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

Sec. 2002. Improving access to services for individuals with limited english proficiency

(a) Purpose. It is the purpose of this section—

(1) to improve Federal agency performance regarding access to federally conducted and federally assisted programs and activities for individuals with limited English proficiency;

(2) to require each Federal agency to examine the services it provides and develop and implement a system by which individuals with limited English proficiency can obtain culturally competent services and meaningful access to those services consistent with, and without substantially burdening, the fundamental mission of the agency;

(3) to require each Federal agency to translate any English language written material prepared for the general public into the top 15 non-English languages in the United States (according to the most recent data from the American Community Survey or its replacement) within established timelines described in subsection (b)(2)(C)(v);

(4) to require each Federal agency to ensure that recipients of Federal financial assistance provide meaningful access to applicants and beneficiaries who are individuals with limited English proficiency and culturally competent services to all individuals;

(5) to ensure that recipients of Federal financial assistance take reasonable steps, consistent with the guidelines set forth in the Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons (67 Fed. Reg. 41455 (June 18, 2002)), to ensure culturally and linguistically appropriate access to their programs and activities by individuals with limited English proficiency; and

(6) to ensure compliance with title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.) and section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116) (prohibiting health care providers and organizations from discriminating in the provision of services).

(b) Federally conducted programs and activities

(1) In general. Not later than 120 days after the date of enactment of this Act, each Federal agency providing financial assistance to, or administering, a health program or activity described in section 2003(a) shall prepare a plan or update a plan to improve culturally and linguistically appropriate access to such program or activity with respect to individuals with limited English proficiency. Not later than 1 year after the date of enactment of this Act, each such Federal agency shall ensure that such plan is fully implemented.

(2) Plan requirement. Each plan under paragraph (1) shall include—

(A) the steps the agency will take to ensure that individuals with limited English proficiency have access to each health program or activity supported or administered by the agency;

(B) the policies and procedures for identifying, assessing, and meeting the culturally and linguistically appropriate language needs of its beneficiaries, including those who are individuals with limited English proficiency, served by such a program or activity;

(C) the steps the agency will take for such program or activity to be culturally and linguistically appropriate by—

(i) providing a range of language assistance options;

(ii) giving notice to individuals with limited English proficiency of the right to competent language services;

(iii) training staff (at least annually);

(iv) monitoring and assessing the quality of the language services (at least annually); and

(v) translating any English language written material prepared for the general public into the top 15 non-English languages in the United States (according to the most recent data from the American Community Survey or its replacement) within established timelines that ensure that high-quality, culturally competent translated material is provided promptly within not more than 15 calendar days in general and within not more than 7 calendar days in the case of any national emergency or State disaster declaration;

(D) the steps the agency will take for such program or activity to provide reasonable accommodations necessary for all individuals, including individuals with limited English proficiency and other groups, to understand communications from the agency;

(E) the steps the agency will take to ensure that applications, forms, and other significant documents for such program or activity are competently translated into the primary language of a client that is an individual with limited English proficiency where such materials are needed to improve access of such client to such program or activity;

(F) the resources the agency will provide to improve cultural and linguistic appropriateness to assist recipients of Federal funds to improve access to health care-related programs and activities for individuals with limited English proficiency;

(G) the resources the agency will provide to ensure that competent language assistance is provided to patients that are individuals with limited English proficiency by interpreters or trained bilingual staff;

(H) the resources the agency will provide to ensure that family, particularly minor children, and friends are not used to provide interpretation services, except as permitted under section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116); and

(I) the steps the agency will take and resources the agency will provide to ensure that individuals know their rights, including the ability to and procedures to file a complaint.

(3) Submission of plan to DOJ. Each agency that is required to prepare a plan under paragraph (1) shall—

(A) consult with populations who are directly impacted by policies in the plan and their representatives in the development of the plan; and

(B) when the plan is finalized, send a copy of the plan, and any subsequent material updates to such plan, to the Attorney General, who shall serve as the central repository of all such plans.

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

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