adds to the law

(l) Discharge plan requirements for pregnant individuals

(1) In general. For purposes of subsection (a)(1)(Z), the requirements described in this paragraph are, with respect to a hospital, critical access hospital, or rural emergency hospital, that the hospital—

(A) provides for the development and implementation of a discharge plan meeting the standards under paragraph (2) with respect to any individual (whether or not eligible for benefits under this title) admitted to the hospital who—

(i) is identified as pregnant;

(ii) is experiencing signs or symptoms consistent with labor, which may include contractions; and

(iii) is expected to be discharged from the hospital, critical access hospital, or rural emergency hospital prior to delivery, as determined based on the documented clinical judgment of the treating physician or practitioner at the time that such discharge is contemplated;

(B) includes such discharge plan in the individual’s medical record; and

(C) provides for such discharge plan to be discussed with the individual (or the individual’s representative) prior to discharge.

(2) Discharge plan standards. A discharge plan for an individual described in paragraph (1)(A) meets the standards under this paragraph if such plan includes at least the following information:

(A) A clinical justification for the discharge.

(B) An assessment of travel distance and time between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.

(C) Verification of reliable transportation between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.

(D) Identification of a back-up hospital or facility at which such individual may obtain labor and delivery services.

(E) Confirmation that the plan was reviewed and approved by a qualified medical professional (as defined by the Secretary through regulations).

(F) Confirmation that the individual (or the individual’s representative) has received the information described in subparagraphs (A) through (D), that such information was provided in the primary language of such individual (or representative), and that such individual (or representative) confirmed their understanding of such information.

(3) Rule of construction. Nothing in this subsection shall be construed as limiting or otherwise affecting the discharge planning requirements otherwise applicable to a hospital, critical access hospital, or rural emergency hospital under this title.

(b) Rural maternal and obstetric care training demonstration grants. Section 764 of the Public Health Service Act (42 U.S.C. 294s) is amended—

(1) in subsection (c)(1)—

(A) in subparagraph (A), by striking and at the end;

(B) by redesignating subparagraph (B) as subparagraph (C); and

(C) by inserting after subparagraph (A) the following:

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(B) shall use the grant funds to provide racial bias training as part of such training program; and

(2) by redesignating subsections (d) and (e) as subsections (e) and (f), respectively;

(3) by inserting after subsection (c) the following:

Text this section adds to the law

(d) Minimum performance milestones

(1) Establishment. Beginning with the grants awarded under this section for fiscal year 2027, the Secretary shall establish minimum performance milestones that grant recipients must meet during a fiscal year as a condition of remaining eligible for funding through such a grant for any subsequent fiscal year.

(2) Milestones related to percent of staff trained. The minimum performance milestones referred to in paragraph (1) shall include milestones related to the percent of all staff of the grant recipient that are trained, or that receive refresher training, with support from a grant under this section.

; and

(4) in subsection (e), as so redesignated—

(A) in the subsection heading, by striking report and inserting reports;

(B) in paragraph (1)(B), by striking the report described in paragraph (2) and inserting the reports described in paragraphs (2) and (3); and

(C) by adding at the end the following:

Text this section adds to the law

(3) Subsequent reports. Not later than January 1, 2027, and annually thereafter, the Secretary shall submit to Congress, and make publicly available, a report that includes—

(A) updates to the information described in subparagraphs (A) through (C) of paragraph (2); and

(B) additional information regarding the grants under this section, including—

(i) a list of the entities receiving such grants;

(ii) the number and amount of such grants;

(iii) whether training supported by such grants was delivered in-person, virtually, asynchronously, or through some other format; and

(iv) descriptions of the geographical coverage of such grants, the number of providers trained under such grants, and patient-level metrics linked to such training (such as changes in clinical outcomes, patient experience, and racial disparities).

(c) Multi-Center implementation science initiative for maternal health. The Secretary of Health and Human Services, in consultation with the Director of the Agency for Healthcare Research and Quality and the Director of the National Institutes of Health, shall establish a multi-center implementation science initiative for maternal health to rigorously evaluate different training models for health care professionals (including in-person, virtual, simulation, and cohort-based) and the impact of such models on provider behavior, patient outcomes, and maternal health disparities.

(d) Maternal health dashboard. The Secretary of Health and Human Services shall develop, maintain, and make publicly available on the websites of the Department of Health and Human Services an interagency maternal health dashboard, which shall include maternal health outcome metrics from agencies within the Department of Health and Human Services and the data collected as part of the initiative under subsection (c), such as data related to maternal mortality and severe maternal morbidity, the number and outcomes of discharges of pregnant individuals prior to delivery from institutions, and data on Federal investments in maternal health research.

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