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

E Reproductive and Sexual Health

Sec. 5403. Duties of pharmacies to ensure provision of FDA-approved contraception

Part B of title II of the Public Health Service Act (42 U.S.C. 238 et seq.) is amended by adding at the end the following:

Text this section adds to the law

249. Duties of pharmacies to ensure provision of FDA-approved contraception

(a) In general. Subject to subsection (c), a pharmacy that receives Food and Drug Administration-approved drugs or devices in interstate commerce shall maintain compliance with each of the following:

(1) If a customer requests a contraceptive or a medication related to a contraceptive, including emergency contraception, that is in stock, the pharmacy shall ensure that the requested contraceptive or medication is provided to the customer without delay.

(2) If a customer requests a contraceptive or a medication related to a contraceptive that is not in stock and the pharmacy in the normal course of business stocks contraception, the pharmacy shall immediately inform the customer that the requested contraceptive or medication is not in stock and without delay offer the customer the following options:

(A) If the customer prefers to obtain the requested contraceptive or medication through a referral or transfer, the pharmacy shall—

(i) locate a pharmacy of the customer’s choice or the closest pharmacy confirmed to have the requested contraceptive or medication in stock; and

(ii) refer the customer or transfer the prescription to that pharmacy.

(B) If the customer prefers for the pharmacy to order the requested contraceptive or medication, the pharmacy shall obtain the contraceptive or medication under the pharmacy’s standard procedure for expedited ordering of medication and notify the customer when the contraceptive or medication arrives.

(3) The pharmacy shall ensure that—

(A) the pharmacy does not operate an environment in which customers are intimidated, threatened, or harassed in the delivery of services relating to a request for contraception or a medication related to a contraceptive;

(B) the pharmacy’s employees do not interfere with or obstruct the delivery of services relating to a request for contraception or a medication related to a contraceptive;

(C) the pharmacy’s employees do not intentionally misrepresent or deceive customers about the availability of a contraceptive or a medication related to a contraceptive, or the mechanism of action of such contraceptive or medication;

(D) the pharmacy’s employees do not breach medical confidentiality with respect to a request for a contraceptive or a medication related to a contraceptive or threaten to breach such confidentiality; or

(E) the pharmacy’s employees do not refuse to return a valid, lawful prescription for a contraceptive or a medication related to a contraceptive upon customer request.

(b) Contraceptives not ordinarily stocked. Nothing in subsection (a)(2) shall be construed to require any pharmacy to comply with such subsection if the pharmacy does not ordinarily stock contraceptives or medications related to contraceptives, as the case may be, in the normal course of business.

(c) Refusals pursuant to standard pharmacy practice. This section does not prohibit a pharmacy from refusing to provide a contraceptive or a medication related to a contraceptive to a customer in accordance with any of the following:

(1) If it is unlawful to dispense the requested contraceptive or medication to the customer without a valid, lawful prescription and no such prescription is presented.

(2) If the customer is unable to pay for the requested contraceptive or medication.

(3) If the employee of the pharmacy refuses to provide the requested contraceptive or medication on the basis of a professional clinical judgment.

(d) Relation to other law

(1) Rule of construction. Nothing in this section shall be construed to invalidate or limit rights, remedies, procedures, or legal standards under title VII of the Civil Rights Act of 1964.

(2) Certain claims. The Religious Freedom Restoration Act of 1993 shall not provide a basis for a claim concerning, or a defense to a claim under, this section, or provide a basis for challenging the application or enforcement of this section.

(e) Preemption. This section does not preempt any provision of State law or affect any professional obligation made applicable by a State board or other entity responsible for licensing or discipline of pharmacies or pharmacists, to the extent that such State law or professional obligation provides protections for customers that are greater than the protections provided by this section.

(f) Enforcement

(1) Civil penalty. A pharmacy that violates a requirement of subsection (a) is liable to the United States for a civil penalty in an amount not exceeding $1,000 per day of violation, not to exceed $100,000 for all violations adjudicated in a single proceeding.

(2) Private cause of action. Any person aggrieved as a result of a violation of a requirement of subsection (a) may, in any court of competent jurisdiction, commence a civil action against the pharmacy involved to obtain appropriate relief, including actual and punitive damages, injunctive relief, and a reasonable attorney’s fee and costs.

(3) Limitations. A civil action under paragraph (1) or (2) may not be commenced against a pharmacy after the expiration of the 5-year period beginning on the date on which the pharmacy allegedly engaged in the violation involved.

(g) Definitions. In this section:

(1) Contraception. The term contraception or contraceptive means any drug or device approved by the Food and Drug Administration to prevent pregnancy.

(2) Employee. The term employee means a person hired, by contract or any other form of an agreement, by a pharmacy.

(3) Medication related to a contraceptive. The term medication related to a contraceptive means any drug or device approved by the Food and Drug Administration that a medical professional determines necessary to use before or in conjunction with use of a contraceptive.

(4) Pharmacy. The term pharmacy means an entity that—

(A) is authorized by a State to engage in the business of selling prescription drugs at retail; and

(B) employs one or more employees.

(5) Product. The term product means a Food and Drug Administration-approved drug or device.

(6) Professional clinical judgment. The term professional clinical judgment means a clinical judgment, formed with the use of professional knowledge and skills, in accordance with prevailing medical standards.

(7) Without delay. The term without delay, with respect to a pharmacy providing, providing a referral for, or ordering contraception, or transferring the prescription for contraception, means within the usual and customary timeframe at the pharmacy for providing, providing a referral for, or ordering other products, or transferring the prescription for other products, respectively.

(h) Effective date. This section shall take effect on the 31st day after the date of the enactment of this section, without regard to whether the Secretary has issued any guidance or final rule regarding this section.

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