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

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

Sec. 7415. Expanding support for condoms in prisons

(a) Sense of congress regarding distribution of sexual barrier protection devices in state prison systems. It is the sense of Congress that States shall allow for the legal distribution of sexual barrier protection devices in State correctional facilities to reduce the prevalence and spread of STIs in those facilities.

(b) Authority To allow community organizations To provide STI counseling, STI prevention education, and sexual barrier protection devices in federal correctional facilities

(1) Directive to attorney general. Not later than 30 days after the date of enactment of this Act, the Attorney General shall direct the Director of the Bureau of Prisons to allow community organizations to, in accordance with all relevant Federal laws and regulations that govern visitation in Federal correctional facilities—

(A) distribute sexual barrier protection devices in Federal correctional facilities; and

(B) engage in STI counseling and STI prevention education in Federal correctional facilities.

(2) Information requirement. Any community organization permitted to distribute sexual barrier protection devices under paragraph (1) shall ensure that the individuals to whom the devices are distributed are informed about the proper use and disposal of sexual barrier protection devices in accordance with established public health practices. Any community organization conducting STI counseling or STI prevention education under paragraph (1) shall offer comprehensive sexuality education.

(3) Possession of device protected. A Federal correctional facility may not, because of the possession or use of a sexual barrier protection device—

(A) take adverse action against an incarcerated individual; or

(B) consider possession or use as evidence of prohibited activity for the purpose of any Federal correctional facility administrative proceeding.

(4) Implementation. The Attorney General and the Director of the Bureau of Prisons shall implement this section according to established public health practices in a manner that protects the health, safety, and privacy of incarcerated individuals and of correctional facility staff.

(c) Survey of and report on correctional facility programs aimed at reducing the spread of STIs

(1) Survey. Not later than 180 days after the date of enactment of this Act, and annually thereafter for 5 years, the Attorney General, after consulting with the Secretary of Health and Human Services, State officials, and community organizations, shall, to the maximum extent practicable, conduct a survey of all Federal and State correctional facilities, to determine the following:

(A) Counseling, treatment, and supportive services. Whether the correctional facility—

(i) requires incarcerated individuals to participate in counseling, treatment, and supportive services relating to STIs; or

(ii) offers such programs to incarcerated individuals.

(B) Access to sexual barrier protection devices. Whether incarcerated individuals can—

(i) possess sexual barrier protection devices;

(ii) purchase sexual barrier protection devices;

(iii) purchase sexual barrier protection devices at a reduced cost; or

(iv) obtain sexual barrier protection devices without cost.

(C) Incidence of sexual violence. The incidence of sexual violence and assault committed by incarcerated individuals and by correctional facility staff.

(D) Prevention education offered. The type of prevention education, information, or training offered to incarcerated individuals and correctional facility staff regarding sexual violence and the spread of STIs, including whether such education, information, or training—

(i) constitutes comprehensive sexuality education;

(ii) is compulsory for new incarcerated individuals and for new correctional facility staff; and

(iii) is offered on an ongoing basis.

(E) STI testing. Whether the correctional facility tests incarcerated individuals for STIs or gives them the option to undergo such testing—

(i) at intake;

(ii) on a regular basis; and

(iii) prior to release.

(F) STI test results. The number of incarcerated individuals who are tested for STIs and the outcome of such tests at each correctional facility, disaggregated to include results for—

(i) the type of STI tested for;

(ii) the race and ethnicity of an individual tested;

(iii) the age of an individual tested; and

(iv) the gender of the individual tested.

(G) Prerelease referral policy. Whether incarcerated individuals are informed prior to release about STI-related services or other health services in their communities, including free and low-cost counseling and treatment options.

(H) Prerelease referrals made. The number of referrals to community-based organizations or public health facilities offering STI-related or other health services provided to incarcerated individuals prior to release, and the type of counseling or treatment for which the referral was made.

(I) Reinstatement of medicaid benefits. Whether—

(i) the correctional facility assists incarcerated individuals that were enrolled in the State Medicaid program prior to their incarceration in reinstating their enrollment upon release; and

(ii) such individuals receive referrals as described in subparagraph (G) to entities that accept the State Medicaid program, including, if applicable—

(I) the number of such individuals, including those diagnosed with HIV, that have been reinstated;

(II) a list of obstacles to reinstating enrollment or to making determinations of eligibility for reinstatement, if any; and

(III) the number of individuals denied enrollment.

(J) Other actions taken. Whether the correctional facility has taken any other action, in conjunction with community organizations or otherwise, to reduce the prevalence and spread of STIs in that facility.

(2) Privacy. In conducting the survey under paragraph (1), the Attorney General shall not request or retain the identity of any individual who has sought or been offered counseling, treatment, testing, or prevention education information regarding an STI (including information about sexual barrier protection devices), or who has tested positive for an STI.

(3) Report

(A) In general. The Attorney General shall transmit to Congress and make publicly available the results of the survey required under paragraph (1), both for the United States as a whole and disaggregated as to each State and each correctional facility.

(B) Deadlines. To the maximum extent possible, the Attorney General shall—

(i) issue the first report under subparagraph (A) not later than 1 year after the date of enactment of this Act; and

(ii) issue reports under subparagraph (A) annually thereafter for 5 years.

(d) Strategy

(1) Directive to attorney general. The Attorney General, in consultation with the Secretary of Health and Human Services, State officials, and community organizations, shall develop and implement a 5-year strategy to reduce the prevalence and spread of STIs in Federal and State correctional facilities. To the maximum extent possible, the strategy shall be developed, transmitted to Congress, and made publicly available not later than 180 days after the transmission of the first report required under subsection (c)(3).

(2) Contents of strategy. The strategy developed under paragraph (1) shall include the following:

(A) Prevention education. A plan for improving prevention education, information, and training offered to incarcerated individuals and correctional facility staff, including information and training on sexual violence and the spread of STIs, and comprehensive sexuality education.

(B) Sexual barrier protection device access. A plan for expanding access to sexual barrier protection devices in correctional facilities.

(C) Sexual violence reduction. A plan for reducing the incidence of sexual violence among incarcerated individuals and correctional facility staff.

(D) Counseling and supportive services. A plan for expanding access to counseling and supportive services related to STIs in correctional facilities.

(E) Testing. A plan for testing incarcerated individuals for STIs during intake, during regular health exams, and prior to release that—

(i) is conducted in accordance with guidelines established by the Centers for Disease Control and Prevention;

(ii) includes pretest counseling;

(iii) requires that incarcerated individuals are notified of their option to decline testing at any time;

(iv) requires that incarcerated individuals are confidentially notified of their test results in a timely manner; and

(v) ensures that incarcerated individuals testing positive for STIs receive post-test counseling, care, treatment, and supportive services.

(F) Treatment. A plan for ensuring that correctional facilities have the necessary medicine and equipment to treat and monitor STIs and for ensuring that incarcerated individuals living with or testing positive for STIs receive and have access to care and treatment services.

(G) Strategies for demographic groups. A plan for developing and implementing culturally appropriate, sensitive, and specific strategies to reduce the spread of STIs among demographic groups heavily impacted by STIs.

(H) Linkages with communities and facilities. A plan for establishing and strengthening linkages to local community and health facilities that—

(i) provide counseling, testing, care, and treatment services;

(ii) may receive individuals recently released from incarceration who are living with STIs; and

(iii) accept payment through the State Medicaid program.

(I) Enrollment in state medicaid programs. Plans to ensure that—

(i) incarcerated individuals who were enrolled in their State Medicaid program prior to incarceration in a correctional facility are automatically reenrolled in such program upon their release; and

(ii) incarcerated individuals who were not enrolled in their State Medicaid program prior to incarceration, and who are diagnosed with HIV while incarcerated in a correctional facility, are automatically enrolled in such program upon their release.

(J) Other plans. Any other plans developed by the Attorney General for reducing the spread of STIs or improving the quality of health care in correctional facilities.

(K) Monitoring system. A monitoring system that establishes performance goals related to reducing the prevalence and spread of STIs in correctional facilities and which, where feasible, expresses such goals in quantifiable form.

(L) Monitoring system performance indicators. Performance indicators that measure or assess the achievement of the performance goals described in subparagraph (K).

(M) Cost estimate. A detailed estimate of the funding necessary to implement the strategy at the Federal and State levels for all 5 years, including the amount of funds required by community organizations to implement the parts of the strategy in which they take part.

(3) Report. Not later than 1 year after the date of the enactment of this Act, and annually thereafter, the Attorney General shall transmit to Congress and make publicly available an annual progress report regarding the implementation and effectiveness of the strategy described in paragraph (1). The progress report shall include an evaluation of the implementation of the strategy using the monitoring system and performance indicators provided for in subparagraphs (K) and (L) of paragraph (2).

(e) Authorization of appropriations

(1) In general. There are authorized to be appropriated such sums as may be necessary to carry out this section for each of fiscal years 2027 through 2031.

(2) Availability of funds. Amounts made available under paragraph (1) are authorized to remain available until expended.

(f) Definitions. In this section:

(1) Community organization. The term community organization means a public health care facility or a nonprofit organization that provides health- or STI-related services according to established public health standards.

(2) Comprehensive sexuality education. The term comprehensive sexuality education means sexuality education—

(A) that includes information about abstinence and about the proper use and disposal of sexual barrier protection devices; and

(B) that is—

(i) evidence based;

(ii) medically accurate;

(iii) age and developmentally appropriate;

(iv) gender and identity sensitive;

(v) culturally and linguistically appropriate; and

(vi) structured to promote critical thinking, self-esteem, respect for others, and the development of healthy attitudes and relationships.

(3) Correctional facility. The term correctional facility means any prison, penitentiary, adult detention facility, juvenile detention facility, jail, or other facility to which individuals may be sent after conviction of a crime or act of juvenile delinquency within the United States.

(4) Incarcerated individual. The term incarcerated individual means any individual who is serving a sentence in a correctional facility after conviction of a crime.

(5) Sexual barrier protection device. The term sexual barrier protection device means any physical device approved, cleared, or otherwise authorized by the Food and Drug Administration that has not been tampered with and which reduces the probability of STI transmission or infection between sexual partners, including female condoms, male condoms, and dental dams.

(6) Sexually transmitted infection. The term sexually transmitted infection or STI means any disease or infection that is commonly transmitted through sexual activity, including HIV, gonorrhea, chlamydia, syphilis, genital herpes, viral hepatitis, and human papillomavirus.

(7) State. The term State includes the District of Columbia, American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the United States Virgin Islands.

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

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