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. 4706. Enabling State Medicaid programs to provide care through health homes to individuals with sickle cell disease

Section 1945 of the Social Security Act (42 U.S.C. 1396w–4) is amended—

(1) in subsection (a), by inserting (and, beginning January 1, 2027, to eligible individuals with sickle cell disease (as defined in subsection (c)(5))) after chronic conditions;

(2) in subsection (c)—

(A) in paragraph (1), by inserting and each eligible individual with sickle cell disease after chronic conditions; and

(B) by adding at the end the following new paragraph:

Text this section adds to the law

(5) Special rule relating to sickle cell disease health homes

(A) In general. Beginning January 1, 2027, the Secretary may approve a State plan amendment under this section that is designed to provide health home services primarily to eligible individuals with sickle cell disease (in this section referred to as a sickle cell disease-focused State plan amendment).

(B) Requirement to provide dental and vision services. In the case of a sickle cell disease-focused State plan amendment approved by the Secretary on or after January 1, 2027, a State shall ensure the provision of dental and vision services to eligible individuals with sickle cell disease who are enrolled in such health home. Such requirement shall apply irrespective of existing requirements related to comparability or whether or not the State provides dental or vision services to other Medicaid beneficiaries.

(C) Report requirements

(i) In general. In the case of a State with a sickle cell disease-focused State plan amendment, such State shall, at the end of the first 8 fiscal year quarters that such State plan amendment is in effect, submit to the Secretary a report on the following, with respect to eligible individuals with sickle cell disease provided health home services under such State plan amendment:

(I) The quality of health care provided to such individuals, with a focus on outcomes relevant to the recovery of each such individual.

(II) The access of such individuals to health care.

(III) The total expenditures of such individuals for health care.

(ii) Applicable measures. For purposes of the report required under this subparagraph, the Secretary shall specify all applicable measures for determining quality of health care provided to eligible individuals with sickle cell disease, access to health care by such individuals, and expenditures on health care by such individuals.

(D) Best practices. Not later than June 30, 2027, the Secretary shall make publicly available on the website of the Centers for Medicare & Medicaid Services best practices for designing and implementing a sickle cell disease-focused State plan amendment, based on clinical practice guidelines for sickle cell disease developed by medical specialty societies and in consultation with sickle cell disease providers and patient advocacy organizations.

(E) Definitions. For purposes of this section:

(i) Eligible individual with sickle cell disease. The term eligible individual with sickle cell disease means, with respect to a State, an individual who satisfies all of the following:

(I) The individual is eligible for medical assistance under the State plan or under a waiver of such plan.

(II) The individual has sickle cell disease.

(III) The individual may or may not have previously received health home services under any other State plan amendment approved for the State under this section by the Secretary.

(ii) Sickle cell disease. The term sickle cell disease means an inherited blood disorder affecting red blood cells that occurs when an individual has inherited a sickle cell gene from each parent, as identified by a newborn screening or other genetic test.

; and

(3) in subsection (h)—

(A) in paragraph (3), by inserting or an eligible individual with sickle cell disease after chronic conditions; and

(B) in paragraph (5), by inserting or a health home for eligible individuals with sickle cell disease after chronic conditions.

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