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

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

Sec. 10205. Food delivery under supplemental nutrition assistance program

The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) (as amended by section 10204) is amended by adding at the end the following:

Text this section adds to the law

34. Food delivery

(a) Definitions. In this section:

(1) Covered retail food store. The term covered retail food store means a retail food store, a public or private nonprofit meal delivery service, or a public or nonprofit meal delivery provider participating in the supplemental nutrition assistance program that is unable to cover the cost of food delivery for participants of the supplemental nutrition assistance program.

(2) Employee. The term employee has the meaning given the term in section 3 of the Fair Labor Standards Act of 1938 (29 U.S.C. 203).

(b) Program modifications

(1) In general. In carrying out the supplemental nutrition assistance program, the Secretary shall—

(A) notify retail food stores participating in the supplemental nutrition assistance program of existing opportunities through which the retail food stores can deliver food to program participants, including by—

(i) allowing an EBT card to be swiped with a mobile device on delivery of food to the home; and

(ii) preparing food for pickup;

(B) authorize public-private partnerships between the Department of Agriculture, retail food stores participating in the supplemental nutrition assistance program, and community-based organizations to provide free or low-cost food delivery, including through the use of private funds;

(C) in the case of a covered retail food store, use funds made available under subparagraph (E) of paragraph (3) to provide, in accordance with that paragraph, free grocery delivery for participants in the supplemental nutrition assistance program who are older adults or adults with disabilities (as those terms are defined in section 33(a)) who are unable to shop for food or lack safe and accessible transportation options to the covered retail food store; and

(D) require each State to submit to the Secretary a plan that describes the methods by which the State will—

(i) work with retail food stores participating in the supplemental nutrition assistance program and other community-based partners to establish a process for food delivery for program participants;

(ii) administer the reimbursements described in paragraph (3), including timing, eligibility, and distribution processes; and

(iii) ensure that retail food stores participating in the supplemental nutrition assistance program that are reimbursed for delivery costs under paragraph (3) adhere to the requirements described in subparagraph (B) of that paragraph.

(2) State plans. Not later than 10 days after the date on which the Secretary receives a State plan under paragraph (1)(D), the Secretary shall—

(A) determine whether to approve or disapprove the State plan; and

(B) make publicly available on the website of the Department of Agriculture—

(i) the State plan;

(ii) the determination made under subparagraph (A) with respect to that plan; and

(iii) any guidance issued to the State with respect to that plan.

(3) Reimbursement of covered retail food stores

(A) In general. Notwithstanding any other provision of law (including sections 274.7(f) and 278.2(b) of title 7, Code of Federal Regulations (or successor regulations), and any other regulations), subject to the availability of funds, a State agency shall reimburse a covered retail food store for the cost of food delivery to participants described in paragraph (1)(C) if—

(i) the covered retail food store meets the requirements under subparagraph (B); and

(ii) the majority of the number of food items delivered by the covered retail food store are eligible for redemption using benefits under the supplemental nutrition assistance program, regardless of whether the delivery includes nonfood items, subject to the condition that those nonfood items shall be of de minimis value.

(B) Requirements. A covered retail food store may receive reimbursement for the cost of food delivery to participants described in paragraph (1)(C) if the following requirements are met:

(i) Food delivery is performed by employees of the covered retail food store or employees of an entity contracted by the covered retail food store to perform deliveries.

(ii) Before any employee described in clause (i) begins making food deliveries, that employee receives employer-provided health and safety training that reflects the most recent guidelines of the Centers for Disease Control and Prevention.

(iii) All employees described in clause (i) performing deliveries are paid at a rate that is not less than the greater of—

(I) the minimum wage rate established under section 6(a)(1) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(a)(1)); and

(II) the minimum wage rate established by the applicable State or locality in which the employee works.

(iv) The covered retail food store meets the size standard determined by the Small Business Administration for a supermarket or other grocery retailer or a convenience retailer under section 121.201 of title 13, Code of Federal Regulations (or a successor regulation).

(v) The covered retail food store does not—

(I) charge the supplemental nutrition assistance program participant for delivery costs for which the covered retail food store will be reimbursed;

(II) require minimum purchase thresholds in order to provide free delivery;

(III) restrict delivery times to least-favorable windows for those participants; or

(IV) charge surge pricing.

(C) Reimbursable costs. Reimbursable costs under subparagraph (A) include costs associated with purchasing point-of-sale devices or receiving technical assistance relating to point-of-sale devices.

(D) Maximum reimbursement per delivery. The maximum amount of reimbursement under subparagraph (A) for a food delivery fee shall be $10 per delivery, which may be adjusted by the Secretary for inflation.

(E) Authorization of appropriations. There is authorized to be appropriated to the Secretary $500,000,000 for fiscal year 2027, and each fiscal year thereafter, to remain available until expended, to cover the cost of food delivery described in paragraph (1)(C), to be distributed among States to fund reimbursements by States under subparagraph (A).

(4) Report. Not later than April 30, 2027, and April 30 of each year thereafter, the Secretary shall submit to the Committee on Agriculture, Nutrition, and Forestry of the Senate and the Committee on Agriculture of the House of Representatives a report that describes, for the period covered by the report, as applicable—

(A) the number of supplemental nutrition assistance program participants using food delivery services, including the percentage of those participants that are older adults and adults with disabilities (as those terms are defined in section 33(a));

(B) the covered retail food stores that were reimbursed under paragraph (3), including the amount of each reimbursement;

(C) any complications or difficulties experienced by States in administering reimbursements under paragraph (3); and

(D) recommendations or best practices to assist States in implementing food delivery programs similar to the program under this section.

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