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

Sec. 4104. Indian defined in title I of the Patient Protection and Affordable Care Act

(a) Definition of Indian. Section 1304 of the Patient Protection and Affordable Care Act (42 U.S.C. 18024) is amended by adding at the end the following:

Text this section adds to the law

(f) Indian. In this title:

(1) In general. The term Indian means—

(A) an Indian, a California Indian, or an Urban Indian (as those terms are defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)); or

(B) an individual who is of Indian descent and a member of an Indian community served by a local facility or program of the Indian Health Service.

(2) Inclusions. The term Indian includes the following individuals:

(A) A member of a federally recognized Indian Tribe.

(B) A resident of an urban center who meets 1 or more of the following criteria:

(i) A member of a Tribe, band, or other organized group of Indians, including those Tribes, bands, or groups terminated since 1940 and those recognized as of the date of enactment of the Health Equity and Accountability Act of 2026 or later by the State in which they reside, or being a descendant, in the first or second degree, of any such member.

(ii) An Eskimo or Aleut or other Alaska Native.

(iii) An individual who is determined to be an Indian under regulations promulgated by the Secretary.

(C) An individual who is considered by the Secretary of the Interior to be an Indian for any purpose.

(D) An individual who is considered by the Secretary to be an Indian for purposes of eligibility for services provided by the Indian Health Service, including as a California Indian, Eskimo, Aleut, or other Alaska Native.

(b) Conforming amendments

(1) Affordable choices of health benefit plans. Section 1311(c)(6)(D) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)(D)) is amended by striking (as defined in section 4 of the Indian Health Care Improvement Act).

(2) Reduced cost-sharing for individuals enrolling in qualified health plans. Section 1402(d) of the Patient Protection and Affordable Care Act (42 U.S.C. 18071(d)) is amended—

(A) in paragraph (1), in the matter preceding subparagraph (A), by striking (as defined in section 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b(d))); and

(B) in paragraph (2), in the matter preceding subparagraph (A), by striking (as so defined).

(3) Exemption from penalty for not maintaining minimum essential coverage. Section 5000A(e) of the Internal Revenue Code of 1986 is amended by striking paragraph (3) and inserting the following:

Text this section adds to the law

(3) Indians. Any applicable individual who is an Indian (as defined in section 1304(f) of the Patient Protection and Affordable Care Act).

(c) Effective date of IRC amendment. The amendment made by subsection (b)(3) shall apply to taxable years beginning after the date of the enactment of this Act.

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