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. 2005. Pilot program for improvement and development of state medical interpreting services

(a) Grants authorized. The Secretary of Health and Human Services (referred to in this section as the Secretary) shall award 1 grant in accordance with this section to each of 3 States (to be selected by the Secretary) to assist each such State in designing, implementing, and evaluating a statewide program to provide onsite interpreter services under the State Medicaid plan.

(b) Grant period. A grant awarded under this section is authorized for the period of 3 fiscal years beginning on October 1, 2026, and ending on September 30, 2029.

(c) Preference. In awarding a grant under this section, the Secretary shall give preference to a State—

(1) that has a high proportion of qualified LEP enrollees, as determined by the Secretary;

(2) that has a large number of qualified LEP enrollees, as determined by the Secretary;

(3) that has a high growth rate of the population of individuals with limited English proficiency, as determined by the Secretary; and

(4) that has a population of qualified LEP enrollees that is linguistically diverse, requiring interpreter services in at least 200 non-English languages.

(d) Use of funds. A State receiving a grant under this section shall use the grant funds to—

(1) ensure that all health care providers in the State participating in the State Medicaid plan have access to onsite interpreter services, for the purpose of enabling effective communication between such providers and qualified LEP enrollees during the furnishing of items and services and administrative interactions;

(2) establish, expand, procure, or contract for—

(A) a statewide health care information technology system that is designed to achieve efficiencies and economies of scale with respect to onsite interpreter services provided to health care providers in the State participating in the State Medicaid plan; and

(B) an entity to administer such system, the duties of which shall include—

(i) procuring and scheduling interpreter services for qualified LEP enrollees;

(ii) procuring and scheduling interpreter services for individuals with limited English proficiency seeking to enroll in the State Medicaid plan;

(iii) ensuring that interpreters receive payment for interpreter services rendered under the system; and

(iv) consulting regularly with organizations representing LEP consumers, interpreters, and health care providers; and

(3) develop mechanisms to establish, improve, and strengthen the competency of the medical interpretation workforce that serves qualified LEP enrollees in the State, including a national certification process that is valid, credible, and vendor-neutral.

(e) Application. To receive a grant under this section, a State shall submit an application at such time and containing such information as the Secretary may require, which shall include the following:

(1) A description of the language access needs of individuals in the State enrolled in the State Medicaid plan.

(2) A description of the extent to which the program will—

(A) use the grant funds for the purposes described in subsection (d);

(B) meet the health care needs of rural populations of the State; and

(C) collect information that accurately tracks the language services requested by consumers as compared to the language services provided by health care providers in the State participating in the State Medicaid plan.

(3) A description of how the program will be evaluated, including a proposal for collaboration with organizations representing interpreters, consumers, and individuals with limited English proficiency.

(f) Definitions. In this section:

(1) Qualified lep enrollee. The term qualified LEP enrollee means an individual—

(A) who is limited English proficient; and

(B) who is enrolled in a State Medicaid plan.

(2) State. The term State has the meaning given the term in section 1101(a)(1) of the Social Security Act (42 U.S.C. 1301(a)(1)), for purposes of title XIX of such Act (42 U.S.C. 1396 et seq.).

(3) State medicaid plan. The term State Medicaid plan means a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) or a waiver of such a plan.

(4) United states. The term United States has the meaning given the term in section 1101(a)(2) of the Social Security Act (42 U.S.C. 1301(a)(2)), for purposes of title XIX of such Act (42 U.S.C. 1396 et seq.).

(g) Continuation past demonstration. Any State receiving a grant under this section must agree to directly pay for language services in Medicaid for all Medicaid providers by the end of the grant period.

(h) Funding

(1) Authorization of appropriations. There is authorized to be appropriated $5,000,000 to carry out this section.

(2) Availability of funds. Amounts appropriated pursuant to the authorization in paragraph (1) are authorized to remain available without fiscal year limitation.

(3) Increased federal financial participation. Section 1903(a)(2)(E) of the Social Security Act (42 U.S.C. 1396b(a)(2)(E)) is amended by inserting (or, in the case of a State that was awarded a grant under section 2005 of the Health Equity and Accountability Act of 2026, 100 percent for each quarter occurring during the grant period specified in subsection (b) of such section) after 75 percent.

(i) Limitation. No Federal funds awarded under this section may be used to provide interpreter services from a location outside the United States.

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