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

Sec. 4006. HEAL for Immigrant Families Act

(a) Consistency in health insurance coverage for individuals with federally authorized presence, including deferred action

(1) In general. For purposes of eligibility under any of the provisions described in paragraph (2), all individuals granted federally authorized presence in the United States shall be considered to be lawfully present in the United States.

(2) Provisions described. The provisions described in this paragraph are the following:

(A) Exchange eligibility. Section 1411 of the Patient Protection and Affordable Care Act (42 U.S.C. 18031).

(B) Reduced cost-sharing eligibility. Section 1402 of the Patient Protection and Affordable Care Act (42 U.S.C. 18071).

(C) Premium subsidy eligibility. Section 36B of the Internal Revenue Code of 1986 (26 U.S.C. 36B).

(D) Medicaid and chip eligibility. Titles XIX and XXI of the Social Security Act, including under section 1903(v) of such Act (42 U.S.C. 1396b(v)).

(3) Effective date

(A) In general. Paragraph (1) shall take effect on the date of enactment of this Act.

(B) Transition through special enrollment period. In the case of an individual described in paragraph (1) who, before the first day of the first annual open enrollment period under subparagraph (B) of section 1311(c)(6) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)) beginning after the date of enactment of this Act, is granted federally authorized presence in the United States and who, as a result of such subsection, qualifies for a subsidy under a provision described in subparagraph (B) or (C) of paragraph (2), the Secretary of Health and Human Services shall establish a special enrollment period under subparagraph (C) of such section 1311(c)(6) during which such individual may enroll in qualified health plans through Exchanges under title I of the Patient Protection and Affordable Care Act and qualify for such a subsidy. For such an individual who has been granted federally authorized presence in the United States as of the date of enactment of this Act, such special enrollment period shall begin not later than 90 days after such date of enactment. Nothing in this paragraph shall be construed as affecting the authority of the Secretary to establish additional special enrollment periods under such subparagraph (C).

(b) State option To expand Medicaid and CHIP to individuals without lawful presence

(1) Medicaid

(A) In general. Section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended—

(i) in subclause (XXII), by striking or at the end;

(ii) in subclause (XXIII), by striking the semicolon and inserting ; or; and

(iii) by adding at the end the following new subclause:

Text this section adds to the law

(XXIV) who would be eligible under the State plan (or waiver of such plan) under this title if they were citizens of the United States;

(B) Conforming amendment. Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended, in the matter preceding paragraph (1)—

(i) in the matter designated as clause (xvii), by striking or at the end;

(ii) in the matter designated as clause (xviii), by adding or at the end; and

(iii) by inserting after the matter designated as clause (xviii) the following:

Text this section adds to the law

(xix) individuals described in section 1902(a)(10)(A)(ii)(XXIV),

(2) CHIP. Title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) is amended by inserting after section 2112 the following new section:

Text this section adds to the law

2112A. State option to provide coverage for individuals without lawful presence. A State may elect through an amendment to its State child health plan under section 2102 to treat an individual as a targeted low-income child or a targeted low-income pregnant woman for purposes of this title if such individual would otherwise be included as such a child or such a pregnant woman (as applicable) under such plan if the individual were a citizen of the United States.

(3) Nonapplication of eligibility prohibition. Section 401(a) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (42 U.S.C. 1611(a)) is amended by adding at the end the following new sentence: The preceding sentence shall not apply with respect to a noncitizen’s eligibility under a State plan (or waiver of such plan) under title XIX of the Social Security Act or under a State child health plan (or waiver of such plan) under title XXI of such Act to the extent that such State has elected to make such individual so eligible pursuant to section 1902(a)(10)(A)(ii)(XXIV) or 2112A of such Act, respectively..

(c) Preserving access to coverage

(1) In general. Nothing in this section, including the amendments made by this section, shall prevent lawfully present noncitizens who are ineligible for full benefits under the Medicaid program under title XIX of the Social Security Act from securing a credit for which such lawfully present noncitizens would be eligible under section 36B(c)(1)(B) of the Internal Revenue Code of 1986 and under the Medicaid provisions for lawfully present noncitizens, as in effect on the date prior to the date of enactment of this Act.

(2) Definition. For purposes of paragraph (1), the term full benefits means, with respect to an individual and State, medical assistance for all services covered under the State plan under title XIX of the Social Security Act that is not less in amount, duration, or scope, or is determined by the Secretary of Health and Human Services to be substantially equivalent to the medical assistance available for an individual described in section 1902(a)(10)(A)(i) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(i)).

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