H.R. 9877

Health Equity and Accountability Act of 2026

Sponsor: Raul Ruiz

26 cosponsors
Follow this bill

Official summary

No official summary yet.

Text of the bill

Expand all

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

2 Closing the meal gap

Sec. 10212. Inclusion of Puerto Rico in supplemental nutritional assistance program

(a) Definitions. Section 3 of the Food and Nutrition Act of 2008 (7 U.S.C. 2012) is amended—

(1) in subsection (r), by inserting the Commonwealth of Puerto Rico, after Guam,; and

(2) in subsection (u)(3)(B), by striking Guam and and inserting Guam, the Commonwealth of Puerto Rico, and after Guam,.

(b) Eligible households. Section 5 of the Food and Nutrition Act of 2008 (7 U.S.C. 2014) is amended—

(1) in subsection (b), in the first sentence, by inserting the Commonwealth of Puerto Rico, after Guam,;

(2) in subsection (c)—

(A) in paragraph (1), by striking and Guam, and inserting Guam, and the Commonwealth of Puerto Rico,; and

(B) in the undesignated matter at the end, by striking States or Guam and inserting States, Guam, or the Commonwealth of Puerto Rico; and

(3) in subsection (e)—

(A) in paragraph (1)(A), by inserting the Commonwealth of Puerto Rico, after Hawaii, each place it appears; and

(B) in paragraph (6)(B), in the matter preceding clause (i), by inserting the Commonwealth of Puerto Rico, after Guam,.

(c) Effective date

(1) In general. The amendments made by subsections (a) and (b) shall be effective with respect to the Commonwealth of Puerto Rico on the date described in paragraph (2) if the Secretary of Agriculture submits to Congress a certification under subsection (f)(2)(C) of section 19 of the Food and Nutrition Act of 2008 (7 U.S.C. 2028) (as added by subsection (d)).

(2) Date described. The date referred to in paragraph (1) is the date established by the Commonwealth of Puerto Rico in the applicable plan of operation submitted to the Secretary of Agriculture under subsection (f)(1) of section 19 of the Food and Nutrition Act of 2008 (7 U.S.C. 2028) (as added by subsection (d)).

(d) Transition of Puerto Rico to supplemental nutrition assistance program. Section 19 of the Food and Nutrition Act of 2008 (7 U.S.C. 2028) is amended by adding at the end the following:

Text this section adds to the law

(f) Transition of Puerto Rico to supplemental nutrition assistance program

(1) Request for participation. The Commonwealth of Puerto Rico may submit to the Secretary a request to participate in the supplemental nutrition assistance program, which shall include a plan of operation described in section 11(d), including a description of the date on which the Commonwealth of Puerto Rico intends to begin participation in the supplemental nutrition assistance program.

(2) Certification by Secretary

(A) In general. On submission of a request by the Commonwealth of Puerto Rico under paragraph (1), the Secretary shall certify the Commonwealth of Puerto Rico as qualified to participate in the supplemental nutrition assistance program if the Secretary—

(i) approves the plan of operation submitted with the request, in accordance with this subsection; and

(ii) approves the applications described in paragraph (4) in accordance with that paragraph.

(B) Deadline. The Secretary shall certify or deny the request of the Commonwealth of Puerto Rico under paragraph (1) not later than 90 days after the date on which the Secretary receives the request.

(C) Submission to Congress. The Secretary shall submit a certification under subparagraph (A) to Congress.

(3) Determination of plan of operation

(A) Approval. The Secretary shall approve a plan of operation submitted with a request under paragraph (1) if the plan satisfies the requirements under this Act.

(B) Disapproval. If the Secretary does not approve a plan of operation submitted with a request under paragraph (1), the Secretary shall provide a statement that describes each requirement under this Act that is not satisfied by the plan.

(4) Approval of retail food stores. If the Secretary approves a plan of operation under paragraph (3)(A) for the Commonwealth of Puerto Rico, the Secretary shall accept applications from retail food stores located in the Commonwealth of Puerto Rico to be authorized under section 9 to participate in the supplemental nutrition assistance program.

(5) Family Market Program. Notwithstanding subsection (g), the Secretary shall allow the Commonwealth of Puerto Rico to continue to carry out under the supplemental nutrition assistance program the Family Market Program established pursuant to this section.

(6) Temporary funding. If the Commonwealth of Puerto Rico has a request under paragraph (1) pending before the Secretary (including a plan of operation pending under paragraph (3)), the Commonwealth of Puerto Rico shall receive block grants under this section, in amounts determined by the Secretary, until the date on which the Secretary certifies the Commonwealth of Puerto Rico under paragraph (2)(B).

(7) Authorization of appropriations. There are authorized to be appropriated to the Secretary such sums as are necessary to carry out this subsection for fiscal year 2027, to remain available until expended.

(g) Technical infrastructure implementation

(1) In general. The Commonwealth of Puerto Rico may request from the Secretary a 1-time grant to pay for the cost of the technology infrastructure necessary to implement the supplemental nutrition assistance program, including the cost of information technology, information technology personnel, and training relating to program implementation.

(2) Application. In making a request under paragraph (1), the Commonwealth of Puerto Rico shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including—

(A) a description of the costs to be paid for by the grant; and

(B) a plan for implementing the technology infrastructure described in paragraph (1)—

(i) within 1 year of receiving the grant; and

(ii) that is reasonably cost efficient, as determined by the Secretary.

(3) Determination

(A) Time limit. The Secretary shall approve or deny an application submitted under paragraph (2) not later than 90 days after the date on which the application is submitted.

(B) Denial. If the Secretary denies an application submitted under paragraph (2), the Commonwealth of Puerto Rico may amend the plan described in subparagraph (B) of that paragraph, in coordination with the Secretary, to resubmit to the Secretary for approval.

(4) Funding

(A) In general. There is appropriated to the Secretary, out of funds in the Treasury not otherwise appropriated, $112,500,000 to carry out this subsection, to remain available until 3 years after the date of enactment of this subsection.

(B) Reversion of funds. Any funds appropriated to the Secretary under subparagraph (A) that remain available by the date described in that subparagraph shall revert to the Treasury.

(h) Termination of effectiveness

(1) In general. Subsections (a) through (e) shall cease to be effective with respect to the Commonwealth of Puerto Rico on the date described in paragraph (2) if the Secretary submits to Congress a certification under subsection (f)(2)(C) for the Commonwealth of Puerto Rico.

(2) Date described. The date referred to in paragraph (1) is the date established by the Commonwealth of Puerto Rico in the applicable plan of operation submitted to the Secretary under subsection (f)(1).

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