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

B Pregnancy screening

C Pregnancy-Related care

D Federal agency coordination on maternal health

Sec. 5303. Expanding models to be tested by Center for Medicare and Medicaid Innovation to explicitly include maternity care and children’s health models

Section 1115A(b)(2) of the Social Security Act (42 U.S.C. 1315a(b)(2)), as amended by section 5209(b), is amended—

(1) in subparagraph (B), by adding at the end the following:

Text this section adds to the law

(xxix) Promoting evidence-based models of care that have been associated with reductions in pregnancy-related and infant health inequities, including incorporating the use of and payment for doulas, particularly community-based doulas, and promoting support for people during pregnancy and for the one-year period after the last day of such person’s pregnancy, through evidence-based models of antepartum, birth, postpartum care, and two-generation birthing person and newborn care models, and supporting the risk-appropriate use of out-of-hospital birth models, including births at home and in freestanding birth centers. Such models shall be selected and evaluated based on their impact on quality, equity, and developmental outcomes, notwithstanding any other provision of this section.

(2) in subparagraph (C), by adding at the end the following:

Text this section adds to the law

(ix) Whether the model includes a regular process for ensuring the provision of culturally and linguistically appropriate services.

(x) Whether health care services and supportive services included in the model are tailored to community health and health-related social needs and provided by community-based and community-led providers.

(xi) Whether the model is designed to mitigate harmful effects of discrimination on the basis of race, sex, disability, ethnicity, language, and age.

; and

(3) by adding at the end the following:

Text this section adds to the law

(D) Mandatory health equity models to be tested. The Secretary shall select— Such models shall be selected and evaluated based on their impact on quality, equity, and developmental outcomes, notwithstanding any other provision of this section.

(i) Medicaid payment models for culturally and linguistically appropriate antepartum, labor and delivery, and postpartum doula services, including community-based doula services, that are—

(I) structured to provide payment to doulas as individuals, health care entity staff, or members of a doula group or collective, or through a third-party administrator;

(II) designed to reduce racial and intersecting health inequities;

(III) designed to provide doulas providing support with an equitable and sustainable reimbursement rate;

(IV) designed to reduce barriers to workforce entry for culturally and linguistically competent and racially congruent doulas to provide services to Medicaid enrollees; and

(V) designed with input from community-based doulas, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries;

(ii) a Medicaid episode-based payment model for pregnancy-related services, including health care services and supportive services to address health-related social needs, during the prenatal, intrapartum, and postpartum periods, to improve health outcomes and reduce racial health inequities, and to be designed with input from maternity care providers, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries;

(iii) a Medicaid alternative payment model for a pregnancy-related health home service to improve health outcomes during and for one year after pregnancy and during the newborn period, and to reduce racial health inequities, designed with input from maternity care providers, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries;

(iv) a Medicaid perinatal health worker service delivery model for culturally and linguistically appropriate and respectful health care and supportive services that are tailored to community health and health-related social needs, designed to improve health outcomes and mitigate harmful effects of racism and other forms of discrimination, and provided by community-based and community-led providers; and

(v) one or more models exclusively focused on early intervention and prevention for children enrolled in a State plan (or waiver of such plan) under title XIX or a State child health plan under title XXI using evidence-based interventions including parenting support programs, home-visiting services, and dyadic therapy treatment for children and adolescents at risk.

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