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

Sec. 4201. Amendment to the Public Health Service Act

Title XXXIV of the Public Health Service Act, as amended by titles I, II, and III of this Act, is further amended by inserting after subtitle C the following:

Text this section adds to the law

D Reconstruction and Improvement Grants for Public Health Care Facilities Serving Pacific Islanders and the Insular Areas

3441. Grant support for quality improvement initiatives

(a) In general. The Secretary, in collaboration with the Administrator of the Health Resources and Services Administration, the Director of the Agency for Healthcare Research and Quality, and the Administrator of the Centers for Medicare & Medicaid Services, shall award grants to eligible entities for the conduct of demonstration projects to improve the quality of and access to health care.

(b) Eligibility. To be eligible to receive a grant under subsection (a), an entity shall—

(1) be a health center, hospital, health plan, health system, community clinic, hospice or palliative care provider, or other health entity determined appropriate by the Secretary—

(A) that, by legal mandate or explicitly adopted mission, provides patients with access to services regardless of their ability to pay;

(B) that provides care or treatment for a substantial number of patients who are uninsured, are receiving assistance under a State plan under title XIX of the Social Security Act (or under a waiver of such plan), or are members of vulnerable populations, as determined by the Secretary; and

(C)

(i) with respect to which, not less than 50 percent of the entity’s patient population is made up of racial and ethnic minority groups; or

(ii) that—

(I) serves a disproportionate percentage of local patients who are from a racial and ethnic minority group, or has a patient population at least 50 percent of which is composed of individuals with limited English proficiency; and

(II) provides an assurance that amounts received under the grant will be used only to support quality improvement activities in the racial and ethnic minority group served; and

(2) prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

(c) Priority. In awarding grants under subsection (a), the Secretary shall give priority to eligible entities that—

(1) demonstrate an intent to operate as part of a health care partnership, network, collaborative, coalition, or alliance where each member entity contributes to the design, implementation, and evaluation of the proposed intervention; or

(2) intend to use funds to carry out systemwide changes with respect to health care quality improvement, including—

(A) improved systems for data collection and reporting;

(B) innovative collaborative or similar processes;

(C) group programs with behavioral or self-management interventions;

(D) case management services;

(E) physician or patient reminder systems;

(F) educational interventions;

(G) comprehensive and patient-centric health care;

(H) creation and distribution of education materials on available health care options; or

(I) other activities determined appropriate by the Secretary.

(d) Use of funds. An entity shall use amounts received under a grant under subsection (a) to support the implementation and evaluation of health care quality improvement activities or minority health and health care disparity reduction activities that include—

(1) with respect to health care systems, activities relating to improving—

(A) patient safety;

(B) timeliness of care;

(C) effectiveness of care;

(D) efficiency of care;

(E) patient centeredness;

(F) health information technology;

(G) accessibility and availability of information on health care;

(H) comprehensiveness of health care; and

(I) patient involvement and choice in health care; and

(2) with respect to patients, activities relating to—

(A) staying healthy;

(B) getting well, mentally and physically;

(C) living effectively with illness or disability;

(D) preparing for end of life and ensuring that end-of-life care is accessible and available, as well as coping with end-of-life issues; and

(E) shared decision making.

(e) Common data systems. The Secretary shall provide financial and other technical assistance to grantees under this section for the development of common data systems.

(f) Authorization of appropriations. There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2034.

3442. Centers of excellence

(a) In general. The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall designate centers of excellence at public hospitals, and other health systems serving large numbers of patients from minority populations, that—

(1) meet the requirements of section 3441(b)(1);

(2) demonstrate excellence in providing care to minority populations; and

(3) demonstrate excellence in reducing disparities in health and health care.

(b) Requirements. A hospital or health system that serves as a center of excellence under subsection (a) shall—

(1) design, implement, and evaluate programs and policies relating to the delivery of care in racially, ethnically, and linguistically diverse populations;

(2) provide training and technical assistance to other hospitals and health systems relating to the provision of high-quality health care to minority populations; and

(3) develop activities for graduate or continuing medical education that institutionalize a focus on cultural competence training for health care providers.

(c) Authorization of appropriations. There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2027 through 2034.

3443. Reconstruction and improvement grants for public health care facilities serving pacific islanders and the insular areas

(a) In general. The Secretary shall provide direct financial assistance to designated health care providers and community health centers in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii for the purposes of reconstructing and improving health care facilities and services in a culturally competent and sustainable manner.

(b) Eligibility. To be eligible to receive direct financial assistance under subsection (a), an entity shall be a public health facility or community health center located in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, or Hawaii that—

(1) is owned or operated by—

(A) the Government of American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, or Hawaii or a unit of local government; or

(B) a nonprofit organization; and

(2)

(A) provides care or treatment for a substantial number of patients who are uninsured, are receiving assistance under title XVIII of the Social Security Act or under a State plan under title XIX of such Act (or under a waiver of such plan), or are members of a vulnerable population, as determined by the Secretary; or

(B) serves a disproportionate percentage of local patients that are from a racial and ethnic minority group.

(c) Report. Not later than 180 days after the date of enactment of this title and annually thereafter, the Secretary shall submit to the Congress and the President a report that includes an assessment of health resources and facilities serving populations in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii. In preparing such report, the Secretary shall—

(1) consult with and obtain information on all health care facilities needs from the entities receiving direct financial assistance under subsection (a);

(2) include all amounts of Federal assistance received by each such entity in the preceding fiscal year;

(3) review the total unmet needs of health care facilities serving American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii, including needs for renovation and expansion of existing facilities;

(4) include a strategic plan for addressing the needs of each such population identified in the report; and

(5) evaluate the effectiveness of the care provided by measuring patient outcomes and cost measures.

(d) Authorization of appropriations. There are authorized to be appropriated such sums as necessary to carry out this section.

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