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

2 Closing the meal gap

D Universal school meals

1 School breakfast program

2 School lunch program

3 Elementary and secondary education data

Sec. 10341. Measure of poverty

Section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)) is amended—

(1) in subparagraph (A), by striking the number of children eligible for a free or reduced price lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) and inserting the number of children from low-income backgrounds, identified under subparagraph (D); and

(2) by adding at the end the following:

Text this section adds to the law

(D) Identification of children from low-income backgrounds

(i) In general. A local educational agency or State agency, for the purpose of identifying children from low-income backgrounds enrolled in a school served by a local educational agency, may—

(I) maintain a record, with respect to each student for whom the local educational agency provides a free public education that contains the information collected from the survey described in clause (iii);

(II) distribute and collect a student survey based on the template developed under clause (iii) to identify children from low-income backgrounds; and

(III) utilize direct certification data described in clause (iv)(I) to identify children from low-income backgrounds.

(ii) Privacy

(I) In general. All individual data collected under this subparagraph shall be protected by the local educational agency or State agency in a manner consistent with all applicable local, State, and Federal privacy laws.

(II) Reporting data. Only aggregated data, which may include data disaggregated at the school, local educational agency, or State level, shall be reported to the Secretary at such time and in such manner as the Secretary may reasonably require.

(iii) Survey. Not later than 180 days after the date of enactment of the Universal School Meals Program Act of 2026, the Secretary, in consultation with the Secretary of Agriculture, shall develop a template survey—

(I) to identify children from low-income backgrounds that contains only the information necessary to identify a child as a child from a low-income background by using the criteria of eligibility for a free or reduced priced lunch under the Richard B. Russell National School Lunch Act, as such criteria were in effect on September 30, 2022; and

(II) that shall be designed to be easily accessible and in a user-friendly manner.

(iv) Transition authority from FRPL to ESEA measures. The Secretary, in coordination with the Secretary of Agriculture, shall have the authority to take such steps as are necessary to provide for the orderly transition to, and implementation of—

(I) activities that are necessary for the continuity of direct certification carried out by local educational agencies and State agencies specified in paragraphs (4), (5), and (15) section 9(b) of the Richard B. Russell National School Lunch Act, as in effect on September 30, 2022, for the purposes of identifying any child eligible for free or reduced priced lunch under such Act, as in effect on such date, as a child from a low-income background;

(II) procedures for verification of information collected under this subparagraph, which may include procedures modeled on the requirement specified in section 9(b)(3) of the Richard B. Russell National School Lunch Act, as in effect on September 30, 2022; and

(III) data privacy provisions for information collected under this subparagraph, in accordance with the requirements specified in section 9(b)(6) of the Richard B. Russell National School Lunch Act, as in effect on September 30, 2022.

(v) Special rule. For the purposes of subparagraph (A), a local educational agency may determine the number of children from low-income backgrounds enrolled in a school served by such agency using one or more of the following methods:

(I) Results from surveys specified in clause (i)(II).

(II) Direct certification data specified in clause (i)(III).

(III) Utilization of both methods described in subclauses (I) and (II).

4 Amendments to other programs and laws

XI Protections to combat regulatory harm to health equity