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

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

Sec. 5001. Grants to promote health for underserved communities

Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:

Text this section adds to the law

399Z–3. Grants to promote health for underserved communities

(a) Grants Authorized. The Secretary, in collaboration with the Administrator of the Health Resources and Services Administration and other Federal officials determined appropriate by the Secretary, may award grants to eligible entities—

(1) to promote health for medically underserved communities, such as racial and ethnic minority women, racial and ethnic minority children, adolescents, and lesbian, gay, bisexual, transgender, queer, nonbinary, gender-nonconforming, or questioning communities; and

(2) to strengthen health outreach initiatives in medically underserved communities, including linguistically isolated populations.

(b) Use of Funds. Grants awarded pursuant to subsection (a) may be used to support the activities of community health workers, including such activities—

(1) to provide education and outreach regarding enrollment in health insurance including the State Children’s Health Insurance Program under title XXI of the Social Security Act, Medicare under title XVIII of such Act, and Medicaid under title XIX of such Act;

(2) to provide education and outreach in a community setting regarding health problems prevalent among medically underserved communities, and especially among racial and ethnic minority women, racial and ethnic minority children, adolescents, and lesbian, gay, bisexual, transgender, queer, nonbinary, gender-nonconforming, or questioning communities;

(3) to provide education and experiential learning opportunities and target risk factors and healthy behaviors that impede or contribute to achieving positive health outcomes, including—

(A) healthy nutrition;

(B) physical activity;

(C) overweight or obesity;

(D) tobacco use, including the use of e-cigarettes and vaping;

(E) alcohol and substance use;

(F) injury and violence;

(G) sexual health;

(H) mental health;

(I) musculoskeletal health and arthritis;

(J) prenatal and postnatal care;

(K) dental and oral health;

(L) understanding informed consent;

(M) stigma; and

(N) environmental hazards;

(4) to promote community wellness and awareness; and

(5) to provide education and refer target populations to appropriate health care agencies and community-based programs and organizations in order to increase access to quality health care services, including preventive health services.

(c) Application

(1) In general. Each eligible entity that desires to receive a grant under subsection (a) shall submit an application to the Secretary at such time, in such manner, and accompanied by such additional information as the Secretary may require.

(2) Contents. Each application submitted pursuant to paragraph (1) shall—

(A) describe the activities for which assistance under this section is sought;

(B) contain an assurance that, with respect to each community health worker program receiving funds under the grant awarded, such program provides in-language training and supervision to community health workers to enable such workers to provide authorized program activities in (at least) the most commonly used languages within a particular geographic region;

(C) contain an assurance that the applicant will evaluate the effectiveness of community health worker programs receiving funds under the grant;

(D) contain an assurance that each community health worker program receiving funds under the grant will provide culturally competent services in the linguistic context most appropriate for the individuals served by the program;

(E) contain a plan to document and disseminate project descriptions and results to other States and organizations as identified by the Secretary; and

(F) describe plans to enhance the capacity of individuals to utilize health services and health-related social services under Federal, State, and local programs by—

(i) assisting individuals in establishing eligibility under the programs and in receiving the services or other benefits of the programs; and

(ii) providing other services, as the Secretary determines to be appropriate, which may include transportation and translation services.

(d) Priority. In awarding grants under subsection (a), the Secretary shall give priority to those applicants—

(1) who propose to target geographic areas that—

(A)

(i) have a high percentage of residents who are uninsured or underinsured (if the targeted geographic area is located in a State that has elected to make medical assistance available under section 1902(a)(10)(A)(i)(VIII) of the Social Security Act to individuals described in such section);

(ii) have a high percentage of underinsured residents in a particular geographic area (if the targeted geographic area is located in a State that has not so elected); or

(iii) have a high number of households experiencing extreme poverty; and

(B) have a high percentage of families for whom English is not their primary language or including smaller limited English-proficient communities within the region that are not otherwise reached by linguistically appropriate health services;

(2) with experience in providing health or health-related social services to individuals who are underserved with respect to such services; and

(3) with documented community activity and experience with community health workers.

(e) Collaboration with academic institutions. The Secretary shall encourage community health worker programs receiving funds under this section to collaborate with academic institutions, including minority-serving institutions. Nothing in this section shall be construed to require such collaboration.

(f) Quality assurance and cost-Effectiveness. The Secretary shall establish guidelines for ensuring the quality of the training and supervision of community health workers under the programs funded under this section and for ensuring the cost-effectiveness of such programs.

(g) Monitoring. The Secretary shall monitor community health worker programs identified in approved applications and shall determine whether such programs are in compliance with the guidelines established under subsection (f).

(h) Technical assistance. The Secretary may provide technical assistance to community health worker programs identified in approved applications with respect to planning, developing, and operating programs under the grant.

(i) Report to Congress

(1) In general. Not later than 4 years after the date on which the Secretary first awards grants under subsection (a), the Secretary shall submit to Congress a report regarding the grant project.

(2) Contents. The report required under paragraph (1) shall include the following:

(A) A description of the programs for which grant funds were used.

(B) The number of individuals served.

(C) An evaluation of—

(i) the effectiveness of these programs;

(ii) the cost of these programs; and

(iii) the impact of these programs on the health outcomes of the community residents.

(D) Recommendations for sustaining the community health worker programs developed or assisted under this section.

(E) Recommendations regarding training to enhance career opportunities for community health workers.

(j) Definitions. In this section:

(1) Community health worker. The term community health worker means an individual who promotes health or nutrition within the community in which the individual resides—

(A) by serving as a liaison between communities and health care agencies;

(B) by providing guidance and social assistance to community residents;

(C) by enhancing community residents’ ability to effectively communicate with health care providers;

(D) by providing culturally and linguistically appropriate health or nutrition education;

(E) by advocating for individual and community health, including dental, oral, mental, and environmental health, or nutrition needs;

(F) by taking into consideration the needs of the communities served, including the prevalence rates of risk factors that impede achieving positive healthy outcomes among pregnant, birthing, and postpartum people and children, especially among racial and ethnic minority pregnant, birthing, and postpartum people and children; or

(G) by providing referral and followup services.

(2) Community setting. The term community setting means a home or a community organization that serves a population.

(3) Eligible entity. The term eligible entity means—

(A) a unit of State, territorial, local, or Tribal government (including a federally recognized Tribe or Alaska Native village); or

(B) a community-based organization.

(4) Medically underserved community. The term medically underserved community means a community—

(A) that has a substantial number of individuals who are members of a medically underserved population, as defined by section 330(b)(3);

(B) a significant portion of which is a health professional shortage area as designated under section 332; and

(C) that includes populations that are linguistically isolated, such as geographic areas with a shortage of health professionals able to provide linguistically appropriate services.

(5) Support. The term support means the provision of training, supervision, and materials needed to effectively deliver the services described in subsection (b), reimbursement for services, and other benefits.

(k) Authorization of Appropriations. There are authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2027 through 2031.

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