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

Sec. 4003. Removing barriers to health care and nutrition assistance for children, pregnant persons, and lawfully present individuals

(a) Medicaid. Section 1903(v) of the Social Security Act (42 U.S.C. 1396b(v)) is amended by striking paragraphs (4) and (5) and inserting the following new paragraph:

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(4)

(A) Notwithstanding sections 401(a), 402(b), 403, and 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and paragraph (1), payment shall be made to a State under this section for medical assistance furnished to an alien under this title (including an alien described in such paragraph) who meets any of the following conditions:

(i) The alien is otherwise eligible for such assistance under the State plan approved under this title (other than the requirement of the receipt of aid or assistance under title IV, supplemental security income benefits under title XVI, or a State supplementary payment) within either or both of the following eligibility categories:

(I) Children under 21 years of age, including any optional targeted low-income child (as such term is defined in section 1905(u)(2)(B)).

(II) Pregnant persons during pregnancy and during the 12-month period beginning on the last day of the pregnancy.

(ii) The alien is lawfully present in the United States.

(B) No debt shall accrue under an affidavit of support against any sponsor of an alien who meets the conditions specified in subparagraph (A) on the basis of the provision of medical assistance to such alien under this paragraph and the cost of such assistance shall not be considered as an unreimbursed cost.

(b) CHIP. Subparagraph (Q) of section 2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is amended to read as follows:

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(Q) Paragraph (4) of section 1903(v) (relating to coverage of categories of children, pregnant persons, and other lawfully present individuals).

(c) Supplemental nutrition assistance program benefits

(1) Personal Responsibility and Work Opportunity Reconciliation Act of 1996

(A) Federal public benefits. Section 401(b) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1611(b)) is amended by adding at the end the following:

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(6) Subsection (a) shall not apply to benefits under the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) for an individual who is lawfully present in the United States, regardless of—

(A) the immigration status of the individual; or

(B) the date of entry by the individual into the United States.

(B) Other specified Federal programs. Section 402(a) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1612(a)) is amended—

(i) in paragraph (2)—

(I) in subparagraph (D)(ii)—

(aa) in the clause heading, by striking Food stamps and inserting Supplemental nutrition assistance program; and

(bb) in subclause (I), in the first sentence, by striking Food Stamp Act of 1977 and inserting Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.);

(II) in subparagraph (F)(ii), by striking (within and all that follows through the end of the clause and inserting (within the meaning of section 3(j) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(j))).;

(III) in subparagraph (G)(ii), by striking section 4(e) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b(e))) and inserting section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304));

(IV) in subparagraph (I), in the subparagraph heading, by striking Food stamp and inserting Supplemental nutrition assistance program;

(V) in subparagraph (J), in the subparagraph heading, by striking Food stamp and inserting Supplemental nutrition assistance program;

(VI) in subparagraph (K)—

(aa) in the subparagraph heading, by striking Food stamp and inserting Supplemental nutrition assistance program; and

(bb) in clause (i), by striking subclause (I) and inserting the following:

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(I) is lawfully present in the United States, regardless of the immigration status of the individual or the date of entry by the individual into the United States; and

; and

(VII) by striking subparagraph (L) and inserting the following:

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(L) Supplemental nutrition assistance program benefits generally. With respect to eligibility for benefits for the specified Federal program described in paragraph (3)(B), paragraph (1) shall not apply to any individual who is lawfully present in the United States, regardless of—

(i) the immigration status of the individual; or

(ii) the date of entry by the individual into the United States.

; and

(ii) in paragraph (3)—

(I) in the matter preceding subparagraph (A), by striking For purposes of and inserting In; and

(II) by striking subparagraph (B) and inserting the following:

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(B) SNAP. The supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.).

(C) Certain limited eligibility. Section 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1613) is amended—

(i) in subsection (b)—

(I) in the matter preceding paragraph (1), by striking aliens;

(II) in paragraph (2)(C), by striking an individual described in clause (i) or (ii) and inserting such an individual; and

(III) by adding at the end the following:

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(4) Supplemental nutrition assistance program benefits. Benefits under the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) for an individual who is lawfully present in the United States, regardless of—

(A) the immigration status of the individual; or

(B) the date of entry by the individual into the United States.

; and

(ii) in subsection (c)(2)(L), by striking the Food Stamp Act of 1977 (7 U.S.C. 2011 et seq.) and inserting the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.).

(2) Food and Nutrition Act of 2008

(A) In general. Section 6(f) of the Food and Nutrition Act of 2008 (7 U.S.C. 2015(f)) is amended—

(i) in paragraph (2)—

(I) by redesignating subparagraphs (B), (C), and (D) as clauses (ii), (iii), and (iv), respectively;

(II) by striking the paragraph designation and all that follows through a citizen in subparagraph (A) and inserting the following:

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(B)

(i) a citizen

; and

(III) in the undesignated matter following clause (iv) of subparagraph (B) (as so redesignated)—

(aa) by striking the individual and inserting an individual; and

(bb) by striking The income and inserting the following:

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(2) Factor for consideration. The income

(ii) by redesignating paragraph (1) as subparagraph (A) and indenting the subparagraph appropriately;

(iii) by striking (f) No individual and inserting the following:

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(f) Aliens

(1) In general. Subject to paragraph (3), no individual

; and

(iv) by adding at the end the following:

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(3) Clarification of applicability. Notwithstanding paragraph (1), an individual who is lawfully present in the United States shall not be considered to be ineligible for benefits under that paragraph on the basis of—

(A) the immigration status of the individual; or

(B) the date of entry by the individual into the United States.

(B) Conforming amendment. Section 5(i)(1) of the Food and Nutrition Act of 2008 (7 U.S.C. 2014(i)(1)) is amended, in the first sentence, by striking section 6(f)(2)(B) of this Act and inserting section 6(f)(1)(B)(ii).

(d) Eligibility for families with children. Section 421(d) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1631(d)) is amended by striking paragraph (3) and inserting the following:

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(3) Supplemental nutrition assistance program. This section shall not apply to benefits under the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.), to the extent that a child is a member of a household under that program.

(e) Ensuring proper screening. Section 11(e)(2)(B) of the Food and Nutrition Act of 2008 (7 U.S.C. 2020(e)(2)(B)) is amended—

(1) by redesignating clauses (vi) and (vii) as clauses (vii) and (viii), respectively; and

(2) by inserting after clause (v) the following:

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(vi) shall provide a method for implementing section 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1631) that does not require any unnecessary information from an individual who may be exempt from that provision;

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