H.R. 9877 — Health Equity and Accountability Act of 2026

This section establishes a national working group on health workforce diversity, with representatives from specified federal agencies, institutions, organizations, and at least five health professions students. The group must convene at least twice annually to review initiatives, identify successful programs, develop a national strategic plan, evaluation methods, diversity standards, training guidelines, a workforce tracking system, and admissions strategies, and issue annual public reports with recommendations. It also establishes a technical clearinghouse within the Office of Minority Health to provide information on workforce diversity, statistical data, model practices, admissions and retention policies, and scholarship and loan programs. The section authorizes such sums as necessary for fiscal years 2027 through 2031.

This section establishes a grant program for Hispanic-serving institutions, historically Black colleges and universities, Asian American and Native American Pacific Islander-serving institutions, Tribal Colleges, regional community-based organizations, and national minority medical associations to provide counseling, mentoring, and financial assistance information to prepare underrepresented minority individuals for enrollment and graduation from health professional schools. It requires annual loan repayments of at least $50,000 per person for such individuals under the National Health Service Corps Loan Repayment Program and the program under section 317F. It authorizes appropriations for fiscal years 2027 through 2031.

This section reauthorizes the loan repayment program for health professionals serving at the Centers for Disease Control and Prevention or the Agency for Toxic Substances and Disease Registry through fiscal years 2027 through 2031 (from fiscal years 1995 through 2002). The program repays up to $50,000 per year in educational loans for professionals who agree to at least two years of prevention or preparedness and response activities.

This section authorizes the Secretary of Health and Human Services, acting through the Health Resources and Services Administration, to enter into cooperative agreements with schools of public health and schools of allied health to design and implement online degree programs. It requires priority for schools with a track record serving medically underserved communities, mandates enrollment of secondary school graduates with significant participation and high completion rates by underrepresented minority or disadvantaged students, limits agreements to three years, and authorizes such sums as necessary for fiscal years 2027 through 2031.

This section expresses the sense of Congress that the National Health Care Workforce Commission should give attention to the needs of racial and ethnic minority groups, individuals with lower socioeconomic status, individuals with mental, developmental, and physical disabilities, lesbian, gay, bisexual, transgender, queer, and questioning populations, and individuals who are members of multiple minority or special population groups. It authorizes appropriations of $3,000,000 for each of fiscal years 2027 through 2029 for the Commission (from such sums as may be necessary).

This section establishes the David Satcher Public Health and Health Services Corps to award grants supporting internships that increase awareness of non-research health professions careers among secondary and postsecondary students in health professional shortage areas, with stipends limited to $50 per day for up to 6 months. It creates the Louis Stokes Public Health Scholars Program to award scholarships of up to $20,000 per academic year for up to 4 years to eligible students pursuing public health careers. It also establishes the Patsy Mink Health and Gender Research Fellowship Program to award research fellowships examining gender and health disparities. All three programs are authorized for fiscal years 2027 through 2031.

This section requires the Secretary of Education to coordinate with the Secretary of Health and Human Services to align the Ronald E. McNair Postbaccalaureate Achievement Program with Health Resources and Services Administration efforts that promote health workforce diversity, and to encourage participating students to consider health profession careers. It also directs allocation of at least $31,000,000 annually for the program for each of fiscal years 2027 through 2031.

This section counts all time spent by interns and residents in approved medical residency training programs toward full-time equivalency determinations for both direct graduate medical education and indirect medical education payments. The change applies for cost-reporting periods beginning on or after October 1, 2027, at subsection (d) hospitals, subsection (d) Puerto Rico hospitals, hospitals reimbursed under section 1814(b)(3), and provider-based hospital outpatient departments.

This section establishes a grant program under which the Secretary of Health and Human Services, jointly with the Secretaries of Education and Labor, awards grants to eligible institutions of higher education to build evidence on strategies for increasing local health equity, serve as national models, and form strategic community partnerships to address health and health workforce needs. It authorizes such sums as may be necessary for each of fiscal years 2027 through 2031.

This section establishes the Health Professions Workforce Fund in the Health Resources and Services Administration to support health professions and nursing workforce programs under titles VII and VIII of the Public Health Service Act. It appropriates $392 million for FY2027, rising annually to $552 million for FY2034, of which $265 million to $373 million funds title VII programs and $127 million to $179 million funds title VIII programs.

This section establishes a grant program authorizing $1 billion for schools of nursing to increase faculty and students to strengthen preparedness for public health emergencies and pandemics, and to enhance and modernize nursing education programs. It requires priority for schools located in medically underserved communities or health professional shortage areas, and for certain minority-serving institutions, with equitable geographic distribution of awards. Funds may support student enrollment and retention (with priority for disadvantaged and rural students), curriculum modernization, faculty retention and hiring (with emphasis on underrepresented groups), infrastructure upgrades including simulation and telehealth equipment, clinical education partnerships, and nurse researcher programs. Grantees must submit annual reports, and the Secretary must submit a comprehensive report to Congress within 5 years. It also removes “Basic” from the heading of Part D of title VIII of the Public Health Service Act.

This section expresses the sense of Congress that eliminating the cap on Medicare-supported residency positions under section 1886(h) of the Social Security Act is critical to ensuring an adequate physician supply, equitable health care access, increased racial and ethnic diversity among physicians, and reduced health disparities.

This section authorizes the Secretary of Health and Human Services to award grants to clinical, public health, academic, nonprofit, and other eligible entities to assist unemployed and underemployed internationally educated health professionals who have legal permanent work authorization. The grants fund workforce entry and advancement services, training to reduce barriers, employer education on their skills, foreign credential evaluation, preceptorships for international medical graduates in primary care, and contextualized English language courses.

This section directs the Comptroller General to study strategies for increasing diversity in the health professional workforce, including the most effective approaches for recruiting from rural, lower-income, and underrepresented minority communities, and to report findings and recommendations for legislation and administrative action to Congress within 2 years of enactment.

This section extends the Conrad State 30 program through the date that is 3 years after enactment of the Health Equity and Accountability Act of 2026 (from September 30, 2015), effective as if enacted on September 30, 2018. It exempts from annual numerical limits alien physicians who completed required service under a J-1 waiver in medically underserved areas, along with their spouses and children. It authorizes the Secretary of Homeland Security to adjust such physicians to employment-authorized status, extends nonimmigrant status for up to 6 months when states reach annual waiver caps, and revises employment start deadlines, duration requirements, and violation standards for the 3-year service commitment.

This section authorizes the Secretary to award grants to institutions of higher education for the establishment, improvement, or expansion of schools of medicine or osteopathic medicine, or branch campuses. It requires priority for proposals to locate new schools in medically underserved communities or health professional shortage areas with no existing school (or no minority-serving school), or for minority-serving institutions, and directs funds to recruit students from disadvantaged, rural, low-income, and first-generation backgrounds while developing curricula on care for rural and underserved populations.

This section establishes the Substance Use Disorder Treatment and Behavioral and Mental Health Workforce Scholarship Program to award scholarships to full-time students in accredited programs leading to covered employment in substance use disorder treatment or behavioral and mental health services. Recipients must sign contracts for obligated service in mental health professional shortage areas, with the Secretary prioritizing applicants likely to remain in such areas after service and those from underrepresented groups.

This section states the purpose of the subtitle as increasing the number, size, and quality of accredited graduate training programs for mental and behavioral health professions at minority-serving institutions to address shortages in the mental and behavioral health professional workforce and diversify such workforce.

This section establishes a new competitive grant program under subpart 5 of Part A of title VII of the Higher Education Act to support graduate training in mental and behavioral health professions at historically Black colleges and universities, Hispanic-serving institutions, Tribal Colleges and Universities, and other minority-serving institutions. It authorizes grants to establish, expand, or plan such programs (including for school-based mental health services providers), requires at least 5 percent of funds for need-based scholarships or stipends prioritizing students from health professional shortage areas, and reserves up to 2 percent for technical assistance.

This section gives priority to applications for National Health Service Corps assignments in health professional shortage areas that are Federally qualified health centers and rural health clinics. It also directs the Secretary of Health and Human Services to award grants to Federally qualified health centers to make loan repayments for health care professionals serving at such centers, with applications requiring data on regional workforce shortages, repayment plans, and use of interdisciplinary care teams.

This section authorizes the Secretary to award grants to health centers for recruiting and hiring staff to serve rural and underserved populations and for supporting career advancement and workforce development. It directs the Secretary of Labor to revise regulations within 180 days so that federally qualified health centers are eligible to register as apprenticeship programs. It also authorizes grants to institutions of higher education, including community colleges and minority-serving institutions, for partnerships with health centers to train students in clinical, information technology, operations, finance, and other health professions, and grants to health centers to establish training programs for behavioral health specialists that may include stipends and apprenticeships.

This section expands eligibility for direct and indirect expense payments under the Teaching Health Center Graduate Medical Education program (42 USC 256h) to qualified teaching health centers that maintain a covered agreement of at least 2 years with a listed sponsoring institution, effective for expenses incurred on or after October 1, 2027. It also increases the otherwise applicable Medicare resident limit by 3 full-time equivalent positions for hospitals whose approved residency programs place a significant portion of training at a Federally qualified health center, for cost reporting periods beginning on or after October 1, 2027.

This section expands Medicare-covered services at federally qualified health centers to include behavioral health services furnished on or after October 1, 2026, by behavioral health consultants, peer support specialists, or other behavioral health professionals, and case management services furnished on or after October 1, 2026, by case managers. It requires the Secretary to study differences in State Medicaid payment adjustments to FQHCs and issue annual guidance on best practices beginning October 1, 2027.

This section prohibits immigration enforcement actions by DHS, ICE, CBP, and designated officers within 1,000 feet of sensitive locations except under exigent circumstances or rare premeditated operations targeting terrorists or national security threats with prior written approval. It requires officers to cease actions when exigent circumstances end, consult supervisors in real time if uncertain, limit time and scope at sensitive locations, and conduct operations discreetly. The section mandates annual training for specified officials, requires DHS to report each such action within 30 days to the DHS Inspector General and Office for Civil Rights and Civil Liberties, and bars use of resulting information as evidence in removal proceedings while allowing motions to terminate those proceedings.

This section repeals the requirement that individuals provide documentation evidencing citizenship or nationality to receive Medicaid benefits. It also repeals the corresponding requirement under the Children's Health Insurance Program (CHIP), eliminates related state plan provisions and verification rules, and takes effect on the date of enactment.

This section expands Medicaid eligibility for medical assistance to children under 21 years of age (including optional targeted low-income children) and pregnant persons during pregnancy and the following 12-month period, as well as to all lawfully present aliens, and bars sponsor debt accrual under affidavits of support for such coverage. It applies the same Medicaid rules to CHIP and removes all immigration status and entry-date restrictions on SNAP eligibility for lawfully present individuals.

This section revises the premium tax credit under section 36B by replacing the applicable percentage table for household income tiers. It sets contribution rates at 0.0 percent up to 150 percent of the poverty line, rising on a sliding scale to 8.5 percent at 400 percent and above, and extends eligibility to taxpayers with income at or above 400 percent of the poverty line (from the prior limit). The changes apply to taxable years beginning after December 31, 2026.

This section expands eligibility for premium tax credits under section 36B to noncitizens with household income at or below 100 percent of the poverty line who are ineligible for Medicaid due to immigration status, treating such taxpayers as applicable taxpayers. It also removes immigration status requirements for cost-sharing reductions under section 1402, basic health program eligibility under section 1331, and federal payment restrictions under section 1412, and eliminates the individual mandate penalty for certain noncitizens under section 5000A(d). The changes apply to plan years and taxable years beginning after December 31, 2026.

This section treats individuals granted federally authorized presence in the United States as lawfully present for eligibility under Affordable Care Act Exchanges, premium tax credits, cost-sharing reductions, Medicaid, and CHIP. It requires the Secretary to establish a special enrollment period, beginning no later than 90 days after enactment, during which such individuals may enroll and qualify for subsidies. It authorizes states to extend Medicaid and CHIP coverage to individuals without lawful presence. It preserves existing premium tax credit access for lawfully present noncitizens ineligible for full Medicaid benefits.

This section directs the Secretary of Health and Human Services to study the demographic characteristics of individuals without health insurance or oral health coverage and to predict the demographics of those who would remain uninsured after any annual or special enrollment period or after enactment of changes to the Patient Protection and Affordable Care Act. The Secretary must submit a report to Congress within 12 months, stratified by racial and ethnic minority group and by sexual orientation, gender identity, primary language, disability status, sex, socioeconomic status, age group, citizenship, and immigration status, and may not share data with immigration enforcement agencies or use it for exploitation or discrimination.

This section establishes a federal Medicaid fallback coverage program administered directly by the Secretary of Health and Human Services for individuals who would qualify under the Medicaid expansion group in section 1902(a)(10)(A)(i)(VIII) of the Social Security Act but reside in states that have not expanded Medicaid and did not do so as of the date of enactment. The coverage must include essential health benefits, impose no premiums, and limit cost-sharing to levels allowed under section 1916, with such sums as necessary appropriated beginning in fiscal year 2027.

This section extends the temporary enhanced Federal Medical Assistance Percentage (FMAP) for states that begin covering certain mandatory Medicaid individuals to a 40-quarter period (from 8 quarters) and increases the enhancement to 10 percentage points (from 5 percentage points). The changes apply retroactively as if enacted in section 9814 of the American Rescue Plan Act of 2021.

This section eliminates the Medicaid funding caps for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa beginning in fiscal year 2027. It removes the federal medical assistance percentage limitation for Puerto Rico for fiscal years 2027 and later. It also establishes disproportionate share hospital allotments for the territories, totaling $300 million in fiscal year 2027 allocated based on the number of low-income or uninsured individuals in each territory, with subsequent years subject to annual increases.

This section extends the Supplemental Security Income program under title XVI to Puerto Rico, the United States Virgin Islands, Guam, and American Samoa. It removes the prior cap on total federal payments to the territories. It treats United States nationals the same as citizens for eligibility and includes the territories in the geographic definition of the United States. It authorizes the Commissioner of Social Security to waive or modify statutory requirements as needed to adapt the program to each territory. The changes take effect on the first day of the first fiscal year beginning at least one year after enactment.

This section extends the Medicare secondary payer coordination period for individuals entitled to benefits due to end-stage renal disease to 42 months (from 12 months). The extension applies to items and services furnished on or after January 1, 2027, and lengthens the period for any individual already within the coordination period as of the date of enactment.

This section defines the term Indian in title I of the Patient Protection and Affordable Care Act to include members of federally recognized tribes, certain urban residents meeting specified tribal or descent criteria, Eskimos, Aleuts, Alaska Natives, and individuals considered Indian by the Secretary of the Interior or for Indian Health Service eligibility. It applies this definition to qualified health plan standards, reduced cost-sharing for Indians, and the exemption from the penalty for failing to maintain minimum essential coverage, with the tax code change effective for taxable years beginning after enactment.

This section expands Medicare Part A eligibility under section 1818 to individuals lawfully present in the United States (from aliens lawfully admitted for permanent residence with 5 years of continuous U.S. residency). It makes the same change to Part B eligibility under section 1836.

This section establishes the Medicare Cost Assistance Program effective January 1, 2027, to cover Part A and Part B premiums, coinsurance, and deductibles for individuals entitled to hospital insurance benefits with income at or below 200 percent of the poverty line, as well as individuals receiving Medicaid assistance for Medicare cost-sharing as of December 31, 2026. It requires joint eligibility determinations with the low-income subsidy program, annual redeterminations, automatic continuation absent changed circumstances, and a simplified multilingual application form developed in consultation with beneficiary groups.

This section increases the income eligibility threshold for qualified Medicare beneficiaries to 135 percent of the federal poverty level (from 100 percent) effective January 1, 2027, and for specified low-income Medicare beneficiaries to 200 percent (from 120 percent) effective the same date. It excludes in-kind support and maintenance from income, provides a 100 percent federal medical assistance percentage for newly eligible individuals, and consolidates resource tests for the Medicare Part D low-income subsidy by excluding life insurance policies, vehicles, and certain pension benefits.

This section makes permanent the 100 percent federal medical assistance percentage for medical assistance provided by urban Indian organizations, removing the prior eight-quarter limit that began after enactment of the American Rescue Plan Act of 2021. The change applies to services furnished on or after the date of enactment.

This section makes permanent the 100 percent federal medical assistance percentage for Medicaid services furnished to Native Hawaiians through a federally qualified health center or a Native Hawaiian health care system. The change applies to medical assistance provided on or after the date of enactment.

This section prohibits states from imposing liens on the property of Medicaid recipients prior to death, except pursuant to a court judgment for incorrectly paid benefits. It also prohibits any adjustment or recovery of correctly paid medical assistance from an individual's estate or otherwise.

This section establishes a 6-month special enrollment period for Medicare Part B beginning the first day after an individual is released from incarceration, for those incarcerated at initial eligibility or who declined enrollment during their initial period. It sets the monthly Part B premium to $0 for any month an individual is in custody under penal authority, and applies the same $0 premium rule to Part A premiums for such individuals.

This section directs the Director of the Office of Personnel Management to issue regulations treating pregnancy as a change in family status and qualifying life event for enrollment in a Federal Employees Health Benefits plan by an eligible individual who is not enrolled. The requirement applies to contracts entered into under 5 U.S.C. 8902 on or after the date that is one year after enactment.

This section removes the 185 percent upper income limit for Medicaid eligibility of pregnant individuals and infants. It requires states, beginning January 1, 2027, to maintain coverage at no less than the percentage each state had in effect as of January 1, 2014 (or the level set in its authorizing legislation or appropriations on that date if no plan amendment specified a percentage).

This section requires clinicians and other professionals in Medicare pay-for-reporting or value-based payment programs to stratify clinical quality measures by race, ethnicity, sex, primary language, disability status, sexual orientation, gender identity, and socioeconomic status. It incorporates performance in reducing disparities across those variables into value-based payment assessments, mandates certified EHR technology for Quality Payment Program participation, and adds implementation of Culturally and Linguistically Accessible Standards as quality improvement activities.

This section establishes a dedicated fund at the Center for Medicare and Medicaid Innovation to identify, test, evaluate, and scale delivery and payment models targeting health disparities among racial and ethnic minorities, including support for nonmedical services addressing social barriers such as transportation, housing, nutrition, and English proficiency. It revises the Center’s purpose to reduce expenditures and improve health equity, prioritizes models involving partnerships with community-based organizations, and requires all tested models to track impacts on disparities stratified by race, ethnicity, English proficiency, gender identity, sexual orientation, and disability status.

This section requires the Center for Medicare and Medicaid Innovation to consult clinical and analytical experts with expertise in the health care needs of minority, rural, and underserved populations and in the financial needs of safety net, community-based, rural, and critical access providers, including federally qualified health centers. It also directs the Center to use open door forums or other mechanisms to seek external feedback from interested parties and incorporate that feedback into model development.

This section requires any pay-for-performance or alternative payment model developed or tested by the Center for Medicare and Medicaid Innovation or other Department of Health and Human Services agencies for the Medicare, Medicaid, or CHIP programs to be assessed for its potential impact on safety net, community-based, and critical access providers, including federally qualified health centers. It also requires that rollout of such models include training and upfront resources to enable participation by community-based and safety net providers.

This section directs the Center for Medicare and Medicaid Innovation to advance health equity when selecting and testing payment and service delivery models. It requires consultation with the Office of Minority Health, the Office of Rural Health Policy, and the Office on Women’s Health before model selection and expands required expertise to include causes of health disparities and social determinants of health. It adds selection criteria on access for high-risk patients in underserved areas and on reducing minority and rural disparities. For models tested on or after January 1, 2027, it requires demonstration of improved health equity and access. It mandates testing of a new social determinants of health payment model by December 31, 2027, covering behavioral health, underserved-area capacity, and Medicaid pregnant and postpartum women. It also expands annual reporting to cover interventions, federal savings, and effectiveness in addressing disparities.

This section authorizes the Secretary to designate up to 110 health empowerment zones in areas where one or more communities experience disproportionate disparities in health status and health care. Designations require a request from an eligible community partnership demonstrating widespread public support and broad stakeholder representation, with approval or disapproval required within 60 days; at least one zone must be designated in each state, the District of Columbia, and each territory.

This section requires the Secretary to provide technical assistance, and authorizes grants, to any organization or entity seeking designation under section 4401 to form an eligible community partnership, complete a health assessment including of health disparities, or prepare and submit a request with a strategic plan.

This section prioritizes grant awards to applicants proposing activities in designated health empowerment zones that directly advance the approved strategic plan. It authorizes grants to community partnerships for initial plan implementation for 2-year periods, renewable up to a total of 10 years, and requires grantees to report progress every 6 months using metrics established by the Secretary.

This section defines the term Secretary, for purposes of this subtitle, as the Secretary of Health and Human Services acting through the Administrator of the Health Resources and Services Administration and the Deputy Assistant Secretary for Minority Health, in cooperation with the Director of the Office of Community Services and the Director of the National Institute on Minority Health and Health Disparities.

This section requires the Secretary of Health and Human Services, in consultation with the Directors of Civil Rights and Health Equity, NIH, CMS, AHRQ, CDC, and the Deputy Assistant Secretary for Minority Health, to issue proposed regulations within 90 days mandating that health care providers and facilities disaggregate reported health outcomes data by race, national origin, sex (including sexual orientation and gender identity), disability, and age. It also directs the Secretary to establish a public repository of the disaggregated data within one year while prohibiting release of individually identifiable information.

This section requires the Secretary to adopt measures of equitable health care for the hospital value-based purchasing program beginning in fiscal year 2027. It directs the Secretary to solicit input from representatives of communities of color and other protected classes and to ensure the measures account for social determinants of health. Equitable health care is defined as high-quality care that does not vary on the basis of race, national origin, sex (including sexual orientation and gender identity), disability, or age.

This section authorizes the Secretary to exclude health care providers from Medicare and State health care programs for a pattern of providing inequitable health care on the basis of race, national origin, sex including sexual orientation and gender identity, disability, or age. Exclusion is prohibited if it would increase access difficulties for underserved or low-income communities.

This section renames the Office for Civil Rights of the Department of Health and Human Services as the Office for Civil Rights and Health Equity beginning on the date of enactment and retitles its head as the Director for Civil Rights and Health Equity, who shall be appointed by the President with the advice and consent of the Senate.

This section prohibits health care providers from providing inequitable care on the basis of race, sex (including sexual orientation and gender identity), disability, age, or religion. It requires the Secretary to issue patient rights notices, directs the Director to investigate complaints within 180 days while accounting for social determinants of health, facilitates conciliation agreements, and authorizes referral to the Attorney General for enforcement.

This section establishes the Federal Health Equity Commission. The Commission consists of 8 voting members appointed for 6-year terms—4 by the President, 2 by the Senate majority and minority leaders from different parties, and 2 by the House Speaker upon recommendations from the majority and minority leaders from different parties—plus 4 specified nonvoting ex officio members from the Department of Health and Human Services. It requires the Commission to monitor implementation of the Act, investigate progress toward health equity and the elimination of disparities, and submit annual reports to the President and Congress with agency action descriptions and recommendations. The Commission may hold hearings, issue and enforce subpoenas, and pay witness expenses.

This section directs the Secretary of Health and Human Services to award grants to hospitals within 180 days of enactment to promote equitable health care treatment and reduce disparities in care and outcomes. It authorizes such sums as necessary for fiscal years 2027 through 2031, gives priority to hospitals that received disproportionate share hospital payments for fiscal year 2026, and limits uses to bias training, translation services, diverse workforce recruitment, data tracking, and cultural sensitivity training.

This section defines terms used throughout the subtitle, including the Advisory Council as the Pay for Equity Advisory Council convened under section 4603, the Secretary as the Secretary of Health and Human Services, and the Strategy as the Pay for Equity Strategy set forth under section 4602.

This section requires the Secretary of Health and Human Services, jointly with the Advisory Council, to develop and submit to the Senate Finance Committee and the House Energy and Commerce and Ways and Means Committees a Pay for Equity Strategy that sets goals for federal programs, including Medicare and Medicaid, to incentivize health equity. The strategy must incorporate equity measures into all payment models by 2028, tie a percentage of value-based reimbursement to equity performance by 2031, and increase safety net provider participation in value-based models by a set percentage by 2033; the Secretary must publish it on the HHS website within 18 months of enactment, update it biennially, coordinate related federal activities, provide technical assistance, and establish a public input process.

This section directs the Secretary to convene a Pay for Equity Advisory Council to advise on the Pay for Equity Strategy. The Council includes up to 15 appointed voting members, with at least one representative each from Medicare and Medicaid beneficiaries, safety net health care providers, value-based payment experts, and others with relevant expertise, plus nonvoting federal members from CMS and HRSA; meetings occur quarterly in the first year after enactment and at least three times annually thereafter, and are open to the public.

This section provides Medicare coverage for qualified acupuncturist services furnished by a licensed or certified acupuncturist or by a physician authorized to perform acupuncture under state law. It adds these services to the physician fee schedule, permits separate billing by institutional providers and in inpatient hospital settings, and applies the changes to services furnished on or after the date that is 270 days after enactment.

This section repeals the denial of supplemental nutrition assistance program benefits for individuals convicted of a felony drug offense under federal or state law. It retains the denial of assistance under state programs funded under part A of title IV of the Social Security Act.

This section sets a floor of 0.70 on the average geographic adjustment factor used to calculate Medicare Advantage base payment amounts for 2027 and subsequent years. It requires that at least 50 percent of any resulting increase in the blended benchmark amount be directed to payments for basic benefits.

This section requires Medicare-participating hospitals, critical access hospitals, and rural emergency hospitals, beginning January 1, 2027, to develop and implement discharge plans for any pregnant individual expected to be released prior to delivery. Plans must include a clinical justification, travel distance and time assessment, verification of reliable transportation, identification of a backup facility, approval by a qualified medical professional, and confirmation that the individual received and understood the information in their primary language. This section also requires racial bias training in rural maternal and obstetric care demonstration grants, establishes minimum performance milestones for grant recipients starting in FY2027, and requires annual reports on grant activities, training formats, geographic coverage, providers trained, and patient-level outcomes. It directs the Secretary of Health and Human Services to establish a multi-center implementation science initiative to evaluate maternal health training models.

This section requires pharmacies receiving drugs or devices in interstate commerce to dispense requested contraceptives or related medications without delay if in stock and to order such items if not in stock. It applies to all FDA-approved, cleared, or authorized contraceptive methods and medications.

This section expands Medicaid health home services to eligible individuals with sickle cell disease beginning January 1, 2027. It permits sickle cell disease-focused State plan amendments, requires participating States to provide dental and vision services to enrollees irrespective of other Medicaid rules, mandates reports on quality, access, and expenditures after the first eight fiscal quarters, and directs the Secretary to publish best practices by June 30, 2027. It defines sickle cell disease as an inherited blood disorder affecting red blood cells when an individual inherits a sickle cell gene from each parent.

This section establishes a competitive grant program, administered by the Secretary of Education in coordination with the Secretary of Health and Human Services, to support implementation or expansion of school-based health services in community schools. Eligible entities, including local educational agencies and partnerships with Federally qualified health centers or community organizations, may use funds to expand services, hire and train nurses, mental health professionals, and coordinators, deliver wraparound supports such as nutrition and housing referrals, address social determinants of health, provide culturally appropriate services, implement trauma-informed practices, and build health career pathways. The Secretaries must enter a memorandum of understanding to reduce administrative burdens and provide technical assistance. Grantees must submit annual reports on students served and outcomes, and the Secretary of Education must submit triennial reports to Congress evaluating effectiveness and best practices.

This section establishes a grant program authorizing the Secretary, in collaboration with the Administrator of the Health Resources and Services Administration, to fund eligible entities that promote health in medically underserved communities, including racial and ethnic minority women, children, adolescents, and lesbian, gay, bisexual, transgender, queer, nonbinary, gender-nonconforming, or questioning communities, and that strengthen health outreach initiatives in linguistically isolated populations. Grants may support community health workers providing education and outreach on insurance enrollment under CHIP, Medicare, and Medicaid; prevalent health problems; risk factors such as nutrition, physical activity, obesity, tobacco use, substance use, injury, sexual health, mental health, and environmental hazards; community wellness; and referrals to care, with priority for applicants targeting high-uninsured or high-poverty areas with limited English proficiency and for those with documented experience serving underserved populations.

This section establishes a demonstration program, administered by the Centers for Disease Control and Prevention, to facilitate clinical adoption of pregnancy intention screening initiatives by health care and social services providers. It authorizes grants to eligible community-based and health organizations, requires an evaluation of implementation and outcomes across diverse settings, and provides $10 million annually for fiscal years 2027 through 2031, with no more than 20 percent for evaluation.

This section establishes a birth defects prevention and public awareness program at the Centers for Disease Control and Prevention. It directs the Secretary to conduct a nationwide media campaign on pregnancy and breastfeeding information services and to award grants to state or regional agencies for such services, related surveillance and research on maternal exposures, and networking. Grants require a 25 percent nonfederal match and preference for states with existing services. It authorizes appropriations of $5 million for fiscal year 2027, rising to $9 million for fiscal year 2031.

This section establishes the State-Based Perinatal Quality Collaborative Grant Program and authorizes $35 million annually for FY2027 through FY2031, with individual grants not to exceed $250,000 per year, to develop and sustain such collaboratives in every state, the District of Columbia, and eligible territories. It requires Medicaid coverage of oral health services for pregnant and postpartum women (defined as services furnished during pregnancy or the 1-year period beginning on the last day of pregnancy), including at minimum preventive, diagnostic, periodontal, and restorative care consistent with specified professional recommendations. It imposes parallel dental coverage requirements under CHIP. It also mandates 12-month continuous full-benefit coverage for pregnant and postpartum individuals under both Medicaid and CHIP.

This section requires the Comptroller General to report to Congress within one year on coverage gaps for pregnant and postpartum individuals under Medicaid and CHIP, including state transition processes, factors disproportionately affecting underserved populations, and recommendations to reduce such gaps, with data disaggregated by age, race, ethnicity, income, and other demographics. It also establishes a maternity care home demonstration project under which the Secretary awards grants to states to implement or expand such models, with goals that include improving birth equity, ensuring at least five post-pregnancy visits, reducing maternal mortality and cesarean rates for low-risk pregnancies, and addressing racial and other disparities in outcomes.

This section establishes a task force, chaired by the Secretary of Health and Human Services and including 15 specified federal officials plus appointed patient representatives, community leaders, perinatal workers, and maternity care providers, to develop a strategy coordinating federal efforts on social determinants of maternal health for pregnant and postpartum individuals and to report recommendations on funding and Medicaid coverage expansions within two years. It also creates the Housing for Moms grant program under the Secretary of Housing and Urban Development to award grants to community-based organizations, state and local governments, Indian tribes, and urban Indian organizations for outreach, housing provision, and application assistance targeting low-income pregnant and postpartum individuals in high-poverty or high-adverse-outcome areas.

This section authorizes the Secretary of Health and Human Services to award grants to community-based organizations to establish or expand programs preventing maternal mortality and severe maternal morbidity among Black pregnant and postpartum individuals, following a one-year outreach and technical assistance period beginning on the date of enactment. It requires special consideration for entities based in communities with high adverse maternal health outcomes or led by Black people, provides technical assistance to recipients, mandates an evaluation of the program by the end of fiscal year 2031, and authorizes $10 million annually for fiscal years 2027 through 2031.

This section directs the Secretary of Health and Human Services to issue guidance to States within 2 years on recruiting and retaining diverse maternity care providers, midwives, perinatal health workers, registered dietitians, and lactation consultants, and to conduct a study on respectful and culturally congruent maternity care with a report to Congress within 2 years that includes best practices and examples of reduced inequities. It establishes perinatal workforce grants to fund new or expanded education programs for physician assistants and perinatal health workers, with priority for entities recruiting students and faculty from racial and ethnic minority groups and health professional shortage areas.

This section authorizes $10 million annually for fiscal years 2027 through 2031 for grants to State, tribal, and Urban Indian maternal mortality review committees to increase racial, ethnic, and professional diversity of committee membership, provide compensation and training for community members, conduct outreach to minority communities, and issue public reports on review processes and fund impacts. It reserves at least $1.5 million of those amounts for Indian tribes, tribal organizations, and Urban Indian organizations. It expands committee reviews to include severe maternal morbidity cases, deaths from suicide, overdose, or mental health conditions linked to pregnancy, and input from community-based organizations on non-clinical factors. It requires the Secretary of Health and Human Services to consult stakeholders and recommend improvements to maternal health data collection processes and quality measures.

This section establishes a maternal mental health equity grant program to award grants to eligible entities addressing maternal mental health conditions and substance use disorders among pregnant and postpartum individuals, with a focus on racial and ethnic minority groups. It prioritizes entities operating in health professional shortage areas designated under section 332 of the Public Health Service Act (42 U.S.C. 254e) or areas with high rates of adverse maternal health outcomes or racial inequities, requires use of funds for specified activities such as integrating behavioral health into maternity care and provider training, and mandates annual grantee reports plus a Secretary's evaluation report to Congress by the end of FY2028.

This section reduces Edward Byrne Memorial Justice Assistance Grant Program funding by 25 percent for states that lack laws restricting restraints on pregnant individuals in prison substantially similar to those in 18 U.S.C. 4322, with noncompliant amounts reallocated to compliant states beginning 6 months after enactment. It also directs the Attorney General to establish 5-year model maternal health programs for pregnant and postpartum incarcerated individuals in at least 6 Bureau of Prisons facilities, with priority for facilities serving higher numbers from groups with elevated maternal mortality rates, to begin no later than 18 months after enactment.

This section defines the postpartum period as the 1-year period after pregnancy, severe maternal morbidity, and social determinants of maternal health. It directs the Center for Medicare and Medicaid Innovation to test telehealth models for screening, monitoring, and managing pregnancy complications for Medicaid recipients during pregnancy and the 1-year postpartum period, effective 1 year after enactment. It also establishes a grant program, beginning not later than 1 year after enactment, that awards funds to expand technology-enabled collaborative learning models for maternal health providers in health professional shortage areas, areas with high maternal mortality or severe morbidity, and areas with significant racial and ethnic inequities; requires training on implicit bias, maternal mental health, substance use disorders, and screening for social determinants of health; and permits support for hardware, software, and distance learning tools.

This section establishes the Perinatal Care Alternative Payment Model Demonstration Project for fiscal years 2027 through 2030. It allows states to test alternative payment models for maternity care provided to pregnant and postpartum individuals enrolled in Medicaid and CHIP, requires coordination with stakeholders including doulas and community-based organizations, directs consideration of risk-stratified payments and social determinants of health, and mandates an evaluation and report on maternal health outcomes and spending.

This section establishes a grant program, administered by the Secretary of Health and Human Services, that awards competitive grants to 10 covered entities to protect vulnerable mothers and babies from climate change risks. Grants must target high-risk counties, address racial and ethnic inequities in maternal and infant health outcomes, and support initiatives including provider training, community health workers, data monitoring, direct assistance such as air conditioning and housing support, and mitigation efforts such as urban forestry and infrastructure improvements.

This section directs the Secretary of Health and Human Services to study the extent to which domestic violence, dating violence, sexual assault, stalking, human trafficking, sex trafficking, child sexual abuse, or forced marriage increases risks of maternal mortality or severe maternal morbidity, and to submit a report to Congress within 2 years that includes analyses by race and ethnicity, recommendations, and best practices. It requires the Secretary to arrange for a National Academy of Medicine study on the health impacts of such violence relative to maternal mortality and morbidity, with particular focus on African American, American Indian, Native Hawaiian, Alaskan Native, and LGBTQ birthing persons. It also establishes a grant program, administered through the Health Resources and Services Administration, for states, tribes, and nonprofits to develop innovative approaches to improve maternal and child health outcomes for victims of such violence.

This section authorizes grants to institutions of higher education for direct student support, establishment or expansion, and preceptor recruitment in accredited midwifery schools or programs, with $15,000,000 appropriated for fiscal years 2027 through 2031 and allocated 50/25/25 across those purposes. It requires special consideration for applicants prioritizing practice in health professional shortage areas and increasing racial and ethnic minority representation, while prohibiting funds for programs within schools of nursing. It separately authorizes $20,000,000 for the same period and purposes for accredited nurse-midwifery programs at schools of nursing, with identical allocation and special consideration requirements. It also updates statutory definitions to include midwifery schools and programs.

This section establishes a multisite gestational diabetes research project within the CDC diabetes program to expand surveillance data collection, vital statistics collaboration, postpartum tracking of individuals with gestational diabetes, and analysis of risk factors and interventions. It requires annual reports on prevalence and findings beginning two years after enactment. It authorizes $5 million per year for FY2027 through FY2031 to expand related public health research and awards competitive grants to eligible entities for demonstration projects reducing gestational diabetes incidence, recurrence, and progression to type 2 diabetes.

This section requires the Office on Women's Health to develop and implement, not later than 1 year after enactment, a 4-year culturally and linguistically appropriate multimedia consumer education campaign on evidence-based maternity practices and models of care. The campaign targets individuals of childbearing age and their families and must highlight the importance of obstetric interventions only when medically necessary, promote underused noninvasive practices such as continuous labor support and nonsupine birth positions, educate consumers on provider qualifications and birth setting outcomes, address the effects of racism on maternal health, and undergo pilot testing for comprehension and cultural sensitivity across diverse populations.

This section directs the Secretary of Health and Human Services, acting through the Agency for Healthcare Research and Quality, to establish and maintain a publicly available online bibliographic database of systematic reviews on care for childbearing individuals and newborns, including evidence quality assessments, searchable by topic and outcome, with links to full texts and companion materials. It requires outreach, consultation with an advisory committee of specified stakeholders, and regular updates, and authorizes $2.5 million annually for fiscal years 2027 through 2029 for development.

This section directs the Secretary of Health and Human Services, in conjunction with the HRSA Administrator, to convene an Interprofessional Maternity Provider Education Commission within 180 days of enactment for a 1-year period to develop recommendations on a consensus physiologic maternity care curriculum, multidisciplinary integration strategies, continuing education, and pilot demonstrations. The Commission must include representatives from obstetrician-gynecologists, certified nurse-midwives, family physicians, certified professional midwives, perinatal nurses, doulas, and other listed professions plus consumer advocates. The curriculum must incorporate a public health focus, physiologic childbearing, strategies to reduce maternal and infant morbidity and mortality, respectful consultation and transfer protocols, cultural sensitivity, and implicit bias training. The section authorizes $1 million for each of fiscal years 2027 and 2028, and such sums as necessary for fiscal years 2029 through 2031, and requires a report to Congress and the public within 180 days after the Commission’s final meeting.

This section requires the Secretary of Health and Human Services and the Director of the Centers for Disease Control and Prevention, within 180 days of enactment, to develop a plan for outreach to publicly funded health care providers—including federally qualified health centers and Indian Health Service branches—about the quality family planning guidelines, and to award grants to eligible publicly funded providers serving persons of reproductive age to implement the guidelines for all patients seeking family planning services.

This section establishes the Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes, chaired by the Deputy Assistant Secretary for Women’s Health, to guide federal policy and programs on optimal maternity care across 15 specified agencies without transferring regulatory authority. It requires annual reports to Congress on federal maternity programs, maternal and infant mortality trends, and 12 specific metrics including primary and repeat cesarean rates, vaginal births after cesarean, home births, provider types, severe maternal morbidity, and maternity care costs, all disaggregated by race, ethnicity, and indigenous status. It authorizes $1 million annually for fiscal years 2027 through 2031 and adds this duty to the HHS Office on Women’s Health.

This section expands the CDC Prevention Research Centers Program by directing the Secretary of Health and Human Services to establish additional centers, each known as a Center for Excellence on Optimal Maternity Outcomes, within one year of enactment. Each center must conduct research to reduce cesarean birth rates, early elective inductions, prematurity, and low birth weight in underserved populations with high rates of maternal and infant mortality; involve at least two distinct birth settings; include obstetrician-gynecologists and at least two other specified provider types; and incorporate at least two supportive services such as mental health, doula labor support, or substance use disorder services. It authorizes $2 million annually for fiscal years 2027 through 2031.

This section expands the Center for Medicare and Medicaid Innovation’s testing authority to include evidence-based maternity and children’s health models that reduce pregnancy-related and infant health inequities. It requires the Secretary to test five specific Medicaid models: payments for culturally and linguistically appropriate doula services (including community-based doulas) with equitable reimbursement rates; an episode-based payment model for prenatal, intrapartum, and postpartum services; a pregnancy-related health home model; a perinatal health worker service delivery model provided by community-based entities; and early intervention models using parenting support, home visiting, and dyadic therapy for children enrolled in Medicaid or CHIP. All models must be designed with input from community advocates and beneficiaries and evaluated on quality, equity, and developmental outcomes.

This section requires the Director of the Centers for Disease Control and Prevention and the Office of Population Affairs to review and expand the 2014 Quality Family Planning Guidelines within 180 days after enactment to address health inequities and the importance of patient-directed contraceptive decision making. It also directs them to consult experts on health inequities and reproductive coercion, along with provider organizations, patient advocates, reproductive justice organizations, and groups representing racial and ethnic minorities, people with disabilities, LGBTQ persons, and those with limited English proficiency.

This section expresses the sense of Congress that eliminating the Hyde amendment and enacting the Equal Access to Abortion Coverage in Health Insurance Act of 2025 and the Women’s Health Protection Act of 2025 are critical to promoting equitable abortion access and coverage, creating enforceable rights to such care, advancing comprehensive health coverage, and alleviating racial, gender, and other inequities in health care.

This section establishes an emergency contraception public education program, administered by the Centers for Disease Control and Prevention, and an information program for health care providers, administered by the Health Resources and Services Administration. It requires dissemination of medically accurate information on use, safety, efficacy, affordability, and over-the-counter access, with pilot testing for diverse populations, and authorizes such sums as may be necessary for fiscal years 2027 through 2031.

This section requires pharmacies that receive FDA-approved drugs or devices in interstate commerce to dispense in-stock contraceptives without delay and, for out-of-stock items, to refer the customer to another pharmacy or order the item under expedited procedures. It prohibits intimidation, interference, misrepresentation of availability or mechanism of action, confidentiality breaches, and refusal to return valid prescriptions. Refusals remain permitted without a valid prescription, for inability to pay, or on professional clinical judgment. The section imposes civil penalties of up to $1,000 per day of violation, not exceeding $100,000, authorizes private actions for damages and injunctive relief, and sets a 5-year statute of limitations.

This section establishes definitions for the Real Education and Access for Healthy Youth Act, including age and developmentally appropriate, consent, culturally responsive, evidence-informed, gender identity, inclusive, institution of higher education (adopting the meaning in 20 U.S.C. 1001), interpersonal violence, marginalized young people, medically accurate and complete, sex education, sexual health services, and trauma-informed.

This section requires hospitals, critical access hospitals, and rural emergency hospitals to adopt policies ensuring that, beginning January 1, 2027, any individual identified as a victim of sexual assault receives medically accurate information on emergency contraception and post-exposure prophylaxis (PEP) for HIV prevention, an immediate offer of those medications, and on-site or on-call staff authorized to dispense or prescribe them, regardless of ability to pay. It also bars Medicaid payments for services furnished by any such hospital that fails to meet these requirements.

This section authorizes local educational agencies to use funds under the Student Support and Academic Enrichment Grant program to provide free menstrual products to students. It defines menstrual products as sanitary napkins and tampons that meet industry standards and directs the Secretary of Education, in consultation with the Secretary of Health and Human Services, to issue implementing rules within one year. It establishes a competitive grant program, authorized at $5 million annually from the Fund for the Improvement of Postsecondary Education, to award funds to at least four institutions of higher education (with at least 50 percent to community colleges and priority for those with 25 percent or more Pell Grant recipients and minority-serving institutions) to supply free menstrual products in campus restrooms, wellness centers, and residential buildings, conduct outreach, assist with public benefits enrollment, and report best practices. It requires states receiving Byrne JAG grants to certify annually that incarcerated individuals and detainees have free, on-demand access to menstrual products and that visitors are not barred for using them, with a 20 percent reduction in the following year’s grant for noncompliance.

This section expands the duties of the Office on Women's Health to facilitate understanding among policymakers, health system leaders, providers, consumers, and stakeholders on optimal maternity care. The new duties include protecting innate capacities for childbirth, breastfeeding, and attachment; limiting obstetric interventions such as continuous fetal monitoring, labor induction, epidurals, and cesarean sections to those supported by strong evidence; incorporating evidence-based practices including group prenatal care, midwifery, and doula support; ensuring integrated care across hospital, birth center, and home settings; advancing childbirth education; and developing standardized performance and quality measures.

This section expands the definition of inpatient hospital services under Medicare to include services furnished by student midwives or interns or residents-in-training in obstetrics and gynecology when supervised by a certified nurse-midwife or certified midwife, to the extent permitted under state law. It also permits hospitals with approved teaching programs to receive Medicare payment for reasonable costs of services furnished by certified nurse-midwives or certified midwives if the hospital elects such payment and all such midwives agree not to bill separately for professional services. The changes apply to services furnished on or after the date of enactment.

This section establishes grant programs administered by the Secretary of Health and Human Services to increase diversity in maternal, reproductive, and sexual health professions. It provides planning grants of up to $300,000 in FY2027 and implementation grants of up to $500,000 per year for up to four years to professional organizations representing obstetrician-gynecologists, certified nurse midwives, nurse practitioners, and related providers. It also provides planning grants of up to $400,000 for two years in FY2027–2028 and implementation grants for the subsequent ten years to minority-serving institutions.

This section permanently extends CHIP funding as such sums as necessary for fiscal year 2029 and each subsequent year (from a $15.3 billion one-year appropriation). It also permanently extends the pediatric quality measures program with annual CPI-U adjustments; the express lane eligibility option; affordability standards for children and families; the qualifying states option; the outreach and enrollment grants program, with $12 million for fiscal year 2030 and CPI-U adjustments thereafter; and the child enrollment contingency fund, with related allotment and trigger changes.

This section increases the annual funding level specified for the Social Services Block Grant to $1.9 billion (from $1.7 billion) for fiscal years 2027 through 2030. It requires States to obligate $200 million of the increase, reduced by up to 2 percent reserved for technical assistance and $2 million for evaluation in fiscal year 2027, to distribute free diapers, diapering supplies, medically necessary diapers, and adult incontinence materials to low-income families with infants, toddlers, medically complex children, or adults with disabilities.

This section establishes a culturally and linguistically competent public health awareness campaign, administered by the Secretary of Health and Human Services through the Health Resources and Services Administration in consultation with the CDC and NIH, to reduce risk factors for sudden unexpected infant death and sudden unexplained death in childhood through education on safe sleep environments, sleep positions, and smoking exposure. It targets populations with high rates of these deaths, requires consultation with national organizations representing health care providers, parents, child care providers, and maternal and child health programs, awards grants to national organizations, state and local health departments, and community-based organizations for related education and outreach, and authorizes such sums as may be necessary for each of fiscal years 2027 through 2031.

This section establishes a nonrefundable tax credit equal to 35 percent (phased down by 1 percentage point for each $2,000 of AGI above $15,000, but not below 20 percent) of employment-related household and elder care expenses, including respite and hospice care. The credit applies to qualifying individuals age 50 or older who meet specified support, incapacity, and residency tests, with annual limits of $3,000 for one qualifying individual or $6,000 for two or more, reduced by any section 129 exclusions and subject to earned-income limits.

This section expands uses of Maternal and Child Health Services Block Grant funds to reduce stillbirth incidence. It authorizes states to apply funds toward that goal and directs the Secretary to support evidence-based programs and research including fetal movement tracking, birth timing for at-risk pregnancies, safe sleeping positions, fetal growth restriction screening, smoking cessation during pregnancy, and community home-visit programs.

This section expands Medicare Part B coverage to include substance use disorder counselor services and peer support specialist services beginning January 1, 2027. It sets payment at 80 percent of the lesser of the actual charge or 75 percent of the psychologist payment amount, adds these services to rural health clinics and federally qualified health centers, excludes peer support specialist services from the skilled nursing facility prospective payment system, and treats both providers as practitioners for claims assignment.

This section increases the annual authorization of appropriations for the Minority Fellowship Program to $36,700,000 (from $25,000,000) and extends it through FY2031 (from FY2027). The program awards fellowships, which may include stipends, for postbaccalaureate training of mental and substance use disorder professionals serving racial and ethnic minority populations.

This section provides an additional $150 million per year to the National Institutes of Health for each of fiscal years 2027 through 2032 to build relations with communities and conduct or support clinical research on racial or ethnic disparities in physical and mental health, and to carry out the National Institute of Mental Health's Strategic Framework for Addressing Youth Mental Health Disparities.

This section authorizes an additional $750 million per year for the National Institute on Minority Health and Health Disparities for each of fiscal years 2027 through 2032.

This section directs the Secretary of Health and Human Services to award 4-year grants to community-based organizations that provide culturally and linguistically appropriate, evidence-based trauma-informed care to increase racial and ethnic minority access to such services and mental health care. It authorizes $20 million annually for fiscal years 2027 through 2031, requires priority for communities facing high rates of trauma including from law enforcement violence, and mandates an evaluation with a report to Congress within 6 months after the grant period ends.

This section directs the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to award grants to qualified national organizations to develop and disseminate culturally and linguistically appropriate curricula on mental health inequities among racial and ethnic minority groups for training in social work, psychology, psychiatry, marriage and family therapy, mental health counseling, peer support, and substance use disorder counseling, and to certify community health workers and peer wellness specialists for use in health care and community settings. It authorizes such sums as may be necessary for each of fiscal years 2027 through 2031.

This section authorizes grants to federally qualified health centers, rural health clinics, women’s health clinics, and behavioral health programs serving high proportions of racial and ethnic minority groups to establish interprofessional teams providing behavioral health care in primary care settings. It requires each grantee to devote at least $10,000 to loan forgiveness for practitioners committing to two years in the mental health field and authorizes $20 million annually for fiscal years 2027 through 2031.

This section establishes a grant program under which the Secretary awards funds to Federally qualified health centers, rural health clinics, and behavioral health programs that serve high proportions of racial and ethnic minority individuals. The grants support interprofessional health care teams delivering behavioral health care in primary care settings, with all funded care required to be based on the most recent peer-reviewed research. The section authorizes $20 million annually for each of the first five fiscal years after enactment of the Health Equity and Accountability Act 2026.

This section directs the Secretary of Health and Human Services, in coordination with specified federal officials and organizations, to develop strategies that expand career pathways for diverse mental health professionals, identify workforce shortages, and expand training and incentives across community, educational, and clinical settings. It authorizes $50 million annually for fiscal years 2027 through 2037 for subgrants to youth-serving entities, the Health Resources and Services Administration’s Behavioral Health Workforce Education and Training Program, and a National Health Service Corps program focused on community trauma.

This section establishes a demonstration program awarding grants to health centers already funded under section 330 of the Public Health Service Act to recruit, hire, and supervise behavioral health professionals proficient in English and at least one other language. It gives preference to centers where at least 10 percent of patients are best served in a non-English language, requires outreach using grant funds, mandates an initial report to Congress within 6 months of the first awards and a final report by the end of FY2028, and authorizes up to $10 million annually for FY2027 through FY2032.

This section authorizes the Secretary of Health and Human Services to award grants to qualified national organizations to develop and disseminate best practices or core competencies addressing mental health disparities among racial and ethnic minority groups for training students in social work, psychology, psychiatry, marriage and family therapy, mental health counseling, and substance use disorder counseling. It also permits grants to certify community health workers and peer wellness specialists in those practices and integrate them into health care.

This section establishes two new grant programs administered by the Health Resources and Services Administration. The first awards grants, contracts, or cooperative agreements to eligible entities—including children’s hospitals, Federally qualified health centers, rural health clinics, and pediatric mental health providers—to integrate and coordinate community-based pediatric behavioral health services, with uses including co-location of providers, telehealth, urgent care clinics, school partnerships, and data collection on service gaps; the second supports evidence-based workforce training for the same entities. It authorizes such sums as necessary for each of fiscal years 2027 through 2031 and requires prioritization of applicants serving high-need, rural, or under-resourced communities and those expanding care to individuals under age 21.

This section establishes a grant, contract, and cooperative agreement program under which the Secretary, acting through the Health Resources and Services Administration Administrator, awards funds to hospitals and rural health clinics that predominantly treat individuals under age 21 to construct or modernize pediatric behavioral health sites, expand capacity including telehealth and digital infrastructure, increase short-term psychiatric and substance use inpatient beds, and add intermediate care services such as intensive outpatient and partial hospitalization programs. It authorizes such sums as necessary for fiscal years 2027 through 2031, requires recipient reports within 180 days of project completion, and requires the Secretary to report to Congress within one year on project outcomes.

This section authorizes the Secretary of Health and Human Services, in consultation with the Secretary of Education, to award grants, contracts, or cooperative agreements to partnerships of state and local educational agencies and community-based mental health providers. The awards fund comprehensive school-based mental health services for children dealing with trauma, grief, suicide risk, and violence; services must be trauma-informed, culturally appropriate, and incorporate positive behavioral interventions. Awards last 5 years with renewal options, require equitable geographic distribution, HIPAA and FERPA compliance, and annual outcome evaluations.

This section establishes a 100 percent federal medical assistance percentage for qualifying youth and young adult mental health and substance use intervention services furnished to individuals aged 16 to 25 who are experiencing a mental health or substance use crisis, are homeless or in foster care, are pregnant or parenting, have a disability, or meet other specified criteria. It permits states to provide these services—including mobile crisis intervention, telehealth, youth peer support, adverse childhood experiences screening, and trauma-responsive care—under section 1115 or 1915(c) waivers or plan amendments without complying with statewideness, comparability, or freedom-of-choice requirements, for a 5-year period beginning with the first fiscal quarter on or after January 1, 2027, and for the first 20 quarters of such coverage.

This section requires states to describe in their biennial mental health services plans their use of demonstration grants or contracts for early intervention and prevention programs for transition-age youth aged 16 to 25 who meet out-of-school youth criteria under the Workforce Innovation and Opportunity Act. It also requires states to expend at least 15 percent of their Community Mental Health Services Block Grant allotments on such programs each fiscal year, or alternatively at least 30 percent over two consecutive fiscal years.

This section directs the Secretary of Health and Human Services to issue guidance within one year on strategies to overcome barriers and increase telehealth access under Medicaid and the Children’s Health Insurance Program, including best practices on service delivery, billing codes, provider licensing and credentialing reciprocity, value-based care integration, and state waiver examples. It also requires the Medicaid and CHIP Payment and Access Commission to study and report to Congress within one year on telehealth impacts on access, utilization, cost, and outcomes across at least 10 states, disaggregated by race, ethnicity, sex, age, disability status, and ZIP Code, and requires the Comptroller General to study and report on federal agency collaboration for telehealth services to individuals under age 18, including in early care and education settings.

This section establishes a grant program authorizing the Secretary to award funds to local educational agencies, institutions of higher education, nonprofits, states, tribes, and other eligible entities for youth and young adult mental health promotion, prevention, intervention, and treatment programs. It requires 10 percent nonfederal matching funds and authorizes $25 million annually for fiscal years 2027 through 2036.

This section requires the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to develop and implement an outreach and education strategy targeting Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, Middle Eastern and North African, and Hispanic and Latino populations to promote behavioral health, emphasize treatment availability and reasonable accommodations, and reduce stigma. It authorizes appropriations of $15 million for each of fiscal years 2027 through 2032 and requires annual reports to Congress on behavioral health outcomes.

This section directs the Director of the National Institutes of Health, in consultation with the Director of the National Institute of Mental Health and the Assistant Secretary for Substance Use and Mental Health, to arrange within 9 months for the National Academies of Sciences, Engineering, and Medicine (or an alternative entity) to study mental health disparities research gaps affecting racial and ethnic minority groups and to report to Congress on prevalence of mental health outcomes and the effects of community violence, adverse childhood experiences, structural bias, and other traumas.

This section requires the Secretary of Health and Human Services, acting through the Director of the Office of Minority Health at the Centers for Disease Control and Prevention, to conduct research on the adverse health effects of interactions with law enforcement. The research must examine trauma-related health consequences for racial and ethnic minorities and the disproportionate burden of associated morbidity and mortality, with a report to Congress due within one year of enactment.

This section directs the Assistant Secretary for Mental Health and Substance Use to conduct a study within 180 days of enactment identifying geographic areas with shortages of racially and ethnically diverse mental health providers and providers trained to serve diverse clients with multiple disabilities. It also requires an assessment of provider preparedness to deliver culturally and linguistically appropriate, affordable, and accessible services, with a report submitted to Congress.

This section requires the Comptroller General to submit a report to Congress within 2 years of enactment assessing barriers to behavioral health and substance use disorder treatment for low-income, uninsured, and Medicaid-enrolled adults. The report must examine coverage options in nonexpansion states, behavioral health benefits in expansion states, enrollment effects on treatment access, COVID-19 impacts, social determinants and cultural barriers, and disparities in provider access stratified by race, ethnicity, gender identity, location, and insurance type, along with recommendations to address barriers and promote equity for women and racial and ethnic groups.

This section directs the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use and in coordination with the Directors of NIH, CDC, and the Office of Minority Health, to study the prevalence, risk factors, and root causes of mental health challenges, substance misuse, suicide attempts, overdoses, and related deaths and treatment among AANHPI youth. It requires a public report with findings, barriers, and recommendations to the Senate HELP and House Energy and Commerce Committees within one year of enactment, with data disaggregated by race, ethnicity, age, sex, gender identity, sexual orientation, geography, disability status, and other factors, and authorizes $1,500,000 for FY2027.

This section directs the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use and in coordination with the Health Resources and Services Administration, the Secretary of Labor, and the Office of Minority Health, to study the number, geographic distribution, cultural and linguistic capabilities, and barriers to entry of licensed behavioral health providers who identify as AANHPI. It requires a report with findings and recommendations to the Senate HELP Committee and House Energy and Commerce Committee within one year, mandates data disaggregation by race, ethnicity, age, sex, gender identity, sexual orientation, geographic region, and disability status, and authorizes $1,500,000 for fiscal year 2027.

This section expands annual reporting requirements for states receiving Community Mental Health Services Block Grants and Substance Abuse Prevention and Treatment Block Grants. States must describe services provided to adults with serious mental illness and children with serious emotional disturbance who are members of racial and ethnic minority groups, including the extent of services and outcomes on diversions from hospitalization and criminal justice involvement, first episode psychosis treatment, suicide reductions, crisis services, support for homeless or rural individuals, and family engagement; states must also report outreach to and hiring of minority mental health providers from multiple disciplines and training on culturally effective and linguistically competent services. The requirements apply to funding agreements entered into on or after the date of enactment.

This section establishes a grant program within the existing public health data framework to support data analysis and early intervention strategies that prevent and mitigate childhood trauma. It directs the Secretary to award grants to up to 5 eligible entities, which may use no more than 25 percent of funds in the first 24 months and 10 percent thereafter for data analysis to identify high-risk census tracts, and no more than 5 percent for administration; grants fund strategies including home visiting, voluntary substance use and mental health services, housing supports, and family resource centers for children aged 0 through 17.

This section increases the Medicare payment rate for clinical social worker services to 85 percent of the fee schedule amount under section 1848 (from 75 percent of the psychologist rate). It permits separate billing for clinical social worker services furnished to skilled nursing facility residents. It expands covered clinical social worker services to include health and behavior assessment and intervention (HCPCS codes 96150 through 96161 as of January 1, 2022). These changes apply to items and services furnished on or after January 1, 2027.

This section establishes the Mental Health Excellence in Schools Program under which the Secretary of Education matches up to 50 percent of the cost of attendance for graduate students pursuing degrees in school psychology, school counseling, school social work, or related fields at participating institutions. Eligible institutions must prioritize Pell Grant recipients and students from institutions listed in section 371(a) of the Higher Education Act, require participants to commit to at least 3 years in a school-based mental health field, submit annual reports on enrollment, tuition coverage, graduation, and employment, and the Secretary must publish participating institutions online, conduct targeted outreach, submit an interim report to Congress within 2 years, and commission an independent national evaluation within 4 years.

This section establishes a grant program authorizing the Secretary to award competitive grants for up to 4 years to high-need local educational agencies to retain or hire school social workers. Grants must supplement, not supplant, other funds and must achieve a ratio of at least 1 school social worker per 250 students served (or 1 per 50 students in schools with a majority of higher-risk students), with contractors permitted only when agencies demonstrate recruitment efforts have failed. Grantees must ensure social workers provide specified services including counseling, trauma-informed care, case management, home visits, and coordination of behavioral and mental health supports.

This section extends authorization for State Opioid Response Grants through FY2031 (from FY2027). It adds a new allowable use of funds for opioid prevention and treatment services provided to children, caregivers, kinship care families, and kinship caregivers, including workforce recruitment and training, health care services, and foster and adoptive parent recruitment and training. It sets aside 1 percent of appropriated amounts for these activities and defines kinship care family and kinship caregiver.

This section renames the Substance Abuse and Mental Health Services Administration as the Substance Use and Mental Health Services Administration, the Center for Substance Abuse Treatment as the Center for Substance Use Services, and the Center for Substance Abuse Prevention as the Center for Substance Use Prevention Services. It requires the Secretary of Health and Human Services to delegate all existing duties and authorities to the renamed entities, deems references in federal law, regulations, and documents to the former names as references to the new names (except for one provision in the 21st Century Cures Act), and permits continued use of the SAMHSA acronym.

This section directs the Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, to develop and implement an outreach and education strategy—in coordination with advocacy and behavioral health organizations serving Hispanic and Latino communities—to promote behavioral and mental health, reduce stigma, and address cultural, linguistic, developmental, and age-appropriate needs. It requires annual reports to Congress beginning one year after enactment and authorizes $1,000,000 for fiscal year 2027.

This section expands the Farm and Ranch Stress Assistance Network to cover farm workers and to fund peer-to-peer mental health support programs for individuals in farming, ranching, farm work, and other agriculture-related occupations. It extends the annual authorization of appropriations of $10,000,000 through FY2031 (from FY2023).

This section directs the Secretary of Health and Human Services to provide education and outreach to stakeholders, within one year of enactment, on the Medicare Benefit Policy Manual provisions covering occupational therapy services furnished under Medicare for substance use or mental health disorder diagnoses using applicable HCPCS codes.

This section authorizes the Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, to award grants to eligible entities for training community mental wellness workers to screen for mental health and substance use conditions and deliver evidence-informed, culturally competent counseling interventions. It requires priority for entities in areas with above-average poverty, unemployment, or substance use rates, medically underserved communities, or high shares of dually eligible Medicare and Medicaid beneficiaries. The section extends Federal Tort Claims Act malpractice protections to covered entities and participating practitioners beginning in the first full fiscal year after enactment, and directs the Secretary to submit an interim report to Congress within one year and a final report by the end of FY2031.

This section directs the Secretary of Health and Human Services to implement the Lung Cancer Mortality Reduction Program within 6 months of enactment, in consultation with the Secretaries of Defense and Veterans Affairs and other specified officials, to reduce lung cancer mortality by at least 25 percent by 2028. The program requires strategic NIH grant prioritization and expanded research at the National Heart, Lung, and Blood Institute, National Institute of Biomedical Imaging and Bioengineering, and National Institute of Environmental Health Sciences; FDA treatment of specified lung cancer drugs as rare disease drugs and expanded access to investigational therapies; CDC early disease research and management; biannual AHRQ guideline updates; and coordinated promotion of screening and tobacco cessation in minority and rural populations.

This section establishes an Interagency Prostate Cancer Coordination and Education Task Force within 180 days, led by the Secretary of Veterans Affairs in cooperation with the Secretaries of Defense and Health and Human Services. The task force develops summaries of federal research advances on diagnosis, prevention, and treatment, considers case-by-case screening guidance for men age 74 or older, coordinates interagency strategies to reduce duplication and close research gaps, and submits recommendations to Congress within two years on research priorities, public participation, partnerships, and agency funding needs.

This section directs the Secretary of Health and Human Services to expand research on advanced prostate cancer imaging technologies, including early-stage grants and later-stage clinical trials, establish public-private partnerships, and conduct a national awareness campaign on screening and improved detection methods. It authorizes $100 million annually for imaging research, $10 million for the campaign, and $20 million for improved blood tests, each for fiscal years 2027 through 2031, requires addressing racial disparities in incidence, mortality, and access to care, and mandates reports to Congress on implementation.

This section establishes an advisory council on prostate cancer within the Department of Health and Human Services to draft a plan for developing and validating accurate tests, such as biomarkers or imaging, to detect and diagnose the disease. The council includes 11 federal designees and 8 nonfederal experts, meets quarterly, and must submit to Congress within one year of enactment an evaluation of existing federal research, the plan, and screening standards coordinated with the U.S. Preventive Services Task Force; it terminates on December 31, 2028. It also directs the National Institutes of Health Director to coordinate and intensify related research and authorizes $1,000,000 annually for the council and $30,000,000 annually for the research from unobligated NIH funds for each of fiscal years 2027 through 2031.

This section establishes the National Prostate Cancer Council on Screening, Early Detection, Assessment, and Monitoring of Prostate Cancer within the Office of the Secretary of Health and Human Services. The Council develops and implements a national strategic plan for prostate cancer diagnostic tools, coordinates federal research and services, reviews existing programs, ensures inclusion of high-risk men including minority populations, submits annual reports to the Secretary and Congress with specified evaluations and recommendations, and terminates on December 31, 2027.

This section removes the Medicaid funding cap for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa for medical assistance provided to breast and cervical cancer patients eligible solely under section 1902(a)(10)(A)(ii)(XVIII), beginning in fiscal year 2027. It also sets the federal matching rate for such services in those territories to the highest rate applied by any state or the District of Columbia. The changes apply to items and services furnished on or after October 1, 2026.

This section directs the Secretary of Health and Human Services to conduct at least nine demonstration projects to reduce racial and ethnic disparities in cancer prevention, screening, and treatment for Medicare beneficiaries who belong to minority groups. The projects must include two per major racial/ethnic group, one in the Pacific Islands or insular areas, one in a rural area, and one in an inner-city area; the Secretary must evaluate best practices within one year, implement the projects within two years, submit biannual reports to Congress, and may expand the projects if they reduce Medicare expenditures or disparities without increasing costs.

This section directs the Secretary of Health and Human Services to develop and annually update a uniform set of measures evaluating disparities in cancer care quality, covering patient outcomes, care processes, counseling, experience, resource use, and coordination. It requires specified Medicare providers, including hospitals, cancer centers, and physicians, to publicly report performance data and assess absolute and relative changes in disparities over time in an easily comprehensible format, with initial reporting beginning no later than six months after the measures are established.

This section requires the Secretary to conduct biennial assessments of the HHS plan for hepatitis B and hepatitis C prevention, control, medical management, education, and research, and to publish the results, including any revisions, in the Federal Register by October 1 of each even-numbered year. It directs the Secretary, acting through the CDC, HRSA, and SAMHSA, to implement education, awareness, immunization, and prevention programs, including school and community outreach to high-risk ethnic populations, health care professional training, and integration of screening and vaccination activities into existing State, local, territorial, and Tribal public health programs.

This section establishes two CDC-administered grant programs for liver cancer and disease prevention and awareness. It authorizes $90 million annually for FY2027 through 2031 for prevention activities including screenings, vaccinations, high-risk detection, and viral hepatitis surveillance, plus $10 million annually for the same period for awareness campaigns that must consult high-risk communities, integrate hepatitis testing information, and give preference to entities working with federally qualified health centers or community-based organizations.

This section establishes a National Acquired Bone Marrow Failure Disease Registry to collect data on incidence, prevalence, demographics, genetic and environmental factors, treatments, and outcomes for myelodysplastic syndromes, aplastic anemia, paroxysmal nocturnal hemoglobinuria, pure red cell aplasia, acute myeloid leukemia progressing from myelodysplastic syndromes, and large granular lymphocytic leukemia. It creates an advisory committee, authorizes $3 million annually for fiscal years 2027 through 2031, and directs pilot studies on environmental causes through the Agency for Toxic Substances and Disease Registry.

This section directs the Secretary of Health and Human Services, acting through the Agency for Healthcare Research and Quality, to convene meetings with professional societies, minority health organizations, researchers, providers, and federal agencies to develop disease screening guidelines for minority patient populations at elevated risk for chronic diseases and cancers. It requires guidelines for 23 conditions including hypertension, diabetes, cardiovascular disease, breast and prostate cancers, HIV/AIDS, sickle cell disease, and mental health conditions, with dissemination to health care providers within two years of enactment and appropriations authorized for fiscal years 2027 through 2031.

This section expands the CDC WISEWOMAN demonstration program, which provides additional preventive screenings such as blood pressure and cholesterol checks plus health education and referrals for women already screened for breast or cervical cancer, by removing the limit of 3 participating states. It authorizes appropriations of $23 million for FY2027, $25.3 million for FY2028, $27.8 million for FY2029, $30.8 million for FY2030, and $34 million for FY2031 (from $3 million for FY1994 and such sums as necessary through FY2003).

This section directs the Secretary to submit to Congress, beginning September 30, 2027, and annually thereafter, a report on the quality of and access to care for women and minorities with heart disease, stroke, and other cardiovascular diseases. The report must include recommendations for eliminating disparities in treatment for those conditions among women, racial and ethnic minorities, individuals whose primary language is not English, and individuals with disabilities.

This section directs the Comptroller General to submit a report to Congress by September 30, 2027, examining structural and systemic factors that perpetuate disparities in cardiovascular disease screenings, care, and treatment. The report must also assess federal agency efforts, CMS quality measures on LDL-C testing and management, collaboration with community-based organizations including community health workers, and prior authorization rejection rates for racial and ethnic minorities and their effects on medication adherence and outcomes.

This section requires Medicaid coverage of counseling and pharmacotherapy for cessation of tobacco use by eligible individuals under the state plan, with no cost sharing, and sets the federal medical assistance percentage for these services at 90 percent for five years after enactment. It also requires states to monitor and promote the services through outreach campaigns with federal reimbursement and permits coverage of certain FDA-approved nonprescription cessation drugs.

This section directs the Secretary of Health and Human Services to expand and intensify National Institutes of Health and National Institute of Dental and Craniofacial Research activities on preventing and managing oral diseases and conditions. It requires comparative effectiveness and clinical disease management research on early childhood cancer and oral cancer, plus grants and contracts to train health services, comparative effectiveness, and clinical researchers focused on oral health.

This section directs the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to develop and disseminate within 2 years of enactment guides on evidence-based strategies for State, territorial, and local health departments and for Indian Tribes and Tribal organizations to build and maintain obesity prevention and reduction programs. It also requires the Secretary to provide technical assistance to support implementation of the guides.

This section expands and coordinates National Institutes of Health research on uterine fibroids. It authorizes $30,000,000 annually for fiscal years 2027 through 2031. It requires the Secretary of Health and Human Services to establish or expand a database tracking Medicaid and Children’s Health Insurance Program services and expenditures for uterine fibroid treatment and to submit a related report to Congress within two years. It directs development of public education materials on incidence, risks for minority individuals, and non-hysterectomy treatment options, and requires outreach to health care providers on evidence-based care. It authorizes such sums as necessary for the education and provider activities for fiscal years 2027 through 2031.

This section establishes the policy of the United States to achieve an AIDS-free generation by expanding access to antiretroviral therapy and continuous care for people living with HIV; expanding evidence-based prevention including routine screening and preexposure prophylaxis in disproportionately affected communities; ensuring laws and policies do not impede prevention, treatment, or care; accelerating research toward a cure and vaccine; and respecting the human rights of persons living with HIV.

This section authorizes such sums as may be necessary, in addition to other amounts, to carry out sections 2612(b)(3)(B) and 2616 of the Public Health Service Act for each of fiscal years 2027 through 2030. These sections fund AIDS Drug Assistance Program treatments under the Ryan White HIV/AIDS Program.

This section directs the Secretary of Health and Human Services, acting through the CDC Director, to award grants to states for integrating HIV surveillance systems into electronic health records. The grants support technical assistance for data interoperability, longitudinal tracking of antiretroviral therapy initiation and dispensing, voluntary collection of sexual orientation, gender identity, and coverage sources (including Medicaid, Medicare, and the Ryan White HIV/AIDS Program), and current geographic residence markers. It requires privacy and security safeguards under HIPAA and prohibits use of data for punitive measures or restrictions without written consent. The section authorizes such sums as necessary for fiscal years 2027 through 2030.

This section directs the Secretary of Health and Human Services, collaborating with the Directors of the CDC and Office of AIDS Research and the Administrators of SAMHSA, HRSA, and CMS, to identify evidence-based strategies addressing barriers to HIV/AIDS status awareness and care linkage and retention, support their implementation across Medicaid, the Ryan White HIV/AIDS Program, and Affordable Care Act exchanges, and report to Congress within one year. It authorizes such sums as necessary for fiscal years 2027 through 2030.

This section directs the Secretary of Health and Human Services, acting through the National Institutes of Health Director, to expand research on methods to increase HIV care adherence and testing rates, reduce related health disparities, integrate services with mental health and substance use treatment, implement preexposure prophylaxis, and promote knowledge of undetectable viral loads. It authorizes appropriations for these activities for fiscal years 2027 through 2030.

This section authorizes the Secretary of Health and Human Services, acting through the Deputy Assistant Secretary for Minority Health, to award grants to public health agencies and faith-based organizations for HIV outreach, prevention, testing, and education campaigns on prevention medication in racial and ethnic minority communities. It authorizes such sums as may be necessary for fiscal years 2027 through 2030.

This section expands the Minority AIDS Initiative, directing the Secretary of Health and Human Services, in collaboration with the Deputy Assistant Secretary for Minority Health, CDC Director, HRSA Administrator, and Assistant Secretary for Mental Health and Substance Use, to fund technical assistance, infrastructure support, expanded access to HIV prevention and care services, and community partnerships targeting racial and ethnic minority populations. It prioritizes interventions for men who have sex with men, youth, persons who inject drugs, women, homeless individuals, incarcerated persons, transgender individuals, and nonbinary individuals. It authorizes $610,000,000 for fiscal year 2027 and such sums as may be necessary for fiscal years 2028 through 2031.

This section directs the Secretary of Health and Human Services, acting through the Health Resources and Services Administration, to expand workforce initiatives that increase the number of culturally competent providers treating individuals with HIV. It authorizes grants for training primary care providers, developing curricula on HIV prevention and comorbidities such as hepatitis and tuberculosis, expanding access to peer navigators and mental health professionals, implementing telehealth in rural and minority communities, and related activities, with appropriations authorized for fiscal years 2027 through 2030.

This section establishes an HIV/AIDS provider loan repayment program under which the Secretary of Health and Human Services repays 85 percent of professional education loans for physicians, nurse practitioners, and physician assistants who serve at least two years at Ryan White-funded or Title X-funded facilities with critical doctor shortages or in high HIV/AIDS incidence areas. It requires annual reports to Congress on enrollment, repayments, placements, defaults, and demographics, and authorizes appropriations for fiscal years 2027 through 2030.

This section establishes a dental education loan repayment program under which the Secretary of Health and Human Services may repay 85 percent of a dentist’s education loans (30 percent after the first year of service, 30 percent after the second, and 25 percent after the third) in exchange for at least two years of service at facilities with critical dentist shortages in areas with high HIV/AIDS incidence. It requires annual reports to Congress on enrollment, payments, placements, defaults, demographics, and program costs, and authorizes such sums as necessary for FY2027 through FY2030.

This section authorizes the Secretary of Health and Human Services to award grants and provide technical assistance to reduce HIV infections among injecting drug users through a comprehensive package of services, including sterile syringes, education and outreach, infectious disease testing, overdose prevention, and drug dependence treatment. It authorizes appropriations for fiscal years 2027 through 2030.

This section directs the Secretary of Health and Human Services to submit an annual report to Congress and the President on the impact of HIV/AIDS on racial and ethnic minority communities, women, and youth aged 24 and younger. The report must address progress in reducing that impact, opportunities and challenges for further reductions, and Federal funding needed to achieve substantial reductions in racial and ethnic minority communities.

This section expresses the sense of Congress that five national observance days highlight the impact of HIV on communities of color: National Black HIV/AIDS Awareness Day, National Latino AIDS Awareness Day, National Asian and Pacific Islander HIV/AIDS Awareness Day, National Native American HIV/AIDS Awareness Day, and National Youth HIV/AIDS Awareness Day. It further states that the President should urge members of those communities to engage in local HIV testing, policy, and advocacy, raise awareness of the epidemic, and promote risk reduction, safe sex, testing, and care.

This section directs the Attorney General, the Secretary of Health and Human Services, and the Secretary of Defense to initiate a national review within 90 days of enactment of Federal and State laws, policies, regulations, and judicial precedents on criminal prosecution and civil commitment of people living with HIV. The Attorney General must transmit a public report to Congress within 180 days that analyzes whether such laws impose unique burdens, assesses their alignment with current public health evidence on transmission risks and treatment benefits, and provides best practice recommendations.

This section directs the Attorney General to allow community organizations to distribute sexual barrier protection devices and provide STI counseling and comprehensive sexuality education in federal correctional facilities within 30 days of enactment. It prohibits adverse actions against incarcerated individuals for possessing or using such devices. It requires the Attorney General to survey all federal and state facilities annually for 5 years on STI testing, prevention education, access to devices, sexual violence, prerelease referrals, and Medicaid reinstatement, with results disaggregated by race, age, gender, and STI type.

This section requires states to automatically enroll or reinstate Medicaid coverage, without a program application, for individuals diagnosed with HIV or previously enrolled in the state plan, at least 30 days before release from a public institution upon sentence completion or as soon as possible before release on parole or probation. It suspends continuous eligibility during incarceration and restores the remaining period upon release. It also increases federal Medicaid matching payments by 5 percentage points for the first four calendar quarters after implementation for related enrollment, administrative, and medical assistance expenditures, subject to state reporting and maintenance of eligibility requirements.

This section requires the Director of the Bureau of Prisons to develop and implement a comprehensive HIV policy for testing, treatment, and prevention in federal correctional facilities and upon reentry. The policy must include routine testing upon intake and for pregnant inmates, confidential pre- and post-test counseling, annual educational programs and materials, testing upon request, and comprehensive medical treatment consistent with HHS guidelines, with regulations drafted within one year after consultation with HHS, ONDCP, ONAP, and CDC.

This section authorizes the Secretary of Health and Human Services to transfer up to 1 percent of discretionary appropriations for HIV-related programs and activities to the Office of the Assistant Secretary for Health to implement the Ending the HIV Epidemic: A Plan for America initiative. It requires congressional notification at least 30 days before any transfer and defines the initiative as one that seeks to reduce new HIV infections in the United States by 75 percent by 2027 and by at least 90 percent by 2032.

This section requires group health plans and issuers of group or individual health insurance coverage to provide coverage without cost sharing for any FDA-approved prescription drug for HIV prevention, administrative fees for such drugs, associated laboratory and diagnostic procedures, and clinical follow-up and monitoring services recommended in current Public Health Service guidelines. It prohibits preauthorization requirements for these services, except that plans may require preauthorization for a particular drug if they cover a therapeutically equivalent drug without such requirements.

This section directs the Director of NIH to expand research on prediabetes and type 2 diabetes in minority populations, including causes, complications, and interventions, and to include minority participants in clinical trials. It requires the Diabetes Mellitus Interagency Coordinating Committee to submit a report to Congress within 6 months and a comprehensive Federal plan within 1 year covering research, surveillance, community interventions, and health professional training. It also authorizes grants for medical education programs and to expand minority participation in diabetes-focused health fields.

This section directs the Secretary, acting through the Director of the Centers for Disease Control and Prevention, to conduct and support research and public health activities on diabetes in minority populations. It requires oversampling of Asian Americans, Native Hawaiians, and Pacific Islanders in the National Health and Nutrition Examination Survey without reducing oversampling of other groups; prevention research and model demonstration projects on health care system changes and community-based interventions; a strategic plan to reduce disparities; expanded diabetes prevention program sites; new outcome metrics stratified by minority population; and culturally and linguistically appropriate public education campaigns.

This section establishes programs, administered through the Health Resources and Services Administration, to educate health professionals on the causes and effects of diabetes in minority populations. It (1) prioritizes grants under the primary care training and enhancement program for diabetes and adds minority populations to the list of vulnerable populations served; (2) provides additional funds for the Health Careers Opportunity Program and Centers of Excellence to partner with the Office of Minority Health and NIH on diabetes career opportunities in underserved regions; and (3) adds a diabetes focus to the National Health Service Corps scholarship program for placements and continuing education in high-impact areas.

This section directs the Secretary, acting through the Indian Health Service and in collaboration with other appropriate Federal agencies, to conduct and support research and other activities on diabetes and to coordinate the collection of data on clinically and culturally appropriate diabetes treatment, care, prevention, and services for American Indian populations.

This section directs the Secretary of Health and Human Services to arrange with the National Academy of Medicine for submission to Congress, within one year of enactment, of an updated version of the 2003 report “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” that addresses changes in racial and ethnic health disparities since the original report.

This section revises the asthma-related activities of the Centers for Disease Control and Prevention to require collaboration with state and local health departments on public education to deter uncontrolled asthma, development of state plans to reduce asthma burden in disproportionately affected populations, annual surveillance and publication of childhood and adult asthma data on prevalence, mortality, hospital admissions, and emergency visits by age, sex, race, ethnicity, and other factors, and reports to Congress not later than 3 years after enactment of the Health Equity and Accountability Act of 2026 and every 2 years thereafter with recommendations on reducing morbidity and disparities.

This section directs the Secretary of Health and Human Services to enhance the annual influenza and pneumonia vaccination campaign with written educational materials, public service announcements, physician education, and other effective means. It requires targeted, culturally appropriate outreach to communities experiencing disparities in incidence and mortality rates and authorizes such sums as may be necessary for each of fiscal years 2027 through 2031.

This section directs the Director of the Centers for Disease Control and Prevention to conduct, support, and expand public health strategies on prevention, diagnosis, surveillance, and awareness of chronic obstructive pulmonary disease. It requires the Director of the National Heart, Lung, and Blood Institute to carry out public education, grants to states and tribes for disproportionately impacted communities, pilot programs with the Indian Health Service and Department of Veterans Affairs, and smoking cessation techniques; mandates a joint data collection assessment within 180 days; and authorizes appropriations for fiscal years 2027 through 2031.

This section establishes a policy for United States foreign assistance to combat tuberculosis. It sets ending the TB public health emergency as a major objective through diagnosis and treatment of all adults and children with all forms of TB and prevention of new infections. It directs support for the World Health Organization End TB Strategy goals to reduce TB deaths by 95 percent and incidence by 90 percent by 2035, and for the Stop TB Partnership Global Plan to End TB 2023–2030 targets to treat 40,000,000 people with active TB (including 3,500,000 children) and provide preventive therapy to 30,000,000 people by 2023.

This section directs the Centers for Disease Control and Prevention to expand the Health Community Program and Arthritis Program to educate the public on the causes, prevention, and effects of arthritis, lupus, and other musculoskeletal conditions in minority populations, as well as their links to comorbidities including obesity, hypertension, and cardiovascular disease. It requires culturally and linguistically appropriate programs and public awareness campaigns targeting Native Americans and Alaska Natives, Asian Americans, African Americans and Blacks, Hispanic and Latino Americans, and Native Hawaiians and Pacific Islanders. It authorizes such sums as necessary for FY2027 and each subsequent fiscal year.

This section authorizes the Secretary of Health and Human Services, in coordination with the Secretary of Education, to award 5-year competitive grants to academic health science centers, health professions schools, and institutions of higher education for education on arthritis, osteoarthritis, obesity-related musculoskeletal diseases, health disparities, and comorbidities such as diabetes and cardiovascular disease. It requires annual reports to Congress for 5 years on grant recipients, activities, students served, and program evaluations, with priority given to minority-serving institutions and those with high enrollment of needy students.

This section directs the Director of the National Institutes of Health, acting through the Director of the National Heart, Lung, and Blood Institute, to expand research addressing sleep health disparities and implement the NIH Sleep Disorders Research Plan across all institutes and centers. It requires specific activities on epidemiology, multilevel determinants, interventions, cultural barriers, and investigator diversity related to sleep and cardiovascular or metabolic health disparities, and authorizes appropriations for fiscal year 2027 and each subsequent year.

This section directs the Director of the Centers for Disease Control and Prevention to conduct, support, and expand surveillance, prevention, diagnosis, and public and professional awareness activities on sleep and circadian rhythm disorders. It requires culturally and linguistically appropriate outreach and programs targeting Native Americans and Alaska Natives, Asian Americans, African Americans and Blacks, Hispanic and Latino Americans, and Native Hawaiians and Pacific Islanders; collection of national and state data on disparities; addition of sleep questions to public health surveillance systems; monthly reports on geographic, racial, and ethnic disparities and links to chronic disease and health behaviors; and public awareness campaigns, and authorizes such sums as may be necessary beginning in fiscal year 2027.

This section authorizes the Secretary of Health and Human Services, in coordination with the Secretary of Education, to award 5-year competitive grants to academic health science centers, health professions schools, and institutions of higher education to integrate education on sleep disorders, sleep health disparities, and the links between sleep and circadian health with metabolic, neurological, and other diseases into curricula, orientation, technology platforms, and peer outreach. It prioritizes institutions that are minority-serving or enroll high numbers of needy students and requires annual reports to Congress for 5 years on grant recipients, activities, students served, and evaluations.

This section directs the Secretary of Health and Human Services to submit a report to Congress and the President within one year of enactment on the impact of sleep and circadian health disorders in racial and ethnic minority communities and other vulnerable populations. The report must cover progress made, opportunities for additional progress, challenges to further reductions, and Federal funding needed for substantial reductions.

This section expands research and training requirements at kidney, urologic, and hematologic diseases centers to include data science and bioinformatics improvements, genetic mapping of kidney function and disease mechanisms especially in minority populations, enhanced humanized animal models and kidney organoids, and cell-specific drug delivery and gene editing systems. It directs the NIH Director to work with the National Institute on Minority Health and Health Disparities to increase minority enrollment in related clinical trials through consortia, novel trial designs, targeted outreach, and studies on quality-of-life interventions. It also requires the Kidney, Urologic, and Hematologic Diseases Coordinating Committee to submit a report to Congress within six months and a comprehensive Federal plan within one year addressing research, surveillance, community interventions, and health professional training on kidney disease in minority populations.

This section directs the Director of the Centers for Disease Control and Prevention to expand public health strategies, prevention, diagnosis, surveillance, and awareness activities on kidney disease. It requires the Director of the National Institute of Diabetes and Digestive and Kidney Diseases, in consultation with the National Institute on Minority Health and Health Disparities and CDC, to develop a national action plan within 2 years that includes recommendations on interventions, research, and federal data collection. It further requires CDC’s Chronic Kidney Disease Initiative to conduct targeted education and awareness activities, award grants to reduce disease burden in disproportionately impacted communities, coordinate pilot programs with NIDDK, the Indian Health Service, HRSA, and the Department of Veterans Affairs, and develop best practices with VA. It mandates a joint assessment within 180 days of kidney disease data in CDC surveys. It authorizes $1 million annually for fiscal years 2027 through 2031.

This section establishes an add-on payment under Medicare for staff-assisted home dialysis furnished on or after the date that is 1 year after enactment to initializing patients, returning patients, or temporary assistance patients, limited to an initial 90-day period (extendable by up to two 30-day intervals) except for patients who are blind, have specified cognitive or neurological impairments, or have mobility-reducing conditions. It requires education of individuals on the option and training of patients and care partners by registered or licensed nurses or other qualified providers.

This section expands National Institutes of Health research into causes of and interventions for lower kidney transplant rates in minority populations. It requires the Centers for Medicare & Medicaid Services to collect and report annual data on dialysis facility and nephrologist transplant referral performance, with emphasis on patients of color. It requires the Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients to collect and report annual transplant center performance data by demographic and socioeconomic characteristics. It requires transplant centers and organ procurement organizations to report data on waitlisted patients, suboptimal kidney offers, referrals, refusals, and acceptances by race, ethnicity, age, ZIP Code, and hospital. It requires transplant centers to provide patients annual data on declined organ offers within a 500-mile radius. It directs the Centers for Medicare & Medicaid Services to certify a third-party organization to accredit transplant education. It requires the Secretary of Health and Human Services to submit a report to Congress within 6 months and a comprehensive plan within 1 year to increase kidney transplants in minority populations.

This section directs the Director of the Centers for Disease Control and Prevention to support research into the environmental and occupational causes and biological mechanisms that contribute to kidney disease and to develop and disseminate public health interventions that lessen the impact of those causes.

This section directs the Secretary of Health and Human Services to study treatment patterns for kidney failure care provided to minority populations under Medicare, Medicaid, and private health insurance. It requires submission of a report with recommendations to Congress within 1 year.

This section expands the definition of primary health services for the National Health Service Corps to include nephrology. It also authorizes kidney health professionals to participate in the Corps scholarship program and loan repayment program.

This section extends guaranteed issue of Medicare supplemental (Medigap) policies to individuals entitled to benefits under section 226A(b) of the Social Security Act (i.e., those with end-stage renal disease) who are enrolled in part B, effective for policies on or after January 1, 2027 (from only those age 65 or older). It also establishes a one-time enrollment period from January 1, 2027, through June 30, 2027, during which such individuals may enroll in any Medigap policy of their choosing.

This section directs the Commissioner of Food and Drugs to aggregate sponsors’ experience with clinical trial diversity plans and analyze which actions succeeded or failed in increasing participation. It requires a public meeting by September 30, 2027, with regulated industry and patient organizations to discuss findings and recommendations, followed by an update to the FDA guidance titled “Enhancing the Diversity of Clinical Trial Populations—Eligibility Criteria, Enrollment Practices, and Trial Designs” by September 30, 2028, to reflect those recommendations.

This section exempts the free provision of digital health technologies to clinical trial participants from civil monetary penalties, anti-kickback, and false claims laws when the technologies promote inclusion of underrepresented racial and ethnic minorities, low-income populations, and the elderly. It authorizes HHS grants and contracts for community outreach and recruitment into clinical trials for conditions disproportionately affecting such populations, with priority for multilingual materials and Tribal areas, and appropriates such sums as necessary for fiscal years 2027 and 2028. It excludes remuneration offered to promote participation in approved clinical trials from the definition of prohibited remuneration under the civil monetary penalties law. It directs the Secretary to arrange a National Academy of Medicine study on a national interoperable health data platform for public health emergencies, with a report due to Congress within 180 days.

This section requires entities seeking National Institutes of Health funding for clinical trials of drugs, devices, or biological products to submit applications with measurable recruitment and retention goals reflecting the race, ethnicity, age, and gender or sex of affected patients or the U.S. population; a rationale and detailed plan for achieving those goals, including separate analysis by group and community review; less burdensome follow-up alternatives; and researcher training on diversity and health inequities. It conditions funding on annual aggregate demographic reporting for underrepresented populations, frequent disaggregated retention rate submissions, and completion of diversity education by researchers and reviewers.

This section requires sponsors of investigational drugs to collect standardized patient experience data during clinical trials and to submit that data with any application for approval or licensing. It directs the Secretary to consider such data when deciding whether to approve or license the drug. These requirements apply to exemption requests submitted on or after the date of enactment of the Health Equity and Accountability Act of 2026, or applications filed two years after that date. It also requires the Secretary to promulgate implementing regulations within one year.

This section establishes Medicare Part B coverage for multi-cancer early detection screening tests, defined as FDA-approved or cleared genomic sequencing blood tests analyzing cell-free nucleic acids (or equivalent urine- or other biological sample-based tests) for early detection of cancer across multiple types. It requires payment under the clinical laboratory fee schedule but prohibits payment if a test was furnished to the same individual in the prior 11 months, and specifies that coverage does not affect existing coverage for other cancer screenings such as those for breast, cervical, colorectal, lung, or prostate cancer.

This section establishes a peripheral artery disease education program, coordinated by the CDC Director in collaboration with the CMS and HRSA Administrators, to inform health care professionals and the public about the disease and methods to reduce related amputations, particularly among at-risk populations. It authorizes such sums as necessary for the program for each of fiscal years 2027 through 2031. It adds Medicare coverage, without cost sharing or deductible, for peripheral artery disease screening tests (including ankle-brachial index testing and arterial duplex scans of lower extremity arteries) furnished to at-risk beneficiaries (defined as individuals age 65 or older; ages 50–64 with atherosclerosis risk factors such as diabetes, smoking history, hyperlipidemia, or hypertension, or a family history of the disease; under age 50 with diabetes plus one additional risk factor; or with known atherosclerotic disease in another vascular bed). It includes the tests in the initial preventive physical examination, requires the Secretary to set frequency standards, and sets payment at 100 percent of the lesser of the actual charge or the amount determined under the physician fee schedule.

This section eliminates the coinsurance requirement for certain colorectal cancer screening tests under Medicare by providing 100 percent coverage for 2027 and each subsequent year.

This section expands Medicare coverage of medical nutrition therapy services to include the prevention, management, or treatment of specified diseases and conditions, including diabetes, prediabetes, obesity, hypertension, dyslipidemia, malnutrition, eating disorders, cancer, gastrointestinal diseases, HIV, AIDS, and cardiovascular disease. It authorizes such services when furnished by a physician, physician assistant, nurse practitioner, clinical nurse specialist, or clinical psychologist (for eating disorders), effective January 1, 2027.

This section establishes an additional Medicare inpatient payment, effective for discharges on or after October 1, 2027, for DISARM antimicrobial drugs at 102 percent of the amount payable under section 1847A. It limits eligibility to subsection (d) hospitals participating in the CDC’s National Healthcare Safety Network Antimicrobial Use and Resistance Module and maintaining a qualifying antimicrobial stewardship program, defines qualifying drugs and biological products (including those licensed on or after June 5, 2014), creates a Secretary designation process with annual Federal Register lists beginning October 1, 2026, and requires manufacturers to submit pricing information.

This section expands Medicare coverage of intensive behavioral therapy for obesity beyond qualified primary care physicians and practitioners to include other physicians, physician assistants, nurse practitioners, clinical nurse specialists, clinical psychologists, registered dietitians or nutrition professionals, and evidence-based community-based lifestyle counseling programs, when furnished upon referral from a physician or primary care practitioner and in specified settings. It also extends Medicare Part D coverage to drugs used for obesity treatment or for weight loss management in overweight individuals with one or more related comorbidities, effective for plan years beginning on or after the date that is 2 years after enactment. It further requires the Secretary of Health and Human Services to report to Congress within 1 year of enactment and every 2 years thereafter on implementation steps and recommendations for coordinating federal obesity-related research and clinical care programs.

This section requires the Director of the National Institute on Aging, beginning January 1, 2027, to fund new Alzheimer’s disease research centers in areas with higher concentrations of minority groups, including historically Black colleges and universities, Hispanic-serving institutions, and Tribal colleges and universities. It mandates that certain federal payments support diagnostic and treatment clinics serving minority, rural, and underserved populations that also operate clinical trials. It requires engagement centers to conduct outreach, education, and recruitment activities to increase minority participation in Alzheimer’s clinical trials, and it directs training, awards, and site incentives for principal investigators and researchers from underrepresented populations.

This section directs the Director of the National Cancer Institute to review stomach cancer incidence, risk factors including H. pylori infection, screening availability and effectiveness, and current awareness efforts, and to submit a report to Congress within 18 months that includes recommendations for defining high-risk populations, establishing routine screening guidelines, and improving prevention and early detection. It also directs the Secretary of Defense, in coordination with the Directors of the National Cancer Institute and the Centers for Disease Control and Prevention, to study stomach cancer incidence, service-related risk factors, and disparities among active-duty and former members of the Armed Forces, and to submit a report to Congress within 18 months with policy recommendations for integrating screening and treatment into the military health system and the Department of Veterans Affairs health system.

This section directs the Director of NIH to expand, intensify, and coordinate research and activities on rare diseases health equity. It establishes a Coordinating Committee of institute directors and other federal agencies to advise the Secretary and Director of NIH, and requires the Committee to develop and periodically revise a plan within one year for research, epidemiological studies, screening, treatments, and education on rare diseases or conditions in minority populations, with the Director of NIH ensuring implementation.

This section directs the Director of NIH, the Director of the National Institute on Minority Health and Health Disparities, the Director of the National Center for Advancing Translational Sciences, the Director of the National Heart, Lung, and Blood Institute, and other NIH directors to develop within 180 days a comprehensive Federal plan to address rare diseases and conditions in minority populations, including a strategy to increase diversity in genetic programs at the Therapeutics for Rare and Neglected Diseases program. It requires them to conduct or support research on early detection, diagnosis, treatment, and quality-of-life improvements for affected individuals and families; clinical training programs for physicians and other practitioners; and guidance to increase participation by minority health professionals in NIH-supported research on such diseases and conditions.

This section directs the award of grants, in coordination with the Centers for Disease Control and Prevention, to public and private nonprofit entities to collect, analyze, and report epidemiological data on rare diseases and conditions in minority populations and to conduct outreach improving health literacy and disseminating information on related services. It also requires submission of biannual reports to Congress on these activities, beginning no later than two years after enactment of the HEARD Act.

This section establishes grant programs for accredited schools of medicine, osteopathic medicine, and nursing to train health care professionals on care for individuals with rare diseases or conditions, including via telehealth and relevant research. It authorizes additional grants for education on the causes and effects of such diseases in minority populations, a mentoring program for professionals seeking to treat these patients, and both a loan repayment program offering up to $50,000 per year (plus inflation adjustment) and a scholarship program requiring a minimum five-year service obligation.

This section authorizes the Secretary to award grants to accredited schools of allopathic medicine, osteopathic medicine, and nursing, and other health professional training programs, to establish programs that increase recruitment and retention of minority researchers conducting studies on the cause, diagnosis, prevention, and treatment of rare diseases or conditions, including by expanding internships and mentoring opportunities.

This section directs the Secretary of Health and Human Services, acting through the National Institutes of Health Director and in consultation with the Centers for Disease Control and Prevention Director, to submit a report to Congress within 2 years of enactment. The report must cover federal research and public health activities on rare diseases and conditions in minority populations, a comprehensive list of those that disproportionately affect such populations, and an analysis of related data gaps.

This section requires the Secretary, acting through the CDC Director, to conduct or support research and public health awareness campaigns on rare diseases and conditions in minority populations. It also directs the Secretary to establish a public education program, directly or through grants or contracts and in cooperation with existing national campaigns, that provides culturally and linguistically appropriate information on prevention and management of such diseases and conditions.

This section directs the Secretary of Health and Human Services, acting through the Commissioner of Food and Drugs, to survey FDA policies and programs that support increased availability of clinical trial data on minority populations, with emphasis on those with rare diseases and conditions. It also requires submission of a report to Congress within 2 years of enactment containing the survey findings and recommendations for statutory or regulatory changes and strategies to promote racial equity in research and development of treatments for rare diseases disproportionately affecting minority populations.

This section establishes the Tribal Epidemiology Center Grant Program. It directs the Secretary, acting through the Indian Health Service, to award grants to Tribal Epidemiology Centers and Tribal and Urban Indian Health Centers to support clinically and culturally appropriate research and other activities on rare diseases and conditions in Native American or Tribal communities, including coordination of data collection on prevention, diagnosis, treatment, and care.

This section directs the Secretary of Health and Human Services to review and report to Congress within 180 days on regulatory barriers under Medicare that inhibit access to rare disease treatments for beneficiaries of color, including barriers affecting providers, as well as telehealth service requirements for such treatments, and to include recommendations.

This section requires each employer to furnish employment and a place of employment free from conditions reasonably anticipated to cause death or serious physical harm from heat stress, and to comply with all standards, regulations, rules, and orders issued under this subtitle.

This section directs the Secretary to promulgate worker heat protection standards that establish the maximum feasible measures to prevent heat-related illness and injury. The standards must include engineering controls, administrative controls, personal protective equipment at employer expense, medical monitoring, training for employees and supervisors, written prevention plans developed with employee participation, and core practices such as cool water, paid rest breaks, shade or cool-down spaces, and acclimatization policies.

This section gives a worker heat protection standard the same legal effect as an occupational safety and health standard under the Occupational Safety and Health Act of 1970. It imposes a 4-year statute of limitations on citations, requires the Occupational Safety and Health Review Commission to grant substantial deference to the Secretary’s reasonable interpretations, authorizes recordkeeping and reporting rules equivalent to those under section 8 of the Act while treating violations as distinct, and extends whistleblower protections allowing complaints within 180 days and private suits after 90 days with attorney fees and costs.

This section provides that if any provision or application of the subtitle is held invalid, the remainder and other applications remain in effect. It also authorizes appropriations of such sums as may be necessary for each fiscal year to carry out the subtitle.

This section directs the Secretary to update the National Agricultural Workers Survey with questions to identify the incidence and prevalence of heat-related illness and injury among agricultural workers and to assess the impact of related standards and enforcement. It also requires the Secretary to submit a report on implementation to the House Committee on Education and Workforce and the Senate Committee on Health, Education, Labor, and Pensions within one year of enactment.

This section defines terms for the subtitle, including heat stress as the combined load from metabolic sources, environmental factors, and clothing or protective equipment; heat-related illness as a material health impairment from such stress; heat-related injury as an injury caused by heat exposure; and a worker heat protection standard as a requirement to prevent such illness and injury.

This section establishes Centers of Excellence on Rare Kidney Disease Research within the National Institute of Diabetes and Digestive and Kidney Diseases. It authorizes the Institute Director to enter cooperative agreements and award grants to nonprofit entities for regional centers that conduct research on rare kidney diseases including primary glomerular disease, increase public awareness in rural and underserved communities, and develop clinical training and resources. It authorizes $6,000,000 annually for fiscal years 2027 through 2031 and requires funded research to include genotype-phenotype studies while prohibiting use of quality-adjusted life years or disability-adjusted life years.

This section directs the Secretary of Health and Human Services to conduct a study on testing, preventative care, precision medicine, and treatment for rare kidney disease. The study must examine the impact of routine urinalysis and kidney biopsies on diagnosis, the utility of genetic and genomic testing including APOL1, social and biological factors, treatment patterns and nephrologist access under Medicare, Medicaid, and private insurance for disproportionately affected populations, efforts to slow end-stage progression, and patient trust. The Secretary must submit a report to Congress within 18 months after consulting stakeholders and coordinating with NIH, CMS, HRSA, and CMMI, with $1,000,000 authorized annually for fiscal years 2027 through 2031.

This section expands primary care training grants to include individuals with kidney disease, including rare kidney disease, among the populations served by accredited residency and fellowship programs in family medicine, internal medicine, and pediatrics. It also authorizes fellowships in nephrology to increase providers’ knowledge of rare kidney disease prevention, diagnosis, and treatment for populations disproportionately impacted by the disease, including those with the APOL1 gene variant; improve care quality for racial and ethnic minorities; and increase the number of nephrologists trained to serve such populations.

This section directs the Secretary to conduct experiments evaluating treatments for rare kidney disease, with emphasis on methods that delay or eliminate the need for dialysis and transplantation. It also requires a comprehensive study of methods to increase public awareness of rare kidney disease and a report to Congress within 24 months of enactment of the Health Equity and Accountability Act of 2026 that includes legislative recommendations.

This section expands Health Resources and Services Administration programs to provide technical assistance and resources to health centers for adopting and meaningfully using certified electronic health record technology to manage chronic diseases and reduce health disparities. It authorizes related funding initiatives, including 5G connectivity for telemedicine, grants for next-generation electronic health records, and technology hardware.

This section directs the National Coordinator for Health Information Technology to evaluate interoperability, access, and use of electronic health records in racial and ethnic minority communities within 18 months of enactment, promulgate a certification criterion stratifying quality measures by race, ethnicity, language, gender identity, sexual orientation, socioeconomic status, and disability status within one year, and establish evaluation criteria and best practices for adoption of certified EHR technology in such communities. It requires the National Center for Health Statistics to report on certified EHR adoption in physicians’ offices in communities of color and rural communities for fiscal years 2023 through 2026, and the Secretary of Health and Human Services to collect provider race and ethnicity data during Medicare and Medicaid EHR incentive program registration.

This section requires covered entities to ensure that electronic and information technology in their health programs or activities does not exclude individuals from participation, deny benefits, or subject individuals to discrimination on the basis of race, color, national origin, sex, age, or disability. Covered entities include health programs or activities receiving federal financial assistance, entities established under title I of the Patient Protection and Affordable Care Act that administer such programs, and the Department of Health and Human Services.

This section requires the National Coordinator for Health Information Technology to propose a rule within 18 months of enactment that mandates certified electronic health record technology to provide patients access to their personal health information in a computable format in the 10 most common non-English languages via patient portals or third-party applications. It also directs the National Coordinator to hold a public hearing on best practices and issue a final regulation within 6 months after the hearing.

This section requires the Secretary of Health and Human Services to invest in health information technology infrastructure, including for communities with a high proportion of individuals from racial and ethnic minority groups. It also requires the National Coordinator for Health Information Technology to report annually to Congress on activities and expenditures under the section.

This section expands competitive grants for loan programs that help health care providers adopt certified EHR technology to include communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)).

This section requires the National Coordinator for Health Information Technology to coordinate data collection and assessments, to the greatest extent possible, with historically Black colleges and universities, Hispanic-serving institutions, Tribal Colleges and Universities, and Asian-American-, Native American-, or Pacific Islander-serving institutions that have accredited public health, health policy, or health services research programs, when addressing communities with high proportions of individuals from racial and ethnic minority groups.

This section directs the Secretary of Health and Human Services to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine to study the development, implementation, and effectiveness of health information technology in medically underserved areas and to submit a report to Congress with findings and recommendations within two years. The study must examine barriers to adoption, interoperability, impacts on care quality and costs, effects on health disparities, best practices for individuals with disabilities, and differences between urban and rural systems.

This section requires the Secretary of Health and Human Services, within 18 months of enactment, to enter into an agreement with the Office of the National Coordinator for Health Information Technology to study the prevalence and practices of using or misusing de-identified protected health information and other de-identified personal health information to discriminate against or benefit medically underserved areas, and to submit a report to Congress with findings and recommendations.

This section expands eligibility for the 90 percent federal matching rate for Medicaid electronic health record incentive payments to include rehabilitation facilities furnishing acute or subacute rehabilitation services, long-term care hospitals described in section 1886(d)(1)(B)(iv), and home health agencies defined in section 1861(o). The change applies to amounts expended for calendar quarters beginning on or after the date of enactment.

This section extends eligibility for Medicaid electronic health record incentive payments under section 1903(a)(3)(F) to physician assistants. The change applies to amounts expended for calendar quarters beginning on or after the date of enactment.

This section removes geographic requirements for Medicare telehealth services furnished on or after the first day after the end of the period for which the temporary exception in clause (iii) applies.

This section expands Medicare telehealth originating sites by making an individual's home a permanent originating site on or after the first day after the end of the period for which clause (iii) applies (from its prior limitation to dialysis services under section 1881(b)(3)(B) or specified telehealth services). It authorizes the Secretary to designate any other appropriate site as an originating site and to establish requirements at those sites for beneficiary and program integrity protections. It also eliminates the originating site facility fee for the home and new sites.

This section defines terms for use in the title, including the Administrator of the Environmental Protection Agency, the built environment as homes, schools, parks, transportation systems, and land-use plans that shape community characteristics, and determinants of health as nonclinical personal, social, economic, and environmental factors that influence health status.

This section establishes a program at the National Center for Environmental Health, in collaboration with the Environmental Protection Agency, to advance health impact assessments. It requires the Secretary to issue guidance on conducting assessments within one year of enactment, award capacity-building grants to states, Indian tribes, and tribal organizations, provide technical assistance and training, conduct research and evaluations, and create a grant program allowing those entities to fund subgrants for eligible community-based organizations to prepare assessments.

This section establishes a grant program administered by the Director of the Centers for Disease Control and Prevention, in collaboration with the Administrator and the Director of the National Institute of Environmental Health Sciences, to fund eligible states, Indian Tribes, Tribal organizations, and local communities. Eligible entities must demonstrate disproportionate exposure to environmental health hazards or unhealthy living conditions, maintain coalitions with community organizations and public health partners, and coordinate funding streams. Grants are awarded at three levels: Level 1 supports planning councils and environmental health assessments; Level 2 supports entities with existing partnerships to address priorities including air and water quality, housing, nutrition, and built environment factors; and Level 3 supports further implementation activities.

This section establishes a grant program, administered by the Secretary in collaboration with the Administrator, that awards funds to eligible public or private nonprofit institutions to research causal links between the built environment and resident health. The research must examine impacts on physical activity, mobility, nutritional food consumption, crime rates, air/water/soil quality, injury risk, health care access, educational attainment, and other indicators; distinguish external influences from personal choices; develop intervention strategies targeting high-risk populations such as racial and ethnic minorities and low-income communities; and receive priority when it involves minority-serving institutions or interdisciplinary expertise from public health, urban planning, and transportation fields.

This section establishes a federal policy of environmental stewardship for public health and directs the National Academy of Sciences to study the effects on public health, air quality, water quality, wildlife, and the environment of 13 specified regulations and laws on clean water, forests, land management, and Endangered Species Act interagency cooperation. The study must begin within 30 days of enactment, with a public report due within 270 days that compares impacts to preexisting rules.

This section directs the Comptroller General to study the type and scope of Department of Health and Human Services programs providing health care to racial and ethnic minorities, including residents, cleanup workers, and volunteers, affected by the April 20, 2010, Deepwater Horizon explosion and resulting hydrocarbon releases. The study must assess Gulf Coast program size and scope, identify merits and disadvantages, analyze costs and benefits, and check for duplication, with a report to Congress due within 180 days that includes findings and recommendations to improve access.

This section establishes the Social Determinants Accelerator Interagency Council, with designees from the Office of Management and Budget, Departments of Agriculture, Education, Housing and Urban Development, Labor, and Transportation, the Indian Health Service, at least three agencies within the Department of Health and Human Services, and up to six non-federal members. The Council recommends criteria for grants, identifies federal authorities to improve coordination of health and social services programs, provides technical assistance to states developing accelerator plans, develops evaluation guidelines, and reports annually to Congress.

This section prohibits Executive agencies from using the terms "alien" or "illegal alien" in proposed or final rules, regulations, interpretations, publications, documents, displays, or signs, except when quoting external sources. It defines "foreign national" as any individual who is not a United States citizen or who owes permanent allegiance to the United States. It deems references to "alien" to mean "foreign national" and references to "illegal alien" to mean "undocumented foreign national."

This section establishes a criminal offense making it unlawful for a federal law enforcement officer, Bureau of Prisons employee, or U.S. Marshals Service employee to negligently fail to obtain or provide immediate medical attention to an individual in federal custody displaying medical distress, including breathing difficulties, if the individual suffers unnecessary pain, injury, or death as a result. It imposes penalties of a fine, up to one year in prison, or both; requires the appropriate Inspector General to investigate such incidents and refer negligent cases for prosecution; authorizes state attorneys general to seek equitable and declaratory relief in federal court; mandates agency training on medical assistance; and directs establishment of a confidential complaint process.

This section directs the Secretary of Health and Human Services to conduct research on the adverse health effects of law enforcement interactions among racial and ethnic minorities and to report findings and recommendations to Congress within one year. It authorizes $20 million annually for FY2027 through FY2031 for four-year grants to community-based organizations to expand culturally competent trauma support and mental health services for racial and ethnic minorities, with priority for communities facing high rates of trauma including law enforcement violence. It also requires the Secretary to develop and implement an outreach and education strategy to promote behavioral health and reduce stigma among those groups, with a report due within one year.

This section establishes the Environmental Justice Mapping Committee, composed of at least one representative from each of 13 specified federal agencies and offices, including multiple components of the Environmental Protection Agency, the Council on Environmental Quality, and offices within the Departments of Commerce, Health and Human Services, Interior, Housing and Urban Development, Energy, Transportation, Justice, and the Treasury. It defines environmental justice, environmental justice communities, ground-truthing, and relevant stakeholders, and requires the Committee to select three co-chairs with staggered three-year terms.

This section establishes the National Center on Antiracism and Health within the Centers for Disease Control and Prevention. The Center declares racism a public health crisis, conducts research and data collection on the health impacts of structural racism and related disparities, awards grants to state, local, territorial, and Tribal entities, establishes at least three regional centers of excellence in racial and ethnic minority communities, creates a public data clearinghouse, provides public education, and coordinates with other CDC offices and Indian Tribes on antiracism activities.

This section directs the Centers for Disease Control and Prevention to improve collection of sexual orientation and gender identity data for deceased individuals through the National Violent Death Reporting System within 120 days of enactment. It authorizes $25,000,000 for fiscal year 2027 and expresses the sense of Congress that participating jurisdictions should be commended.

This section establishes the Social Determinants Accelerator Interagency Council, chaired by a designee of the HHS Secretary and including representatives from OMB, USDA, Education, HUD, Labor, Transportation, Indian Health Service, at least three HHS agencies, and up to six nonfederal members. The Council must recommend criteria for social determinants accelerator grants, identify underused federal authorities for state and local coordination of health and social services, provide technical assistance to states developing cross-sector intervention plans, and report annually to Congress.

This section establishes the Social Determinants of Health Program at the Centers for Disease Control and Prevention to coordinate agency activities on social determinants of health, improve health outcomes and reduce inequities, and build capacity among public health agencies and community organizations. It directs the Director to award grants to State, local, territorial, and Tribal health agencies and other eligible entities for evidence-based, cross-sector strategies in target communities, with priority for areas of significant unmet needs, and to award separate grants for related research, technical assistance, and dissemination of best practices.

This section requires institutions receiving Federal work-study grants to notify each student receiving such assistance of their potential eligibility for SNAP. The notification, developed by the Secretary of Education in consultation with the Secretary of Agriculture, must include state-specific eligibility details, local office contact information, and an official document confirming work-study participation for purposes of the SNAP work-study exclusion under section 6(e)(4) of the Food and Nutrition Act of 2008. It also directs the Secretaries to issue guidance on identifying and communicating with eligible students.

This section expands CDC research on the causes, mechanisms, prevention, diagnosis, and treatment of injuries to include gun violence and data collection, and prohibits the Secretary or any recipient from using the resulting authority or funding to advocate or promote gun control.

This section directs the Secretary of Health and Human Services, acting through the CDC Director, to improve the National Violent Death Reporting System by adding states and increasing the quality, type, and timeliness of reported data. State participation remains voluntary.

This section directs the Surgeon General to submit to Congress, beginning one year after enactment and annually thereafter, a report on the public health effects, including mental health effects, of gun violence in the United States during the preceding year and on actions taken to address those effects.

This section directs the Deputy Assistant Secretary for Minority Health to submit a report to Congress within one year of enactment on the effects of gun violence on public health, including mental health, in minority communities, and the status of actions taken to address those effects.