WHAT THE LAW DOINCongress, in plain words

H.R. 9877 · 119th Congress

Health Equity and Accountability Act of 2026

IntroducedHealth
IntroducedJul 22, 2026
Passed HouseNot yet
Passed SenateNot yet
To PresidentNot yet
Became lawNot yet

How this bill changes the law

Sourced

H.R. 9877 would change 245 sections of existing law, and would create 180 new provisions of its own. Read from the bill text as introduced in the House (Jul 22, 2026).

Would also change: 42 U.S.C. 1395ww, 42 U.S.C. 1395x, 42 U.S.C. 1395k, 42 U.S.C. 1395l, 42 U.S.C. 1395w-27, 42 U.S.C. 1396a, 42 U.S.C. 1396d, 42 U.S.C. 1397cc, 42 U.S.C. 1397jj, 42 U.S.C. 1397ee, 42 U.S.C. 18022, 26 U.S.C. 36B, 42 U.S.C. 300gg-17, 42 U.S.C. 254b, 42 U.S.C. 290dd, 42 U.S.C. 293, 42 U.S.C. 247b-7, 42 U.S.C. 294, 42 U.S.C. 294q, 20 U.S.C. 1070a-15, 42 U.S.C. 296p, Public Law 103-416, 8 U.S.C. 1151, 8 U.S.C. 1184, 8 U.S.C. 1153, 42 U.S.C. 293m, 42 U.S.C. 295h, 26 U.S.C. 117, 20 U.S.C. 1070, 42 U.S.C. 254f, 42 U.S.C. 256h, 8 U.S.C. 1357, 42 U.S.C. 1397gg, 8 U.S.C. 1611, 8 U.S.C. 1612, 8 U.S.C. 1613, 7 U.S.C. 2015, 7 U.S.C. 2014, 8 U.S.C. 1631, 7 U.S.C. 2020, 42 U.S.C. 18071, 42 U.S.C. 18051, 42 U.S.C. 18082, 26 U.S.C. 5000A, 42 U.S.C. 18081, 42 U.S.C. 18032, 42 U.S.C. 1397aa, 42 U.S.C. 1611, 42 U.S.C. 1308, 42 U.S.C. 1396r-4, 42 U.S.C. 1382c, 42 U.S.C. 1395y, 42 U.S.C. 18024, 42 U.S.C. 18031, 42 U.S.C. 1395i-2, 42 U.S.C. 1395o, 42 U.S.C. 1395, 42 U.S.C. 1395r, 42 U.S.C. 1395p, 42 U.S.C. 1395v, 42 U.S.C. 1320b-14, 42 U.S.C. 1396u-3, 42 U.S.C. 1396u-5, 42 U.S.C. 1395w-114, 42 U.S.C. 1396p, 42 U.S.C. 1395m, 42 U.S.C. 1395i-4, 2 U.S.C. 602, 38 U.S.C. 7308, 42 U.S.C. 11705, 42 U.S.C. 11706, 42 U.S.C. 11709, 42 U.S.C. 1395f, 42 U.S.C. 1395z, 42 U.S.C. 1395cc, 42 U.S.C. 254c, 5 U.S.C. 5315, 5 U.S.C. 5316, 25 U.S.C. 1660d, 42 U.S.C. 1395w-22, 42 U.S.C. 1396u-2, 25 U.S.C. 1616l, 42 U.S.C. 1395w-4, 42 U.S.C. 1396u-7, 42 U.S.C. 256g-1, 42 U.S.C. 1315a, 42 U.S.C. 1320a-7, 42 U.S.C. 1395u, 21 U.S.C. 862a, 42 U.S.C. 1395w-23, 42 U.S.C. 1395w-24, 42 U.S.C. 294s, 42 U.S.C. 238, 42 U.S.C. 1396w-4, 42 U.S.C. 1395w-141, 42 U.S.C. 280h, 42 U.S.C. 280g, 42 U.S.C. 1397ll, 42 U.S.C. 1786, 26 U.S.C. 5701, 26 U.S.C. 5702, 42 U.S.C. 1396, 42 U.S.C. 294f, 42 U.S.C. 296j, 42 U.S.C. 247b-12, 42 U.S.C. 254c-20, 42 U.S.C. 294k, 42 U.S.C. 295p, 42 U.S.C. 237a, 42 U.S.C. 202, 42 U.S.C. 300ee, 20 U.S.C. 7906, 42 U.S.C. 710, 20 U.S.C. 7118, 20 U.S.C. 7112, 42 U.S.C. 11346, 29 U.S.C. 655, 42 U.S.C. 603, 42 U.S.C. 613, 42 U.S.C. 1397dd, Public Law 115-123, 42 U.S.C. 1397mm, 2 U.S.C. 905, 42 U.S.C. 1396n, 26 U.S.C. 223, 42 U.S.C. 701, 42 U.S.C. 1395yy, 42 U.S.C. 290ll, 42 U.S.C. 290hh, 42 U.S.C. 300x-1, 42 U.S.C. 300x-9, 42 U.S.C. 300x-52, 42 U.S.C. 300d-51, 20 U.S.C. 7291, 7 U.S.C. 5936, 42 U.S.C. 285, 21 U.S.C. 360aaa, 21 U.S.C. 360bbb, 42 U.S.C. 300k, 42 U.S.C. 241, 42 U.S.C. 300u, 42 U.S.C. 300n-4a, 42 U.S.C. 1396o-1, 42 U.S.C. 1396r-8, 42 U.S.C. 1397bb, 42 U.S.C. 300gg-13, 42 U.S.C. 300ff-31b, 18 U.S.C. 4014, 42 U.S.C. 300gg-111, 29 U.S.C. 1185, 5 U.S.C. 8904, 42 U.S.C. 1395w-102, 38 U.S.C. 1722A, 10 U.S.C. 1079c, 25 U.S.C. 1621v, 42 U.S.C. 285c, 42 U.S.C. 247b-10, 22 U.S.C. 2151b-3, 42 U.S.C. 285c-5, 42 U.S.C. 285c-3, 42 U.S.C. 1395rr, 42 U.S.C. 254d, 42 U.S.C. 254l, 42 U.S.C. 254l-1, 42 U.S.C. 1395ss, 42 U.S.C. 300gg-8, 21 U.S.C. 360bbb-8c, 42 U.S.C. 285e-2, 42 U.S.C. 285e-1, 42 U.S.C. 285e-10a, 42 U.S.C. 285e-4, 42 U.S.C. 284, 42 U.S.C. 285t, 42 U.S.C. 288, 25 U.S.C. 1621, 42 U.S.C. 281, 42 U.S.C. 293k, 42 U.S.C. 300jj-31, 42 U.S.C. 300jj-34, 42 U.S.C. 300jj-38, 42 U.S.C. 1975a, 42 U.S.C. 1975c, 20 U.S.C. 1087-53, 42 U.S.C. 280b, 7 U.S.C. 2012, 7 U.S.C. 2017, 7 U.S.C. 2011, 7 U.S.C. 612c, 7 U.S.C. 3007, 7 U.S.C. 2016, 7 U.S.C. 2025, 26 U.S.C. 51, 29 U.S.C. 3113, 29 U.S.C. 3151, 7 U.S.C. 2028, 42 U.S.C. 1773, 42 U.S.C. 1793, 42 U.S.C. 1789, 42 U.S.C. 1771, 42 U.S.C. 1753, 42 U.S.C. 1758, 42 U.S.C. 1769, 42 U.S.C. 1766, 42 U.S.C. 1769a, 7 U.S.C. 7633, 42 U.S.C. 1769i, 42 U.S.C. 1758a, 42 U.S.C. 1759a, 42 U.S.C. 1755, 42 U.S.C. 1756, 42 U.S.C. 1757, 42 U.S.C. 1760, 42 U.S.C. 1761, 42 U.S.C. 1762, 42 U.S.C. 1766a, 42 U.S.C. 1769b-1, 42 U.S.C. 1751, 20 U.S.C. 6313, 7 U.S.C. 2036a, 20 U.S.C. 1021, 20 U.S.C. 1070a-22, 20 U.S.C. 1090, 20 U.S.C. 1161y, 20 U.S.C. 6641, 20 U.S.C. 7261, 20 U.S.C. 9832, 29 U.S.C. 3102, 42 U.S.C. 1862n, 42 U.S.C. 9858m, 42 U.S.C. 9859c, 34 U.S.C. 11162.

42 U.S.C. 299a General authorities

42 U.S.C. 300u-6 Office of Minority Health

42 U.S.C. 300jj-11 Office of the National Coordinator for Health Information Technology

  • The section as a whole rewritten · Sec. 1001(a) · see the words
  • (b) Purpose added to · Sec. 1001(a) · see the words
  • (c) Duties of the National Coordinator added to · Sec. 8102(d), Sec. 8301 · see the words

42 U.S.C. 300kk Data collection, analysis, and quality

42 U.S.C. 1301

42 U.S.C. 242k

  • (n) changed · Sec. 1005(1), Sec. 1005(2), Sec. 1005(3) · see the words

21 U.S.C. 351

21 U.S.C. 352

21 U.S.C. 379h

42 U.S.C. 243

42 U.S.C. 1395i-3

42 U.S.C. 290aa-4

42 U.S.C. 201

42 U.S.C. 1396b Payment to States

  • (a) Computation of amount added to · Sec. 2005(h), Sec. 7305(e) · see the words
  • (c) Treatment of educationally-related services repealed · Sec. 4002(b) · see the words
  • (cc) new · Sec. 6404 · see the words
  • (m) "Medicaid managed care organization" defined; duties and functions of Secretary; payments to States; reporting requirements; remedies added to · Sec. 5202(c) · see the words
  • (t) Payments to encourage adoption and use of certified EHR technology rewritten · Sec. 8401(a), Sec. 8402(a) · see the words
  • (u) Limitation of Federal financial participation in erroneous medical assistance expenditures removed · Sec. 4101(a) · see the words
  • (v) Medical assistance to aliens not lawfully admitted for permanent residence changed · Sec. 4003(a) · see the words

New provisions of the bill's own

  • Sec. 1002 Elimination of prerequisite of direct appropriations for data collection and analysis
  • Sec. 1004 Revision of HIPAA claims standards
  • Sec. 1006 Disparities data collected by the Federal Government
  • Sec. 1007 Data collection and analysis grants to minority-serving institutions
  • Sec. 1011 Commission on Ensuring Data for Health Equity
  • Sec. 1012 Task Force on Preventing Bias in AI and Algorithms
  • Sec. 1013 Report on health of Middle Eastern and North African populations
  • Sec. 2001 Definitions
  • Sec. 2002 Improving access to services for individuals with limited english proficiency
  • Sec. 2003 Ensuring standards for culturally and linguistically appropriate services in health care
  • Sec. 2008 Increasing understanding of and improving health literacy
  • Sec. 2009 Requirements for health programs or activities receiving federal funds
  • Sec. 2010 Report on federal efforts to provide culturally and linguistically appropriate health care services
  • Sec. 2011 English instruction for individuals with limited english proficiency
  • Sec. 2012 Implementation
  • Sec. 2015 Improving access to Federal services by individuals with limited English proficiency
  • Sec. 3001 Amendment to the Public Health Service Act
  • Sec. 3006 Scholarship and fellowship programs
  • Sec. 3009 Developing and implementing strategies for local health equity
  • Sec. 3010 Health Professions Workforce Fund
  • Sec. 3013 Career support for skilled, internationally educated health professionals
  • Sec. 3014 Study and report on strategies for increasing diversity
  • Sec. 3032 Purpose
  • Sec. 4000 Definition
  • Sec. 4007 Study on the uninsured
  • Sec. 4008 Medicaid fallback coverage program for low-income adults in non-expansion States
  • Sec. 4112 Federal employee health benefits plans
  • Sec. 4201 Amendment to the Public Health Service Act
  • Sec. 4202 Border health grants
  • Sec. 4204 Medicare remote monitoring pilot projects
  • Sec. 4206 Facilitating the provision of telehealth services across State lines
  • Sec. 4209 Protection of the HHS Offices of Minority Health
  • Sec. 4211 Study of DSH payments to ensure hospital access for low-income patients
  • Sec. 4222 Rural Health Quality Advisory Commission and demonstration projects
  • Sec. 4243 Provider network adequacy in communities of color
  • Sec. 4301 Centers for Medicare & Medicaid Services reporting and value-based programs
  • Sec. 4303 Diversity in Centers for Medicare and Medicaid consultation
  • Sec. 4304 Supporting safety net and community-based providers to compete in value-based payment systems
  • Sec. 4401 Designation of health empowerment zones
  • Sec. 4402 Assistance to those seeking designation
  • Sec. 4403 Benefits of designation
  • Sec. 4404 Definition of Secretary
  • Sec. 4405 Authorization of appropriations
  • Sec. 4501 Data collection and reporting
  • Sec. 4504 Office for Civil Rights and Health Equity of the Department of Health and Human Services
  • Sec. 4505 Prohibiting discrimination in health care
  • Sec. 4506 Federal Health Equity Commission
  • Sec. 4507 Grants for hospitals to promote equitable health care and outcomes
  • Sec. 4601 Definitions
  • Sec. 4602 Strategy to incentivize health equity
  • Sec. 4603 Pay for Equity Advisory Council
  • Sec. 4707 Grant program for community schools and health equity
  • Sec. 4803 Medicare DSH target adjustment for hospitals in territories
  • Sec. 4841 Medicaid and CHIP territory transparency and information
  • Sec. 4842 Report on exclusion of territories from exchanges
  • Sec. 4844 Prohibition on disclosing Medicaid data
  • Sec. 5102 Birth defects prevention, risk reduction, and awareness
  • Sec. 5207 Moms matter
  • Sec. 5208 Justice for Incarcerated Moms
  • Sec. 5210 IMPACT To Save Moms Act
  • Sec. 5211 Protecting moms and babies against climate change
  • Sec. 5212 Protect moms from domestic violence
  • Sec. 5216 Bibliographic database of systematic reviews for care of childbearing individuals and newborns
  • Sec. 5217 Development of interprofessional maternity care educational models and tools
  • Sec. 5218 Dissemination of the quality family planning guidelines
  • Sec. 5302 Expansion of CDC Prevention Research Centers Program to include Centers on Optimal Maternity Outcomes
  • Sec. 5304 Interagency update to the quality family planning guidelines
  • Sec. 5402 Emergency contraception education and information programs
  • Sec. 5407 Additional focus area for the Office on Women’s Health
  • Sec. 5409 Grants to professional organizations and minority-serving institutions to increase diversity in maternal, reproductive, and sexual health professionals
  • Sec. 5503 Decreasing the risk factors for sudden unexpected infant death and sudden unexplained death in childhood
  • Sec. 5601 Expenses for household and elder care services necessary for gainful employment
  • Sec. 6103 Additional funds for National Institutes of Health
  • Sec. 6104 Additional funds for National Institute on Minority Health and Health Disparities
  • Sec. 6105 Grants for increasing racial and ethnic minority access to high-quality trauma support services and mental health care
  • Sec. 6201 Health professions competencies to address racial and ethnic mental health inequities
  • Sec. 6301 Building an effective workforce in mental health
  • Sec. 6302 Demonstration program to increase language access at eligible health centers
  • Sec. 6303 Health professions competencies to address racial and ethnic minority mental health disparities
  • Sec. 6406 Strategies to increase access to telehealth under Medicaid and the Children’s Health Insurance Program
  • Sec. 6407 Youth and young adult mental health promotion, prevention, intervention, and treatment
  • Sec. 6601 Addressing racial and ethnic minority mental health disparities research gaps
  • Sec. 6602 Research on adverse health effects associated with interactions with law enforcement
  • Sec. 6603 GeoAccess study
  • Sec. 6604 Co-occurring conditions
  • Sec. 6605 Study and report on the AANHPI youth mental health crisis
  • Sec. 6606 Study and report on strategies on the AANHPI behavioral health workforce shortage
  • Sec. 6704 Program to establish public-private contributions to increase the available workforce of school-based mental health service providers
  • Sec. 6706 Opioid grants to support caregivers, kinship care families, and kinship caregivers
  • Sec. 6710 Clarifying coverage of occupational therapy under Medicare
  • Sec. 7002 Expansion of prostate cancer research, outreach, screening, testing, access, and treatment effectiveness
  • Sec. 7003 Prostate research, imaging, and men’s education
  • Sec. 7004 Prostate cancer detection research and education
  • Sec. 7005 National prostate cancer council
  • Sec. 7007 Cancer prevention and treatment demonstration for ethnic and racial minorities
  • Sec. 7008 Reducing cancer disparities within the Medicare program
  • Sec. 7301 Guidelines for disease screening for minority patients
  • Sec. 7304 GAO report on structural and systemic factors that perpetuate cardiovascular disparities
  • Sec. 7306 Clinical research funding for oral health
  • Sec. 7307 Guide on evidence-based strategies for public health department obesity prevention programs
  • Sec. 7308 Stephanie Tubbs Jones Uterine Fibroid Research and Education Act
  • Sec. 7401 Statement of policy
  • Sec. 7403 Enhancing the national HIV surveillance system
  • Sec. 7404 Evidence-based strategies for improving linkage to, and retention in, appropriate care
  • Sec. 7405 Improving entry into, and retention in, care and antiretroviral adherence for persons with HIV
  • Sec. 7406 Services to reduce HIV/AIDS in racial and ethnic minority communities
  • Sec. 7407 Minority AIDS initiative
  • Sec. 7408 Health care professionals treating individuals with HIV
  • Sec. 7409 HIV/AIDS provider loan repayment program
  • Sec. 7410 Dental education loan repayment program
  • Sec. 7411 Reducing new HIV infections among injecting drug users
  • Sec. 7412 Report on impact of HIV/AIDS in vulnerable populations
  • Sec. 7413 National HIV/AIDS observance days
  • Sec. 7414 Review of all Federal and state laws, policies, and regulations regarding the criminal prosecution of individuals for HIV-related offenses
  • Sec. 7415 Expanding support for condoms in prisons
  • Sec. 7418 Transfer of funds for implementation of ending the HIV epidemic: A plan for America
  • Sec. 7505 Updated report on health disparities
  • Sec. 7602 Influenza and pneumonia vaccination campaign
  • Sec. 7603 Chronic obstructive pulmonary disease
  • Sec. 7801 Osteoarthritis and other musculoskeletal health-related activities of the Centers for Disease Control and Prevention
  • Sec. 7802 Grants for comprehensive osteoarthritis and musculoskeletal disease health education within health professions schools
  • Sec. 7901 Sleep and circadian rhythm disorders research activities of the national institutes of health
  • Sec. 7902 Sleep and circadian rhythm health disparities-related activities of the Centers for Disease Control and Prevention
  • Sec. 7903 Grants for comprehensive sleep and circadian health education within health professions schools
  • Sec. 7904 Report on impact of sleep and circadian health disorders in vulnerable and racial/ethnic populations
  • Sec. 7901A–1 Kidney disease action plan
  • Sec. 7901A–3 Increasing kidney transplants in minority populations
  • Sec. 7901A–4 Environmental and occupational health programs
  • Sec. 7901A–5 Understanding the treatment patterns associated with providing care and treatment of kidney failure in minority populations
  • Sec. 7901B FDA review of clinical trial best practices
  • Sec. 7901B–2 Clinical trial diversity
  • Sec. 7901C–7 Stomach Cancer Prevention and Early Detection Act
  • Sec. 7901D–4 Physician training programs with respect to rare diseases
  • Sec. 7901D–6 Report to Congress on Federal efforts on rare diseases and conditions in minority populations
  • Sec. 7901D–8 FDA survey and report on clinical trial diversity
  • Sec. 7901D–10 Medicare review and report
  • Sec. 7901E Employer duties
  • Sec. 7901E–1 Worker heat protection standards
  • Sec. 7901E–2 Implementation and enforcement
  • Sec. 7901E–3 General provisions
  • Sec. 7901E–4 Agenda for further review and action
  • Sec. 7901E–5 Definitions
  • Sec. 7901F–1 Understanding and Slowing the Progression of Rare Kidney Disease Through Early Intervention, Testing, and Treatment
  • Sec. 8001 Definitions
  • Sec. 8101 HRSA assistance to health centers for promotion of Health IT
  • Sec. 8103 Nondiscrimination and health equity in health information technology
  • Sec. 8104 Language access in health information technology
  • Sec. 8302 Study of health information technology in medically underserved communities
  • Sec. 8303 Assessment of use and misuse of de-identified health data
  • Sec. 9001 Prohibition on discrimination in Federal assisted health care services and research on the basis of sex (including sexual orientation, gender identity, and pregnancy, including termination of pregnancy), race, color, national origin, marital status, familial status, or disability status
  • Sec. 9002 Treatment of Medicare payments under title VI of the Civil Rights Act of 1964
  • Sec. 9003 Accountability and transparency within the Department of Health and Human Services
  • Sec. 9006 GAO and NIH reports
  • Sec. 9007 Investigative and enforcement actions
  • Sec. 9008 Federal Health Equity Commission
  • Sec. 10001 Definitions
  • Sec. 10002 Health impact assessments
  • Sec. 10003 Grant program to conduct environmental health improvement activities and to improve social determinants of health
  • Sec. 10004 Additional research on the relationship between the built environment and the health of community residents
  • Sec. 10005 Environment and public health restoration
  • Sec. 10006 GAO report on health effects of Deepwater Horizon oil rig explosion in the Gulf Coast
  • Sec. 10007 Establish an interagency council and grant programs on social determinants of health
  • Sec. 10008 Correcting Hurtful and Alienating Names in Government Expression (CHANGE)
  • Sec. 10009 Andrew Kearse Accountability for Denial of Medical Care
  • Sec. 10010 Investing in community healing
  • Sec. 10011 Environmental justice mapping and data collection
  • Sec. 10012 Antiracism in public health
  • Sec. 10013 LGBTQ essential data
  • Sec. 10014 Social determinants accelerator
  • Sec. 10015 Improving social determinants of health
  • Sec. 10102 National Violent Death Reporting System
  • Sec. 10103 Report on effects of gun violence on public health
  • Sec. 10104 Report on effects of gun violence on mental health in minority communities
  • Sec. 10332 Reimbursement of school meal delinquent debt program
  • Sec. 11001 Repeal of Executive orders
  • Sec. 11003 Reinstatement of Federal data collection standards
  • Sec. 11004 Reinstatement of anti-discrimination requirements for Federal contractors
  • Sec. 11005 Reaffirmation and codification of disparate impact liability
  • Sec. 11006 Limitations on future Executive action
  • Sec. 11008 Authorization of appropriations
What the words would change: every change, in place (1045)

Today's wording of each part of the law, with what would be struck out and added. Each change also gives the bill's own instruction, word for word.

  1. 42 U.S.C. 299a(a)(8)changedby H.R. 9877 Sec. 1001(a)

    (8) health statistics, surveys, database development, and epidemiology; and

    The bill says: in paragraph (8), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 299a)

  2. 42 U.S.C. 299a(a)(9)changedby H.R. 9877 Sec. 1001(a)

    (9) medical liability.; and

    The bill says: in paragraph (9), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 299a)

  3. 42 U.S.C. 299a(a)added (10)by H.R. 9877 Sec. 1001(a)

    (10) cultural and linguistic competence of health care services and of data collection activities described under section 3101.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 299a)

  4. 42 U.S.C. 300u-6(g)(1)rewrittenby H.R. 9877 Sec. 1001(a)

    (1)(A) The term racial and ethnic minority group means a group of individuals who are any of the following:(i) American Indian or Alaska Native.(ii) Asian.(iii) Black or African American, including individuals of African ancestry.(iv) Hispanic or Latino.(v) Middle Eastern or North African.(vi) Native Hawaiian or Pacific Islander.(B) The terms listed in clauses (i) through (vi) of subparagraph (A) shall have the meanings given such terms for purposes of the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024).

    The bill says: Section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u–6(g)(1)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 300u-6)

  5. 42 U.S.C. 300u-6(b)(6)changedby H.R. 9877 Sec. 1001(a)

    (6) Ensure that the National Center for Health Statistics collects data on the health status of each minority group , and subgroups of racial and ethnic minority groups, and collects and reports such data consistent with the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024) and the standards developed under section 3101(a)(2)(B).

    The bill says: Section 1707(b)(6) of the Public Health Service Act (42 U.S.C. 300u–6(b)(6)) is amended by inserting ", and subgroups of racial and ethnic minority groups, and collects and reports such data consistent with the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024) and the standards developed under section 3101(a)(2)(B)" after "the health status of each minority group".

    Bill text · Current law (42 U.S.C. 300u-6)

  6. 42 U.S.C. 300jj-11(b)(10)changedby H.R. 9877 Sec. 1001(a)

    (10) promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services; and

    The bill says: in paragraph (10), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 300jj-11)

  7. 42 U.S.C. 300jj-11(b)(11)changedby H.R. 9877 Sec. 1001(a)

    (11) improves efforts to reduce health disparities.; and

    The bill says: in paragraph (11), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 300jj-11)

  8. 42 U.S.C. 300jj-11(b)added (12)by H.R. 9877 Sec. 1001(a)

    (12) ensures the interoperability of health information systems among federally conducted or supported health care or public health programs, State health agencies, and social service agencies.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300jj-11)

  9. 42 U.S.C. 300jj-11rewrittenby H.R. 9877 Sec. 1001(a)

    The bill says: by amending clause (vii) in subsection (c)(3)(A) to read as follows:

    Bill text · Current law (42 U.S.C. 300jj-11)

  10. 42 U.S.C. 300kk(a)changedby H.R. 9877 Sec. 1001(a)

    …Current Population Surveys and American Community Surveys conducted by the Bureau of Labor Statistics and the Bureau of the Census) collects and reports, to the extent practicable— (A) data on race, ethnicity, sex, primary language, and disability statussexual orientation, gender identity, age, disability status, and socioeconomic status for applicants, recipients, or participants; (B) data at the smallest geographic level such as State, local, or institutional levels if such data can be aggregated; (C) sufficient data to generate statistically reliable estimates by…

    The bill says: in paragraphs (1)(A), (1)(C), (2)(B) and (2)(E), by striking "and disability status" and inserting "sexual orientation, gender identity, age, disability status, and socioeconomic status";

    Bill text · Current law (42 U.S.C. 300kk)

  11. 42 U.S.C. 300kk(a)(1)(C)changedby H.R. 9877 Sec. 1001(a)

    (C) sufficient data to generate statistically reliable estimates by racial, ethnic, sex, primary language, and disability status subgroups for applicants, recipients or participants using, if needed, statistical oversamples of these subpopulations; and

    The bill says: in subparagraph (C), by striking "; and" and inserting a semicolon; and

    Bill text · Current law (42 U.S.C. 300kk)

  12. 42 U.S.C. 300kk(a)(1)changedby H.R. 9877 Sec. 1001(a)

    (D) data for additional population groups if such groups can be aggregated into the data collection standards described under paragraph (2); and(E) data that is disaggregated by population groups, except in cases in which such disaggregation is statistically unreliable and the head of the program, activity, or survey documents such unreliability;

    The bill says: by striking subparagraph (D) and inserting the following:

    Bill text · Current law (42 U.S.C. 300kk)

  13. 42 U.S.C. 300kk(a)(2)rewrittenby H.R. 9877 Sec. 1001(a)

    The bill says: by amending subparagraph (A) to read as follows:

    Bill text · Current law (42 U.S.C. 300kk)

  14. 42 U.S.C. 300kk(a)(2)(B)changedby H.R. 9877 Sec. 1001(a)

    The bill says: in subparagraph (B), as amended by subparagraph (A), by adding before the semicolon "that are equivalent, as practicable, to the standards described in subparagraph (A)"; and

    Bill text · Current law (42 U.S.C. 300kk)

  15. 42 U.S.C. 300kk(a)(2)(C)(i)changedby H.R. 9877 Sec. 1001(a)

    (i) collects self-reported data by the applicant, recipient, or participant; and

    The bill says: in clause (i), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 300kk)

  16. 42 U.S.C. 300kk(a)(2)(C)added (iii)by H.R. 9877 Sec. 1001(a)

    (iii) collects data in a manner that is culturally and linguistically appropriate and does not include questions unrelated to, or that could potentially deter, care, such as questions related to immigration status; and(iv) prohibits assignment of an individual to a population group by a provider or institution;

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300kk)

  17. 42 U.S.C. 300kk(a)(3)rewrittenby H.R. 9877 Sec. 1001(a)

    The bill says: in paragraph (3), by amending subparagraph (B) to read as follows:

    Bill text · Current law (42 U.S.C. 300kk)

  18. 42 U.S.C. 300kk(a)added (4)by H.R. 9877 Sec. 1001(a)

    (4) Responses.— In collecting data under this subsection, the Secretary shall—(A) allow respondents to select multiple race or ethnicities and provide detailed write-in responses, consistent with the Revisions to OMB's Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (89 Fed. Reg. 22182; March 29, 2024); and(B) ensure that any responses selecting multiple race or ethnicities, and write-in responses described in subparagraph (A), are retained by the Secretary and coded for analysis.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300kk)

  19. 42 U.S.C. 1301added 1150Dby H.R. 9877 Sec. 1003

    1150D. Collection of data for the Medicare program.—(a) Requirement.—(1) In general.— The Commissioner of Social Security (in this section referred to as the Commissioner), in consultation with the Administrator of the Centers for Medicare & Medicaid Services (in this section referred to as the Administrator), shall collect data on the race, ethnicity, sex, primary language, sexual orientation, gender identity, socioeconomic status, age, and disability status of all applicants for social security benefits under title II or Medicare benefits under title XVIII.(2) Data collection standards.—(A) In general.— In collecting data under paragraph (1), the Commissioner shall at least use the standards for data collection developed under section 3101 of the Public Health Service Act (42 U.S.C. 300kk) or the standards developed by the Office of Management and Budget, as the baseline standard, consistent with the Office of Management and Budget Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, or any successor Office of Management and Budget directive.(B) No standards available.— In the event there are no standards for the demographic groups listed under paragraph (1), the Commissioner shall consult with stakeholder groups representing the various identities as well as with the Office of Minority Health within the Centers for Medicare & Medicaid Services to develop appropriate standards.(3) Data for additional population groups.— Where practicable, the data collected by the Commissioner under paragraph (1) shall include data for additional population groups if such groups can be aggregated into the race and ethnicity categories outlined by the data collection standards described in paragraph (2)(A).(4) Collection of data for minors and legally incapacitated individuals.— With respect to the collection of the data described in paragraph (1) of applicants who are under 18 years of age or otherwise legally incapacitated, the Commissioner shall require that—(A) such data be collected from the parent or legal guardian of such an applicant; and(B) the primary language of the parent or legal guardian of such an applicant or recipient be used in collecting the data.(5) Quality of data.— The Commissioner shall periodically review the quality and completeness of the data collected under paragraph (1) and make adjustments as necessary to improve both.(6) Transmission of data.— Upon enrollment for Medicare benefits under title XVIII, the Commissioner shall transmit the demographic data of an individual as collected under paragraph (1) to the Centers for Medicare & Medicaid Services.(7) Analysis and reporting of data.— With respect to the data transmitted under paragraph (6), the Administrator, in consultation with the Commissioner, shall—(A) require that such data be uniformly analyzed and that such analysis be reported at least annually to Congress;(B) incorporate such data in other analysis and reporting on health disparities and the provision of inequitable health care services by a health care provider, as appropriate;(C) make such data available to researchers, under the protections outlined in paragraph (8);(D) provide opportunities to individuals enrolled for Medicare benefits under title XVIII to submit updated data;(E) ensure that the provision of assistance or benefits to an applicant, or their relatives, is not denied or otherwise adversely affected because of the failure of the applicant to provide any of the data collected under paragraph (1); and(F) ensure that the provision of assistance or benefit to an applicant or their relatives is not denied or otherwise adversely affected because of the content of the data provided by the applicant, except where it is required by law.(8) Protection of data.— The Commissioner shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant to paragraph (1) is protected—(A) under the same privacy protections as the Secretary applies to health data under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (relating to the privacy of individually identifiable health information and other protections); and(B) from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary.(b) Rule of construction.— Nothing in this section shall be construed to permit the use of information collected under this section in a manner that would adversely affect any individual providing any such information.(c) Technical assistance.— The Secretary may, either directly or by grant or contract, provide technical assistance to enable any entity to comply with the requirements of this section or with regulations implementing this section.(d) Authorization of appropriations.— There are authorized to be appropriated to carry out this section $500,000,000 for fiscal year 2027 and $100,000,000 for each fiscal year thereafter.

    The bill says: Part A of title XI of the Social Security Act (42 U.S.C. 1301 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1301)

  20. 42 U.S.C. 242k(n)(1)changedby H.R. 9877 Sec. 1005(1)

    (1) For health statistical and epidemiological activities undertaken or supported under subsections (a) through (l), there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 1991 through 20032027.

    The bill says: in paragraph (1), by striking "2003" and inserting "2027";

    Bill text · Current law (42 U.S.C. 242k)

  21. 42 U.S.C. 242k(n)(2)changedby H.R. 9877 Sec. 1005(2)

    (2) For activities authorized in paragraphs (1) through (3) of subsection (m), there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 1999 through 20032027. Of such amounts, the Secretary shall use not more than 10 percent for administration and for activities described in subsection (m)(2).

    The bill says: in paragraph (2), in the first sentence, by striking "2003" and inserting "2027"; and

    Bill text · Current law (42 U.S.C. 242k)

  22. 42 U.S.C. 242k(n)(3)changedby H.R. 9877 Sec. 1005(3)

    (3) For activities authorized in subsection (m)(4), there are authorized to be appropriated $1,000,000 for fiscal year 1998, and such sums as may be necessary for each of the fiscal years 1999 through 20022027.

    The bill says: in paragraph (3), by striking "2002" and inserting "2027".

    Bill text · Current law (42 U.S.C. 242k)

  23. 21 U.S.C. 351added 505Hby H.R. 9877 Sec. 1008(a)

    505H. Safety and effectiveness of drugs with respect to racial and ethnic background.—(a) Preapproval studies.— If there is evidence of a racial or ethnic disparity in safety or effectiveness with respect to a drug or biological product, then—(1)(A) in the case of a drug, the investigations required under section 505(b)(1)(A) shall include adequate and well-controlled investigations of the disparity; or(B) in the case of a biological product, the evidence required under section 351(a) of the Public Health Service Act for approval of a biologics license application for the biological product shall include adequate and well-controlled investigations of the disparity; and(2) if the investigations described in subparagraph (A) or (B) of paragraph (1) confirm that there is such a disparity, the labeling of the drug or biological product shall include appropriate information about the disparity.(b) Postmarket studies.—(1) In general.— If there is evidence of a racial or ethnic disparity in safety or effectiveness with respect to a drug for which there is an approved application under section 505 of this Act or of a biological product for which there is an approved license under section 351 of the Public Health Service Act, the Secretary may by order require the holder of the approved application or license to conduct, by a date specified by the Secretary, postmarket studies to investigate the disparity.(2) Labeling.— If the Secretary determines that the postmarket studies confirm that there is a disparity described in paragraph (1), the labeling of the drug or biological product shall include appropriate information about the disparity.(3) Study design.— The Secretary may, in an order under paragraph (1), specify all aspects of the design of the postmarket studies required under such paragraph for a drug or biological product, including the number of studies and study participants, and the other demographic characteristics of the study participants.(4) Modifications of study design.— The Secretary may, by order and as necessary, modify any aspect of the design of a postmarket study required in an order under paragraph (1) after issuing such order.(5) Study results.— The results from a study required under paragraph (1) shall be submitted to the Secretary as a supplement to the drug application or biologics license application.(c) Applications under section 505(j).—(1) In general.— A drug for which an application has been submitted or approved under section 505(j) shall not be considered ineligible for approval under that section or misbranded under section 502 on the basis that the labeling of the drug omits information relating to a disparity on the basis of racial or ethnic background as to the safety or effectiveness of the drug, whether derived from investigations or studies required under this section or derived from other sources, when the omitted information is protected by patent or by exclusivity under section 505(j)(5)(F).(2) Labeling.— Notwithstanding paragraph (1), the Secretary may require that the labeling of a drug approved under section 505(j) that omits information relating to a disparity on the basis of racial or ethnic background as to the safety or effectiveness of the drug include a statement of any appropriate contraindications, warnings, or precautions related to the disparity that the Secretary considers necessary.(d) Definition.— In this section, the term evidence of a racial or ethnic disparity in safety or effectiveness, with respect to a drug or biological product, includes—(1) evidence that there is a disparity on the basis of racial or ethnic background as to safety or effectiveness of a drug or biological product in the same chemical class as the drug or biological product;(2) evidence that there is a disparity on the basis of racial or ethnic background in the way the drug or biological product is metabolized; and(3) other evidence as the Secretary may determine appropriate.

    The bill says: Chapter V of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 351 et seq.) is amended by inserting after section 505G (21 U.S.C. 355h) the following:

    Bill text · Current law (21 U.S.C. 351)

  24. 21 U.S.C. 352added (hh)by H.R. 9877 Sec. 1008(b)

    (hh) If it is a drug and the holder of the approved application under section 505 or license under section 351 of the Public Health Service Act for the drug has failed to complete the investigations or studies required under section 505H, or comply with any other requirement of such section 505H.

    The bill says: Section 502 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 352) is amended by adding at the end the following:

    Bill text · Current law (21 U.S.C. 352)

  25. 21 U.S.C. 379h(a)(1)(A)(ii)addedby H.R. 9877 Sec. 1008(c)

    The bill says: Section 736(a)(1)(A)(ii) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379h(a)(1)(A)(ii)) is amended by inserting after "are not required" the following: ", including postmarket studies required under section 505H,".

    Bill text · Current law (21 U.S.C. 379h)

  26. 42 U.S.C. 243added 317Wby H.R. 9877 Sec. 1009

    317W. Native Hawaiian and Pacific Islander health data.—(a) Definitions.— In this section:(1) Insular area.— The term insular area means Guam, the Commonwealth of the Northern Mariana Islands, American Samoa, the United States Virgin Islands, the Federated States of Micronesia, the Republic of Palau, or the Republic of the Marshall Islands.(2) Native Hawaiians and Pacific Islanders (NHPI).— The term Native Hawaiians and Pacific Islanders or NHPI means people having origins in any of the original peoples of American Samoa, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, Guam, Hawaii, the Republic of the Marshall Islands, the Republic of Palau, or any other Pacific Island.(3) NHPI stakeholder groups.— The term NHPI stakeholder group includes each of the following:(A) Community group.— A group of NHPI who are organized at the community level, and may include a church group, social service group, national advocacy organization, or cultural group.(B) Nonprofit, nongovernmental organization.— A group of NHPI with a demonstrated history of addressing NHPI issues, including a NHPI coalition.(C) Designated organization.— An entity established to represent NHPI populations and which has statutory responsibilities to provide, or has community support for providing, health care.(D) Government representatives of NHPI populations.— Representatives from Hawaii, American Samoa, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, Guam, the Republic of Palau, and the Republic of the Marshall Islands.(b) Preliminary health survey.—(1) In general.— The Secretary, acting through the Director of the National Center for Health Statistics of the Centers for Disease Control and Prevention (referred to in this section as NCHS), shall conduct a preliminary health survey in order to identify the major areas and regions in the continental United States, Hawaii, American Samoa, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, Guam, the Republic of Palau, and the Republic of the Marshall Islands in which NHPI people reside.(2) Contents.— The health survey described in paragraph (1) shall include health data and any other data the Secretary determines to be—(A) useful in determining health status and health care needs of NHPI populations; or(B) required for developing or implementing the national strategy under subsection (c).(3) Methodology.— Methodology for the health survey described in paragraph (1), including plans for designing questions, implementation, sampling, and analysis, shall be developed in consultation with NHPI stakeholder groups.(4) Timeframe.— The survey required under this subsection shall be completed not later than 18 months after the date of enactment of the Health Equity and Accountability Act of 2026.(c) National strategy.—(1) In general.— The Secretary, acting through the Director of the NCHS and other agencies within the Department of Health and Human Services as the Secretary determines appropriate, shall develop and implement a sustainable national strategy for identifying and evaluating the health status and health care needs of NHPI populations living in the continental United States, Hawaii, American Samoa, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, Guam, the Republic of Palau, and the Republic of the Marshall Islands.(2) Consultation.— In developing and implementing a national strategy, as described in paragraph (1), not later than 180 days after the date of enactment of the Health Equity and Accountability Act of 2026, the Secretary—(A) shall consult with representatives of NHPI stakeholder groups; and(B) may solicit the participation of representatives from other Federal agencies.(d) Progress report.— Not later than 2 years after the date of enactment of the Health Equity and Accountability Act of 2026, the Secretary shall submit to Congress a progress report, which shall include the national strategy described in subsection (c)(1).(e) Study and report by the Health and Medicine Division.—(1) In general.— The Secretary shall seek to enter into an agreement with the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine to conduct a study, with input from stakeholders in insular areas, on each of the following:(A) The standards and definitions of health care applied to health care systems in insular areas and the appropriateness of such standards and definitions.(B) The status and performance of health care systems in insular areas, evaluated based upon standards and definitions, as the Secretary determines appropriate.(C) The effectiveness of donor aid in addressing health care needs and priorities in insular areas.(D) The progress toward implementation of recommendations of the Committee on Health Care Services in the United States—Associated Pacific Basin that are set forth in the 1998 report entitled Pacific Partnerships for Health: Charting a New Course.(2) Report.— An agreement described in paragraph (1) shall require the Health and Medicine Division to submit to the Secretary and to Congress, not later than 2 years after the date of the enactment of the Health Equity and Accountability Act of 2026, a report containing a description of the results of the study conducted under paragraph (1), including the conclusions and recommendations of the Health and Medicine Division for each of the items described in subparagraphs (A) through (D) of such paragraph.(f) Authorization of appropriations.— To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2027 through 2031.

    The bill says: Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317V (42 U.S.C. 247b–24) the following:

    Bill text · Current law (42 U.S.C. 243)

  27. 42 U.S.C. 1395i-3added (l)by H.R. 9877 Sec. 1010(a)

    (l) Requirements relating to reporting during public health emergencies.— During a public health emergency declared by the Secretary pursuant to section 319 of the Public Health Service Act, a skilled nursing facility shall, not later than 1 year after the first day of such declaration, and monthly thereafter during the application of such declaration, submit to the Secretary the following information, with respect to such facility and the residents of such facility:(1) Information described in section 483.80(g)(1) of title 42, Code of Federal Regulations.(2) The age, race, ethnicity, sex, sexual orientation, gender identity, socioeconomic status, disability status, and preferred language of the residents of such skilled nursing facility.

    The bill says: Section 1819 of the Social Security Act (42 U.S.C. 1395i–3) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395i-3)

  28. 42 U.S.C. 290aa-4(d)added (3)by H.R. 9877 Sec. 1014

    (3) Inclusion of Puerto Rico.— Beginning with fiscal year 2027, annual surveys carried out under this section shall include Puerto Rico.

    The bill says: Section 505(d) of the Public Health Service Act (42 U.S.C. 290aa–4(d)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 290aa-4)

  29. 42 U.S.C. 201added XXXIVby H.R. 9877 Sec. 2004

    XXXIV Culturally and linguistically appropriate health care.—3400 Definitions.—(a) In general.— In this title:(1) Bilingual.— The term bilingual, with respect to an individual, means an individual who has a sufficient degree of proficiency in 2 languages.(2) Community health worker.— The term community health worker means a frontline health worker who is a trusted member of the community in which the worker serves or who has an unusually close understanding of the community served that enables the worker to build trusted relationships, serve as a liaison between health and social services and the community, facilitate access to services, and improve the quality and cultural competence of service delivery.(3) Cultural.— The term cultural means relating to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, age, and institutions of racial, ethnic, religious, or social groups, including lesbian, gay, bisexual, transgender, queer, and questioning individuals, and individuals with physical and mental disabilities.(4) Culturally and linguistically appropriate.— The term culturally and linguistically appropriate means being respectful of and responsive to the cultural and linguistic needs of all individuals.(5) Effective communication.— The term effective communication means an exchange of information between the provider of health care or health care-related services and the recipient of such services who is limited in English proficiency, or has a communication impairment such as a hearing, vision, speaking, or cognitive disability, that enables access to, understanding of, and benefit from, with consideration for the recipient’s health literacy, health care or health care-related services, and full participation in the development of the treatment plan of the recipient.(6) Grievance resolution process.— The term grievance resolution process means all aspects of dispute resolution including filing complaints, grievance and appeal procedures, and court action.(7) Health care group.— The term health care group means a group of physicians organized, at least in part, for the purposes of providing physician services under the Medicaid program under title XIX of the Social Security Act, the State Children’s Health Insurance Program under title XXI of such Act, or the Medicare program under title XVIII of such Act, including a provider of services under part B of such title XVIII, and may include a hospital, a hospice provider, a palliative care provider, and any other individual or entity furnishing services covered under any such program that is affiliated with the health care group.(8) Health care.— The term health care includes all health care needed throughout the life cycle and the end of life.(9) Health care services.— The term health care services means services that address physical and mental health conditions, as well as conditions impacted by social determinants of health, in all care settings throughout the life cycle and the end of life.(10) Health care-related services.— The term health care-related services means human or social services programs or activities that provide access, referrals, or links to health care services.(11) Health educator.— The term health educator includes a professional with a baccalaureate degree who is responsible for designing, implementing, and evaluating individual and population health promotion, health education (including education on end-of-life care options), end-of-life care, or chronic disease prevention programs.(12) Indian; indian tribe.— The terms "Indian" and "Indian Tribe" have the meanings given such terms in section 4 of the Indian Self-Determination and Education Assistance Act.(13) Individual with a disability.— The term individual with a disability means any individual who has a disability as defined for the purpose of section 504 of the Rehabilitation Act of 1973.(14) Individual with limited english proficiency.— The term individual with limited English proficiency means an individual who self-identifies on the Census as speaking English less than "very well".(15) Integrated health care delivery system.— The term integrated health care delivery system means an interdisciplinary system that brings together providers from the primary health, mental health, substance use disorder, hospice and palliative care, and related disciplines to improve the health outcomes of an individual and the community. Such providers may include hospitals, health, mental health, or substance use prevention and treatment clinics and providers, home health agencies, home- and community-based services providers, congregate settings (including any skilled nursing facilities, assisted living facilities, prisons and jails, residential behavioral health care and psychiatric facilities, shelters, and facilities providing services for older adults and individuals with disabilities), ambulatory surgery centers, rehabilitation centers, employed, independent, or contracted physicians, and oral health care providers.(16) Interpreting; interpretation.— The terms "interpreting" and "interpretation" mean the transmission of a spoken, written, or signed message from one language or format into another, faithfully, accurately, and objectively.(17) Language access.— The term language access means the provision of language services to an individual with limited English proficiency or an individual with communication disabilities designed to enhance that individual’s access to, understanding of, or benefit from health care services or health care-related services.(18) Language assistance services.— The term language assistance services includes—(A) oral language assistance, including interpretation in non-English languages provided in person or remotely by a qualified interpreter for an individual with limited English proficiency, and the use of qualified bilingual or multilingual staff

    The bill says: The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 201)

  30. 42 U.S.C. 1396b(a)(2)(E)changedby H.R. 9877 Sec. 2005(h)

    (E) an amount equal to 75 percent (or, in the case of a State that was awarded a grant under section 2005 of the Health Equity and Accountability Act of 2026, 100 percent for each quarter occurring during the grant period specified in subsection (b) of such section) of so much of the sums expended during such quarter (as found necessary by the Secretary for the proper and efficient administration of the State plan) as are attributable to translation or interpretation services in connection with the enrollment of, retention of, and use of services under this subchapter by, children of families for whom English is not the primary language; plus

    The bill says: Section 1903(a)(2)(E) of the Social Security Act (42 U.S.C. 1396b(a)(2)(E)) is amended by inserting "(or, in the case of a State that was awarded a grant under section 2005 of the Health Equity and Accountability Act of 2026, 100 percent for each quarter occurring during the grant period specified in subsection (b) of such section)" after "75 percent".

    Bill text · Current law (42 U.S.C. 1396b)

  31. 42 U.S.C. 1395ww(h)(4)added (L)by H.R. 9877 Sec. 2006(a)

    (L) Treatment of culturally and linguistically appropriate training.— In determining a hospital’s number of full-time equivalent residents for purposes of this subsection, all the time that is spent by an intern or resident in an approved medical residency training program for education and training in culturally and linguistically appropriate service delivery, which shall include all medically underserved populations (as defined in section 330(b)(3) of the Public Health Service Act), shall be counted toward the determination of full-time equivalency.

    The bill says: Section 1886(h)(4) of the Social Security Act (42 U.S.C. 1395ww(h)(4)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395ww)

  32. 42 U.S.C. 1395ww(d)(5)(B)added (xiv)by H.R. 9877 Sec. 2006(b)

    (xiv) The provisions of subparagraph (L) of subsection (h)(4) shall apply under this subparagraph in the same manner as they apply under such subsection.

    The bill says: Section 1886(d)(5)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1395ww)

  33. 42 U.S.C. 1395x(aa)(1)(C)changedby H.R. 9877 Sec. 2007(b)

    The bill says: in subparagraph (C), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395x)

  34. 42 U.S.C. 1395x(aa)(1)(D)changedby H.R. 9877 Sec. 2007(b)

    The bill says: in subparagraph (D), by inserting "and" after the comma at the end; and

    Bill text · Current law (42 U.S.C. 1395x)

  35. 42 U.S.C. 1395x(aa)(1)added (E)by H.R. 9877 Sec. 2007(b)

    (E) language assistance services as defined in subsection (ooo),

    The bill says: by inserting after subparagraph (D) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  36. 42 U.S.C. 1395xadded (ooo)by H.R. 9877 Sec. 2007(b)

    (ooo) Language assistance services and related terms.— The term language assistance services means language access or language assistance services (as those terms are defined in section 3400 of the Public Health Service Act) furnished by a qualified interpreter for an individual with limited English proficiency or a qualified translator (as those terms are defined in such section 3400) to an individual with limited English proficiency (as defined in such section 3400).

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  37. 42 U.S.C. 1395k(a)(2)(I)changedby H.R. 9877 Sec. 2007(b)

    The bill says: in subparagraph (I), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395k)

  38. 42 U.S.C. 1395k(a)(2)(J)changedby H.R. 9877 Sec. 2007(b)

    The bill says: in subparagraph (J), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1395k)

  39. 42 U.S.C. 1395k(a)(2)added (K)by H.R. 9877 Sec. 2007(b)

    (K) language assistance services (as defined in section 1861(ooo)).

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395k)

  40. 42 U.S.C. 1395l(a)(9)changedby H.R. 9877 Sec. 2007(b)

    The bill says: in paragraph (9), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395l)

  41. 42 U.S.C. 1395l(a)(10)changedby H.R. 9877 Sec. 2007(b)

    The bill says: in paragraph (10), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1395l)

  42. 42 U.S.C. 1395l(a)added (11)by H.R. 9877 Sec. 2007(b)

    (11) in the case of language assistance services (as defined in section 1861(ooo)), 100 percent of the reasonable charges for such services, as determined in consultation with the Medicare Payment Advisory Commission.

    The bill says: by inserting after paragraph (10) the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395l)

  43. 42 U.S.C. 1395w-27(e)added (6)by H.R. 9877 Sec. 2007(c)

    (6) Reporting requirements relating to effective language services.— A contract under this part shall require a Medicare Advantage organization (and, through application of section 1860D–12(b)(3)(D), a contract under section 1860D–12 shall require a PDP sponsor) to annually submit (for each year of the contract) a report that contains information on the internal policies and procedures of the organization (or sponsor) related to recruitment and retention efforts directed to workforce diversity and linguistically and culturally appropriate provision of services in each of the following contexts:(A) The collection of data in a manner that meets the requirements of title I of the Health Equity and Accountability Act of 2026, regarding the enrollee population.(B) Education of staff and contractors who have routine contact with enrollees regarding the various needs of the diverse enrollee population.(C) Evaluation of the language services programs and services offered by the organization (or sponsor) with respect to the enrollee population, such as through analysis of complaints or satisfaction survey results.(D) Methods by which the plan provides to the Secretary information regarding the ethnic diversity of the enrollee population.(E) The periodic provision of educational information to plan enrollees on the language services and programs offered by the organization (or sponsor).

    The bill says: Section 1857(e) of the Social Security Act (42 U.S.C. 1395w–27(e)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395w-27)

  44. 42 U.S.C. 1396a(a)(10)(A)changedby H.R. 9877 Sec. 2007(d)

    The bill says: Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by striking "and (30)" and inserting "(30), and (32)".

    Bill text · Current law (42 U.S.C. 1396a)

  45. 42 U.S.C. 1396d(a)(31)changedby H.R. 9877 Sec. 2007(d)

    The bill says: in paragraph (31), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1396d)

  46. 42 U.S.C. 1396d(a)renumberedby H.R. 9877 Sec. 2007(d)

    The bill says: by redesignating paragraph (32) as paragraph (33); and

    Bill text · Current law (42 U.S.C. 1396d)

  47. 42 U.S.C. 1396d(a)added (32)by H.R. 9877 Sec. 2007(d)

    (32) language assistance services, as such term is defined in section 1861(nnn), provided in a timely manner to individuals with limited English proficiency as defined in section 3400 of the Public Health Service Act; and

    The bill says: by inserting after paragraph (31) the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396d)

  48. 42 U.S.C. 1397cc(a)changedby H.R. 9877 Sec. 2007(d)

    The bill says: in subsection (a), in the matter before paragraph (1), by striking "(5), (6), (7) and (8)" and inserting "(5) through (13)";

    Bill text · Current law (42 U.S.C. 1397cc)

  49. 42 U.S.C. 1397cc(c)added (13)by H.R. 9877 Sec. 2007(d)

    (13) Language assistance services.— The child health assistance provided to a targeted low-income child shall include coverage of language assistance services, as such term is defined in section 1861(nnn), provided in a timely manner to individuals with limited English proficiency (as defined in section 3400 of the Public Health Service Act).

    The bill says: in subsection (c), by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397cc)

  50. 42 U.S.C. 1397cc(e)(2)changedby H.R. 9877 Sec. 2007(d)

    The bill says: in the heading, by striking "PREVENTIVE" and inserting "CERTAIN"; and

    Bill text · Current law (42 U.S.C. 1397cc)

  51. 42 U.S.C. 1397cc(e)(2)changedby H.R. 9877 Sec. 2007(d)

    The bill says: by inserting "language assistance services described in subsection (c)(13)," before "or for pregnancy-related assistance".

    Bill text · Current law (42 U.S.C. 1397cc)

  52. 42 U.S.C. 1397jj(a)(27)changedby H.R. 9877 Sec. 2007(d)

    The bill says: Section 2110(a)(27) of the Social Security Act (42 U.S.C. 1397jj(a)(27)) is amended by striking "transportation, translation, and outreach services" and inserting "transportation services, language assistance services as described in section 2103(c)(13), and outreach services".

    Bill text · Current law (42 U.S.C. 1397jj)

  53. 42 U.S.C. 1397ee(a)(1)changedby H.R. 9877 Sec. 2007(d)

    The bill says: in the matter preceding subparagraph (A), by striking "75" and inserting "95"; and

    Bill text · Current law (42 U.S.C. 1397ee)

  54. 42 U.S.C. 1397ee(a)(1)(D)(iv)changedby H.R. 9877 Sec. 2007(d)

    The bill says: in subparagraph (D)(iv), by striking "translation or interpretation services" and inserting "language assistance services"; and

    Bill text · Current law (42 U.S.C. 1397ee)

  55. 42 U.S.C. 1397ee(c)(2)(A)addedby H.R. 9877 Sec. 2007(d)

    The bill says: in subsection (c)(2)(A), by inserting before the period at the end the following: ", except that expenditures pursuant to clause (iv) of subparagraph (D) of such paragraph shall not count towards this total".

    Bill text · Current law (42 U.S.C. 1397ee)

  56. 42 U.S.C. 18022(b)(1)added (K)by H.R. 9877 Sec. 2013(a)

    (K) Language access services, including oral interpretation and written translations.

    The bill says: Section 1302(b)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)(1)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 18022)

  57. 26 U.S.C. 36B(c)(2)(C)renumberedby H.R. 9877 Sec. 2013(b)

    The bill says: Section 36B(c)(2)(C) of the Internal Revenue Code of 1986 is amended by redesignating clauses (iii) and (iv) as clauses (iv) and (v), respectively, and by inserting after clause (ii) the following new clause:

    Bill text · Current law (26 U.S.C. 36B)

  58. 42 U.S.C. 300gg-17(a)(1)changedby H.R. 9877 Sec. 2013(c)

    The bill says: by striking "and" at the end of subparagraph (C);

    Bill text · Current law (42 U.S.C. 300gg-17)

  59. 42 U.S.C. 300gg-17(a)(1)changedby H.R. 9877 Sec. 2013(c)

    The bill says: by striking the period at the end of subparagraph (D) and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 300gg-17)

  60. 42 U.S.C. 300gg-17(a)(1)added (E)by H.R. 9877 Sec. 2013(c)

    (E) reduce health disparities through the provision of language access services, including oral interpretation and written translations.

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 300gg-17)

  61. 42 U.S.C. 254b(b)(3)rewrittenby H.R. 9877 Sec. 2014

    (3) Medically underserved population.— The term medically underserved population means—(A) the population of an urban or rural area designated by the Secretary as—(i) an area with a shortage of personal health services; or(ii) a population group having a shortage of such services; or(B) a population of individuals, not confined to a particular urban or rural area, who are designated by the Secretary as having a shortage of personal health services due to a specific demographic trait.

    The bill says: Section 330(b)(3) of the Public Health Service Act (42 U.S.C. 254b(b)(3)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 254b)

  62. 42 U.S.C. 290ddadded 554by H.R. 9877 Sec. 2016(c)

    554 National AANHPI behavioral health outreach and education strategy.—(a) In general.— The Secretary, acting through the Assistant Secretary, shall, in coordination with the Director of the Office of Minority Health, the Director of the National Institutes of Health, and the Director of the Centers for Disease Control and Prevention, and in consultation with advocacy and behavioral health organizations serving populations of Asian American, Native Hawaiian, and Pacific Islander individuals or communities, develop and implement a national outreach and education strategy to promote behavioral health and reduce stigma associated with mental health and substance use disorders within the Asian American, Native Hawaiian, and Pacific Islander population. Such strategy shall—(1) be designed to meet the diverse cultural and language needs and preferences of the various Asian American, Native Hawaiian, and Pacific Islander populations;(2) be developmentally and age appropriate;(3) increase awareness of symptoms of mental illnesses common within subgroups of such population, taking into account differences within subgroups, such as gender, gender identity, age, sexual orientation, culture, or ethnicity;(4) provide information, in a publicly accessible manner, on evidence-based, culturally and linguistically appropriate, and adapted interventions and treatments;(5) ensure full participation of, and engage, both consumers and community members in the development and implementation of materials; and(6) seek to broaden the perspective among both individuals in Asian American, Native Hawaiian, and Pacific Islander communities and stakeholders serving such communities to use a comprehensive public health approach to promoting behavioral health that addresses a holistic view of health by focusing on the intersection between behavioral and physical health.(b) Reports.— Beginning not later than 1 year after the date of the enactment of the Health Equity and Accountability Act of 2026 and annually thereafter, the Secretary, acting through the Assistant Secretary, shall submit to Congress, and make publicly available, a report on the extent to which the strategy developed and implemented under subsection (a) increased awareness among the Asian American, Native Hawaiian, and Pacific Islander population of mental health and substance use disorders.(c) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $3,000,000 for each of fiscal years 2026 through 2030.

    The bill says: Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.) is amended by adding at the end the following new section:

    Bill text · Current law (42 U.S.C. 290dd)

  63. 42 U.S.C. 293added 742by H.R. 9877 Sec. 3002

    742 Hispanic-serving institutions, historically Black colleges and universities, historically Black professional or graduate institutions, Asian American and Native American Pacific Islander-serving institutions, and Tribal Colleges.—(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration and in consultation with the Secretary of Education, shall award grants to Hispanic-serving institutions, historically Black colleges and universities, historically Black professional or graduate institutions eligible for grants under section 326 of the Higher Education Act of 1965, Asian American and Native American Pacific Islander-serving institutions, Tribal Colleges or Universities, regional community-based organizations, and national minority medical associations, for counseling, mentoring, and providing information on financial assistance to prepare underrepresented minority individuals to enroll in and graduate from health professional schools and to increase services for underrepresented minority students including—(1) mentoring with underrepresented health professionals;(2) providing financial assistance information for continued education and applications to health professional schools; and(3) retaining existing enrolled underrepresented minority students in a health professions school.(b) Definitions.— In this section:(1) Asian American and Native American Pacific Islander-serving institution.— The term Asian American and Native American Pacific Islander-serving institution has the meaning given such term in section 320(b) of the Higher Education Act of 1965.(2) Hispanic-serving institution.— The term Hispanic-serving institution means an entity that—(A) is a school or program for which there is a definition under section 799B;(B) has an enrollment of full-time equivalent students that is made up of at least 9 percent Hispanic students;(C) has been effective in carrying out programs to recruit Hispanic individuals to enroll in and graduate from the school;(D) has been effective in recruiting and retaining Hispanic faculty members;(E) has a significant number of graduates who are providing health services to medically underserved populations or to individuals in health professional shortage areas; and(F) is a Hispanic Center of Excellence in Health Professions Education designated under section 736(d)(2).(3) Historically Black college and university.— The term historically Black college and university has the meaning given the term part B institution as defined in section 322 of the Higher Education Act of 1965.(4) Tribal college or university.— The term Tribal College or University has the meaning given such term in section 316(b) of the Higher Education Act of 1965.(c) Certain loan repayment programs.— In carrying out the National Health Service Corps Loan Repayment Program established under subpart III of part D of title III and the loan repayment program under section 317F, the Secretary shall ensure, notwithstanding such subpart or section, that loan repayments of not less than $50,000 per year per person are awarded for repayment of loans incurred for enrollment or participation of underrepresented minority individuals in health professional schools and other health programs described in this section.(d) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

    The bill says: Part B of title VII of the Public Health Service Act (42 U.S.C. 293 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 293)

  64. 42 U.S.C. 247b-7(c)(1)changedby H.R. 9877 Sec. 3003

    The bill says: Section 317F(c)(1) of the Public Health Service Act (42 U.S.C. 247b–7(c)(1)) is amended by striking "$500,000 for fiscal year 1994, and such sums as may be necessary for each of the fiscal years 1995 through 2002" and inserting "such sums as may be necessary for each of fiscal years 2027 through 2031".

    Bill text · Current law (42 U.S.C. 247b-7)

  65. 42 U.S.C. 294added 755Aby H.R. 9877 Sec. 3004

    755A. Cooperative agreements for online degree programs.—(a) Cooperative agreements.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, in consultation with the Director of the Centers for Disease Control and Prevention, the Director of the Agency for Healthcare Research and Quality, and the Deputy Assistant Secretary for Minority Health, shall enter into cooperative agreements with schools of public health and schools of allied health to design and implement online degree programs.(b) Priority.— In entering into cooperative agreements under this section, the Secretary shall give priority to any school of public health or school of allied health that has an established track record of serving medically underserved communities.(c) Requirements.— As a condition of entering into a cooperative agreement with the Secretary under this section, a school of public health or school of allied health shall agree to design and implement an online degree program that meets the following restrictions:(1) Enrollment of individuals who have obtained a secondary school diploma or its recognized equivalent.(2) Maintaining a significant enrollment of underrepresented minority or disadvantaged students.(3) Achieving a high completion rate of enrolled underrepresented minority or disadvantaged students.(d) Period of cooperative agreements.— The period during which payments are made through a cooperative agreement entered into under this section may not exceed 3 years.(e) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

    The bill says: Part D of title VII of the Public Health Service Act (42 U.S.C. 294 et seq.) is amended by inserting after section 755 of such Act (42 U.S.C. 294e) the following:

    Bill text · Current law (42 U.S.C. 294)

  66. 42 U.S.C. 294q(h)(2)changedby H.R. 9877 Sec. 3005(b)

    The bill says: Section 5101(h)(2) of the Patient Protection and Affordable Care Act (42 U.S.C. 294q(h)(2)) is amended by striking "such sums as may be necessary" and inserting "$3,000,000 for each of fiscal years 2027 through 2029".

    Bill text · Current law (42 U.S.C. 294q)

  67. 20 U.S.C. 1070a-15changedby H.R. 9877 Sec. 3007

    (g) Collaboration in health profession diversity training programs.— The Secretary shall coordinate with the Secretary of Health and Human Services to ensure that there is collaboration between the goals of the program under this section and programs of the Health Resources and Services Administration that promote health workforce diversity. The Secretary of Education shall take such measures as may be necessary to encourage students participating in projects assisted under this section to consider health profession careers.(h) Funding.— From amounts appropriated pursuant to the authority of section 402A(g), the Secretary shall, to the extent practicable, allocate funds for projects authorized by this section in an amount that is not less than $31,000,000 for each of the fiscal years 2027 through 2031.

    The bill says: Section 402E of the Higher Education Act of 1965 (20 U.S.C. 1070a–15) is amended by striking subsection (g) and inserting the following:

    Bill text · Current law (20 U.S.C. 1070a-15)

  68. 42 U.S.C. 1395ww(h)(4)(E)changedby H.R. 9877 Sec. 3008(a)

    The bill says: in subparagraph (E), by striking "Subject to subparagraphs (J) and (K), such rules" and inserting "Subject to subparagraphs (J), (K), and (M), such rules";

    Bill text · Current law (42 U.S.C. 1395ww)

  69. 42 U.S.C. 1395ww(h)(4)(J)changedby H.R. 9877 Sec. 3008(a)

    The bill says: in subparagraph (J), by striking "Such rules" and inserting "Subject to subparagraph (M), such rules";

    Bill text · Current law (42 U.S.C. 1395ww)

  70. 42 U.S.C. 1395ww(h)(4)(K)changedby H.R. 9877 Sec. 3008(a)

    The bill says: in subparagraph (K), by striking "In determining" and inserting "Subject to subparagraph (M), in determining"; and

    Bill text · Current law (42 U.S.C. 1395ww)

  71. 42 U.S.C. 1395ww(h)(4)added (M)by H.R. 9877 Sec. 3008(a)

    (M) Treatment of certain residents and interns.— For purposes of cost-reporting periods beginning on or after October 1, 2027, in determining the hospital’s number of full-time equivalent residents for purposes of this paragraph, all time spent by an intern or resident in an approved medical residency training program shall be counted toward the determination of full-time equivalency if the hospital—(i) is recognized as a subsection (d) hospital;(ii) is recognized as a subsection (d) Puerto Rico hospital;(iii) is reimbursed under a reimbursement system authorized under section 1814(b)(3); or(iv) is a provider-based hospital outpatient department.

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395ww)

  72. 42 U.S.C. 1395ww(d)(5)(B)(xi)(II)changedby H.R. 9877 Sec. 3008(b)

    The bill says: in subclause (II), by striking "In determining" and inserting "Subject to subclause (IV), in determining";

    Bill text · Current law (42 U.S.C. 1395ww)

  73. 42 U.S.C. 1395ww(d)(5)(B)(xi)(III)changedby H.R. 9877 Sec. 3008(b)

    The bill says: in subclause (III), by striking "In determining" and inserting "Subject to subclause (IV), in determining"; and

    Bill text · Current law (42 U.S.C. 1395ww)

  74. 42 U.S.C. 1395ww(d)(5)(B)(xi)added (IV)by H.R. 9877 Sec. 3008(b)

    (IV) For purposes of cost-reporting periods beginning on or after October 1, 2027, the provisions of subparagraph (M) of subsection (h)(4) shall apply under this subparagraph in the same manner as they apply under such subsection.

    The bill says: by inserting after subclause (III) the following new subclause:

    Bill text · Current law (42 U.S.C. 1395ww)

  75. 42 U.S.C. 296padded 832by H.R. 9877 Sec. 3011(a)

    832 Nursing education enhancement and modernization grants in underserved areas.—(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, may award grants to schools of nursing for—(1) increasing the number of faculty and students at such schools in order to enhance the preparedness of the United States for, and the ability of the United States to address and quickly respond to, public health emergencies declared under section 319 and pandemics; or(2) the enhancement and modernization of nursing education programs.(b) Priority.— In selecting grant recipients under this section, the Secretary shall give priority to schools of nursing that—(1) are located in a medically underserved community;(2) are located in a health professional shortage area as defined under section 332(a); or(3) are institutions of higher education listed under section 371(a) of the Higher Education Act of 1965.(c) Consideration.— In awarding grants under this section, the Secretary, to the extent practicable, may ensure equitable distribution of awards among the geographic regions of the United States.(d) Use of funds.— A school of nursing that receives a grant under this section may use the funds awarded through such grant for activities that include—(1) enhancing enrollment and retention of students at such school, with a priority for students from disadvantaged backgrounds (including racial or ethnic groups underrepresented in the nursing workforce), individuals from rural and underserved areas, low-income individuals, and first generation college students (as defined in section 402A(h)(3) of the Higher Education Act of 1965);(2) creating, supporting, or modernizing educational programs and curriculum at such school;(3) retaining current faculty, and hiring new faculty, with an emphasis on faculty from racial or ethnic groups who are underrepresented in the nursing workforce;(4) modernizing infrastructure at such school, including audiovisual or other equipment, personal protective equipment, simulation and augmented reality resources, telehealth technologies, and virtual and physical laboratories;(5) partnering with a health care facility, nurse-managed health clinic, community health center, or other facility that provides health care in order to provide educational opportunities for the purpose of establishing or expanding clinical education;(6) enhancing and expanding nursing programs that prepare nurse researchers and scientists;(7) establishing nurse-led intradisciplinary and interprofessional educational partnerships; and(8) other activities that the Secretary determines further the development, improvement, and expansion of schools of nursing.(e) Reports from entities.— Each school of nursing awarded a grant under this section shall submit an annual report to the Secretary on the activities conducted under such grant.(f) Report to Congress.— Not later than 5 years after the date of the enactment of this section, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report that provides a summary of the activities and outcomes associated with grants made under this section. Such report shall include—(1) a list of schools of nursing receiving grants under this section, including the primary geographic location of any school of nursing that was improved or expanded through such a grant;(2) the total number of students who are enrolled at or who have graduated from any school of nursing that was improved or expanded through a grant under this section;(3) to the extent such information is available, the effects of the grants awarded under this section on retaining and hiring of faculty, including any increase in diverse faculty, the number of clinical education partnerships, the modernization of nursing education infrastructure, and other ways this section helps address and quickly respond to public health emergencies and pandemics;(4) recommendations for improving the grants awarded under this section; and(5) any other considerations as the Secretary determines appropriate.(g) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $1,000,000,000, to remain available until expended.

    The bill says: Part D of title VIII of the Public Health Service Act (42 U.S.C. 296p et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 296p)

  76. 42 U.S.C. 296pchangedby H.R. 9877 Sec. 3011(b)

    The bill says: The heading of part D of title VIII of the Public Health Service Act (42 U.S.C. 296p et seq.) is amended by striking "Basic".

    Bill text · Current law (42 U.S.C. 296p)

  77. Public Law 103-416(c)changedby H.R. 9877 Sec. 3015(a)

    The bill says: Section 220(c) of the Immigration and Nationality Technical Corrections Act of 1994 (Public Law 103–416; 8 U.S.C. 1182 note) is amended by striking "September 30, 2015" and inserting "the date that is 3 years after the date of the enactment of the Health Equity and Accountability Act of 2026".

    Bill text

  78. 8 U.S.C. 1151(b)(1)added (F)by H.R. 9877 Sec. 3015(b)

    (F)(i) Alien physicians who have completed service requirements of a waiver requested under section 203(b)(2)(B)(ii), including—(I) alien physicians who completed such service before the date of the enactment of the Health Equity and Accountability Act of 2026; and(II) the spouse or children of an alien physician described in subclause (I).(ii) Nothing in this subparagraph may be construed—(I) to prevent the filing of a petition with the Secretary of Homeland Security for classification under section 204(a) or the filing of an application for adjustment of status under section 245 by an alien physician described in clause (i)(I) before the date on which such alien physician completed the service described in section 214(l) or worked full-time as a physician for an aggregate of 5 years at the location identified in the section 214(l) waiver or in an area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals; or(II) to permit the Secretary of Homeland Security to grant a petition or application described in subclause (I) until the alien has satisfied all of the requirements of the waiver received under section 214(l).

    The bill says: Section 201(b)(1) of the Immigration and Nationality Act (8 U.S.C. 1151(b)(1)) is amended by adding at the end the following:

    Bill text · Current law (8 U.S.C. 1151)

  79. 8 U.S.C. 1184(l)(1)changedby H.R. 9877 Sec. 3015(c)

    The bill says: in the matter preceding subparagraph (A), by striking "Attorney General" and inserting "Secretary of Homeland Security";

    Bill text · Current law (8 U.S.C. 1184)

  80. 8 U.S.C. 1184(l)(1)(A)changedby H.R. 9877 Sec. 3015(c)

    The bill says: in subparagraph (A), by striking "Director of the United States Information Agency" and inserting "Secretary of State";

    Bill text · Current law (8 U.S.C. 1184)

  81. 8 U.S.C. 1184(l)(1)(B)changedby H.R. 9877 Sec. 3015(c)

    The bill says: in subparagraph (B), by inserting ", except as provided in paragraphs (7) and (8)" before the semicolon at the end;

    Bill text · Current law (8 U.S.C. 1184)

  82. 8 U.S.C. 1184(l)(1)(C)rewrittenby H.R. 9877 Sec. 3015(c)

    (i) the alien demonstrates a bona fide offer of full-time employment at a health facility or health care organization, which employment has been determined by the Secretary of Homeland Security to be in the public interest; and(ii) the alien—(I) has accepted employment with the health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals;(II) begins employment by the later of the date that is—(aa) 120 days after receiving such waiver;(bb) 120 days after completing graduate medical education or training under a program approved pursuant to section 212(j)(1); or(cc) 120 days after receiving nonimmigrant status or employment authorization, if the alien or the alien’s employer petitions for such nonimmigrant status or employment authorization not later than 120 days after the date on which the alien completes his or her graduate medical education or training under a program approved pursuant to section 212(j)(1); and(III) agrees to continue to work for a total of not less than 3 years in the status authorized for such employment under this subsection, except as provided in paragraph (8); and

    The bill says: in subparagraph (C), by amending clauses (i) and (ii) to read as follows:

    Bill text · Current law (8 U.S.C. 1184)

  83. 8 U.S.C. 1184(l)(1)(D)changedby H.R. 9877 Sec. 3015(c)

    The bill says: in subparagraph (D), in the matter preceding clause (i), by inserting "except as provided in paragraph (8)," before "in the case".

    Bill text · Current law (8 U.S.C. 1184)

  84. 8 U.S.C. 1184(l)(2)(A)rewrittenby H.R. 9877 Sec. 3015(c)

    The bill says: Section 214(l)(2)(A) of such Act (8 U.S.C. 1184(l)(2)(A)) is amended to read as follows:

    Bill text · Current law (8 U.S.C. 1184)

  85. 8 U.S.C. 1184(l)(3)(A)changedby H.R. 9877 Sec. 3015(c)

    The bill says: Section 214(l)(3)(A) of such Act (8 U.S.C. 1184(l)(3)(A)) is amended by inserting "substantial requirement of an" before "agreement entered into".

    Bill text · Current law (8 U.S.C. 1184)

  86. 8 U.S.C. 1184(b)changedby H.R. 9877 Sec. 3015(e)

    The bill says: Section 214(b) of the Immigration and Nationality Act (8 U.S.C. 1184(b)) is amended by striking "and other than a nonimmigrant described in any provision of section 101(a)(15)(H)(i) except subclause (b1) of such section)" and inserting "a nonimmigrant described in any provision of section 101(a)(15)(H)(i) (except subclause (b1) of such section), and an alien coming to the United States to receive graduate medical education or training as described in section 212(j) or to take examinations required to receive graduate medical education or training as described in section 212(j))".

    Bill text · Current law (8 U.S.C. 1184)

  87. 8 U.S.C. 1153(b)(2)(B)(ii)(I)changedby H.R. 9877 Sec. 3015(e)

    (aa) the alien physician agrees to work on a full-time basis practicing primary care, specialty medicine, or a combination thereof, in an area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals, or at a health care facility under the jurisdiction of the Secretary of Veterans Affairs; or(bb) the alien physician is pursuing such waiver based upon service at a facility or facilities that serve patients who reside in a geographic area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals (without regard to whether such facility or facilities are located within such an area) and a Federal agency, or a local, county, regional, or State department of public health determines the alien physician’s work was or will be in the public interest.

    The bill says: Section 203(b)(2)(B)(ii)(I) of the Immigration and Nationality Act (8 U.S.C. 1153(b)(2)(B)(ii)(I)) is amended by striking items (aa) and (bb) and inserting the following:

    Bill text · Current law (8 U.S.C. 1153)

  88. 42 U.S.C. 293madded 749Cby H.R. 9877 Sec. 3016

    749C. Grants for schools of medicine and schools of osteopathic medicine in underserved areas.—(a) In general.— The Secretary may award grants to institutions of higher education (including consortiums of such institutions) for the establishment, improvement, or expansion of a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine.(b) Priority.— In selecting grant recipients under this section, the Secretary shall give priority to any institution of higher education (or consortium of such institutions) that—(1) proposes to use the grant for the establishment of a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine, in an area—(A) in which—(i) no other such school is based; or(ii) in the case in which the school of medicine or osteopathic medicine proposed to be established would be a minority-serving institution, no other minority-serving institution that includes a school of medicine or osteopathic medicine is based; and(B) that is a medically underserved community or a health professional shortage area; or(2) is a minority-serving institution described in section 371(a) of the Higher Education Act of 1965 or an institution or program described in section 326(e) of such Act.(c) Considerations.— In awarding grants under this section, the Secretary, to the extent practicable, may ensure equitable distribution of awards among the geographical regions of the United States.(d) Use of funds.— An institution of higher education (or a consortium of such institutions)—(1) shall use grant amounts received under this section to—(A) recruit, enroll, and retain medical students who are pursuing a degree of doctor of medicine or doctor of osteopathy, including individuals who are from disadvantaged backgrounds (including racial and ethnic groups underrepresented among medical students and health professions), individuals from rural and underserved areas, low-income individuals, and first generation college students, at a school of medicine or osteopathic medicine or a branch campus of a school of medicine or osteopathic medicine; and(B) develop, implement, and expand curriculum that emphasizes care for rural and underserved populations, including accessible and culturally and linguistically appropriate care and services, at such school or branch campus; and(2) may use grant amounts received under this section to—(A) plan and construct—(i) a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine, in an area in which no other such school is based; or(ii) a school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine, that will be a minority-serving institution, in an area in which no other such school that is a minority-serving institution is based;(B) plan, develop, and meet criteria for accreditation for a school of medicine or osteopathic medicine or a branch campus of a school of medicine or osteopathic medicine;(C) hire faculty, including faculty from racial and ethnic groups who are underrepresented among the medical and other health professions, and other staff to serve at such a school or branch campus;(D) support educational programs at such a school or branch campus;(E) modernize and expand infrastructure at such a school or branch campus; and(F) support other activities that the Secretary determines further the establishment, improvement, or expansion of a school of medicine or osteopathic medicine or a branch campus of a school of medicine or osteopathic medicine.(e) Application.— To be eligible to receive a grant under subsection (a), an institution of higher education (or a consortium of such institutions), shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a description of the institution’s or consortium's planned activities described in subsection (d).(f) Reporting.—(1) Reports from entities.— Each institution of higher education, or consortium of such institutions, awarded a grant under this section shall submit an annual report to the Secretary on the activities conducted under such grant.(2) Report to Congress.— Not later than 5 years after the date of enactment of this section and every 5 years thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report that provides a summary of the activities and outcomes associated with grants made under this section. Such reports shall include a list of awardees, including their primary geographic location, and location of any school of medicine or osteopathic medicine, or a branch campus of a school of medicine or osteopathic medicine that was established, improved, or expanded under this program.(g) Definitions.— In this section:(1) Branch campus.—(A) In general.— The term branch campus, with respect to a school of medicine or osteopathic medicine, means an additional location of such school that is geographically apart and independent of the main campus, at which the school offers at least 50 percent of the program leading to a degree of doctor of medicine or doctor of osteopathy that is offered at the main campus.(B) Independence from main campus.— For purposes of subparagraph (A), the location of a school described in such subparagraph shall be considered to be independent of the main campus described in such subparagraph if the location—(i) is permanent in nature;(ii) offers courses in educational programs leading to a degree, certificate, or other recognized educational credential;(iii) has its own faculty and administrative or supervisory organization; and(iv) has its own budgetary and hiring authority.(2) First generation college student.— The term first gener

    The bill says: Subpart II of part C of title VII of the Public Health Service Act (42 U.S.C. 293m et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 293m)

  89. 42 U.S.C. 295hadded 782by H.R. 9877 Sec. 3022(a)

    782 Substance Use Disorder Treatment and Behavioral and Mental Health Workforce Scholarship Program.—(a) Establishment.— The Secretary, acting through the Administrator of the Health Resources and Services Administration (in this section referred to as the "Secretary") shall establish the Substance Use Disorder Treatment and Behavioral and Mental Health Workforce Scholarship Program (in this section referred to as the "Scholarship Program") to award scholarships to assure an adequate supply of individuals in covered employment.(b) Eligibility; application; written contract.— To be eligible to participate in the Scholarship Program, an individual must—(1) be accepted for enrollment, or be enrolled, as a full-time student—(A) in an accredited (as determined by the Secretary) educational institution in a State; and(B) in a course of study or program, offered by such institution and approved by the Secretary, leading to covered employment;(2) submit an application to participate in the Scholarship Program; and(3) sign and submit to the Secretary, at the time of submittal of such application, a written contract (described in subsection (f)) to accept payment of a scholarship and to serve (in accordance with this section) for the applicable period of obligated service in a mental health professional shortage area.(c) Review and evaluation of information and forms by prospective applicant.—(1) Contents of application and contract forms.— In disseminating application forms and contract forms to individuals desiring to participate in the Scholarship Program, the Secretary shall include with such forms—(A) a fair summary of the rights and liabilities of an individual whose application is approved (and whose contract is accepted) by the Secretary, including in the summary a clear explanation of the damages to which the United States is entitled under subsection (j) in the case of the individual’s breach of the contract; and(B) such other information as may be necessary for the individual to understand the individual’s prospective participation in the Scholarship Program, including a statement of all factors considered in approving applications for participation in the Scholarship Program and in approving specific positions and employers that are eligible for the Scholarship Program.(2) Clarity; availability.— The application form, contract form, and all other information furnished by the Secretary under this section shall be written in a manner calculated to be understood by the average individual applying to participate in the Scholarship Program. The Secretary shall make such application forms, contract forms, and other information available to individuals desiring to participate in the Scholarship Program on a date sufficiently early to ensure that such individuals have adequate time to carefully review and evaluate such forms and information.(3) Education and assistance.—(A) Distribution of informational materials.— The Secretary shall distribute to health professions schools materials providing information on the Scholarship Program and shall encourage the schools to disseminate the materials to the students of the schools.(B) End of obligated service.—(i) Encouragement to continue service.— In the case of any health professional whose period of obligated service under the Scholarship Program is nearing completion, the Secretary shall encourage the individual to remain in a mental health professional shortage area and to continue in covered employment.(ii) Assistance in transition.— During the period in which a health professional is planning and making the transition from obligated service under the Scholarship Program, the Secretary may provide assistance to the professional regarding such transition if the professional is remaining in a mental health professional shortage area and is continuing in covered employment.(d) Factors considered in providing contracts; priorities.—(1) Factors considered in providing contracts.— In providing contracts under the Scholarship Program—(A) the Secretary shall consider the extent of the demonstrated interest of the applicants for the contracts in providing substance use disorder treatment and behavioral and mental health services; and(B) may consider such other factors regarding the applicants as the Secretary determines to be relevant to selecting qualified individuals to participate in such Program.(2) Priorities.— In providing contracts under the Scholarship Program, the Secretary shall give priority—(A) to any application for such a contract submitted by an individual who has characteristics that increase the probability that the individual will continue to serve in a mental health professional shortage area after the period of obligated service pursuant to subsection (f) is completed; and(B) to any application for such a contract submitted by an individual who is from a group or population that is underrepresented in the substance use disorder treatment and behavioral and mental health workforce.(e) Commencement of participation in Scholarship Program; notice.—(1) Commencement of participation.— An individual becomes a participant in the Scholarship Program only upon the Secretary’s approval of the individual’s application submitted under subsection (b)(2) and the Secretary’s acceptance of the contract submitted by the individual under subsection (b)(3).(2) Notice.— The Secretary shall provide written notice to an individual promptly upon the Secretary’s approving, under paragraph (1), of the individual’s participation in the Scholarship Program.(f) Written contract; contents.— The written contract (referred to in this section) between the Secretary and an individual shall contain—(1) an agreement that—(A) subject to paragraph (2), the Secretary agrees to provide the individual with a scholarship (described in subsection (g)) for a period of one or more school years during which the individual is pursuing a course of st

    The bill says: Part F of title VII of the Public Health Service Act (42 U.S.C. 295h) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 295h)

  90. 26 U.S.C. 117(c)(2)changedby H.R. 9877 Sec. 3022(b)

    The bill says: by striking "or" at the end of subparagraph (B);

    Bill text · Current law (26 U.S.C. 117)

  91. 26 U.S.C. 117(c)(2)changedby H.R. 9877 Sec. 3022(b)

    The bill says: by striking the period at the end of subparagraph (C) and inserting ", or"; and

    Bill text · Current law (26 U.S.C. 117)

  92. 26 U.S.C. 117(c)(2)added (D)by H.R. 9877 Sec. 3022(b)

    (D) section 782 of the Public Health Service Act.

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (26 U.S.C. 117)

  93. 20 U.S.C. 1070renumberedby H.R. 9877 Sec. 3033(1)

    The bill says: by redesignating subpart 5 as subpart 6;

    Bill text · Current law (20 U.S.C. 1070)

  94. 20 U.S.C. 1070changedby H.R. 9877 Sec. 3033(2)

    The bill says: in the section heading, by striking "subparts 1 through 4" and inserting "subparts 1 through 5";

    Bill text · Current law (20 U.S.C. 1070)

  95. 20 U.S.C. 1070(a)changedby H.R. 9877 Sec. 3033(2)

    The bill says: in subsection (a), by striking "subparts 1 through 4" and inserting "subparts 1 through 5";

    Bill text · Current law (20 U.S.C. 1070)

  96. 20 U.S.C. 1070(b)changedby H.R. 9877 Sec. 3033(2)

    The bill says: in subsection (b), by striking "subparts 1 through 4" and inserting "subparts 1 through 5"; and

    Bill text · Current law (20 U.S.C. 1070)

  97. 20 U.S.C. 1070(d)changedby H.R. 9877 Sec. 3033(2)

    The bill says: in subsection (d), by striking "subpart 1, 2, 3, or 4" and inserting "subpart 1, 2, 3, 4, or 5"; and

    Bill text · Current law (20 U.S.C. 1070)

  98. 20 U.S.C. 1070added 5by H.R. 9877 Sec. 3033(3)

    5 Grants To Support Graduate Programs in Mental and Behavioral Health Professions at Historically Black Colleges and Universities, Tribal Colleges and Universities, and other Minority-Serving Institutions.—727 Definitions.— In this subpart:(1) Cost of attendance.— The term cost of attendance has the meaning given that term in section 472.(2) Culturally responsive care.— The term culturally responsive care means care that is conducted or provided in a manner that is responsive to the beliefs, backgrounds, customs, interpersonal styles, lived experiences, language, and behaviors of individuals who are receiving the care, and in a manner that has the greatest likelihood of ensuring maximum benefit and participation in the treatment provided.(3) Eligible institution.— The term eligible institution means—(A) an institution of higher education that is—(i) a part B institution (as defined in section 322);(ii) a Hispanic-serving institution (as defined in section 502);(iii) a Tribal College or University (as defined in section 316);(iv) an Alaska Native-serving institution (as defined in section 317(b));(v) a Native Hawaiian-serving institution (as defined in section 317(b));(vi) a Predominantly Black Institution (as defined in section 318);(vii) an Asian American and Native American Pacific Islander-serving institution (as defined in section 320(b)); or(viii) a Native American-serving, nontribal institution (as defined in section 319);(B) a consortium of institutions described in subparagraph (A); or(C) an institution described in subparagraph (A), or a consortium described in subparagraph (B), in partnership with any other institution of higher education, but only if the program supported with a grant under this subpart is carried out at an institution described in subparagraph (A).(4) Health professional shortage area.— The term health professional shortage area means an area designated as a health professional shortage area by the Administrator of the Health Resources and Services Administration of the Department of Health and Human Services.(5) Mental or behavioral health professional.— The term mental or behavioral health professional means an individual with a graduate degree from an institution of higher education with an accredited program that prepares students for State licensing or certification in fields such as psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing, social work, school social work, substance use disorder prevention and treatment, marriage and family counseling, school counseling, professional counseling, child and adolescent psychiatry, or any other provider that is a State licensed or certified mental health professional qualified under State law to provide mental health services.(6) School-based mental health services provider.— The term school-based mental health services provider has the meaning given the term in section 4102 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7112).(7) Trauma-informed care.— The term trauma-informed care means care received by individuals who have experienced or witnessed trauma that is healing-centered and culturally responsive in accordance with professional standards of practice and accounting for patients’ experiences and that recognizes the emotional, behavioral, and developmental challenges that can accompany trauma exposure in order to eliminate or mitigate triggers that may cause re-traumatization of the patient.728 Grants to institutions for graduate training programs in mental or behavioral health professions.—(a) Program authorized.— From amounts made available to carry out this section for each fiscal year and not reserved under subsection (b), the Secretary is authorized to award grants, on a competitive basis, to eligible institutions—(1) to establish, expand, or improve graduate programs in mental and behavioral health professions, including programs that train school-based mental services providers; or(2) to engage in planning activities necessary for the establishment of new graduate programs in mental and behavioral health professions, including programs that train school-based mental health services providers.(b) Reservation.— The Secretary may reserve not more than 2 percent of the funds made available to carry out this section for a fiscal year to provide technical assistance to eligible institutions on matters relating to the grant program under this section and the implementation of programs supported by such grants.(c) Use of funds.—(1) Required use of funds.— An eligible institution that receives a grant under subsection (a)(1) shall use not less than 5 percent of grant funds to award scholarships or stipends, based on financial need, to cover all or part of a student’s cost of attendance for the mental or behavioral health graduate program. Scholarships and stipends awarded under this subsection shall prioritize students who are from health professional shortage areas.(2) Allowable use of funds.— After fulfilling the requirement in paragraph (1), an eligible institution that receives a grant under subsection (a)(1) shall use any remaining grant funds to carry out one or more of the following activities:(A) Establish new accredited graduate programs that prepare students for State licensing and certification to serve as mental or behavioral health professionals or school-based mental health services providers, including through hiring and compensating faculty, purchasing or developing culturally responsive course materials, or other activities necessary to establish such programs.(B) Ensure that graduate programs in mental or behavioral health professions offered by the institution are preparing professionals who are highly qualified, are able to provide culturally responsive care and trauma-informed care, and are equipped to serve in health professional shortage areas or other high-need areas or schools, which may include—(i) re

    The bill says: by inserting after subpart 4 the following:

    Bill text · Current law (20 U.S.C. 1070)

  99. 42 U.S.C. 254f(a)added (4)by H.R. 9877 Sec. 3041(a)

    (4) In approving applications for assignment of members of the Corps, the Secretary shall, notwithstanding paragraph (3), give priority to applications with respect to health professional shortage areas that are Federally qualified health centers and rural health clinics, as defined in section 1861(aa) of the Social Security Act.

    The bill says: Section 333(a) of the Public Health Service Act (42 U.S.C. 254f(a)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 254f)

  100. 42 U.S.C. 254brenumberedby H.R. 9877 Sec. 3042(a)

    The bill says: by redesignating subsection (r) as subsection (u); and

    Bill text · Current law (42 U.S.C. 254b)

  101. 42 U.S.C. 254badded (r)by H.R. 9877 Sec. 3042(a)

    (r) Recruiting, training, and retaining a community-Based workforce.— The Secretary may award grants to health centers for the purpose of assisting such centers in—(1) recruiting and hiring staff with the skills and experience necessary to effectively serve health center patient populations in rural and underserved areas; and(2) supporting career advancement and workforce development opportunities for such staff.

    The bill says: by inserting after subsection (q) the following new subsection:

    Bill text · Current law (42 U.S.C. 254b)

  102. 42 U.S.C. 256h(a)(1)changedby H.R. 9877 Sec. 3043(a)

    The bill says: in subsection (a)(1), in the matter preceding subparagraph (A), by inserting ", or that have in effect a covered agreement with a sponsoring institution so listed," after "relevant accrediting body"; and

    Bill text · Current law (42 U.S.C. 256h)

  103. 42 U.S.C. 256h(j)added (5)by H.R. 9877 Sec. 3043(a)

    (5) Covered agreement.— The term covered agreement means a written contract, memorandum of understanding, or other written agreement entered into for a period of not less than 2 years for the purpose of conducting an approved graduate medical residency training program.

    The bill says: in subsection (j), by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 256h)

  104. 42 U.S.C. 1395ww(h)(4)(F)(i)changedby H.R. 9877 Sec. 3043(b)

    The bill says: in paragraph (4)(F)(i), by striking "and (10)" and inserting "(10), and (11)"; and

    Bill text · Current law (42 U.S.C. 1395ww)

  105. 42 U.S.C. 1395ww(h)added (11)by H.R. 9877 Sec. 3043(b)

    (11) Training programs at Federally qualified health centers.—(A) In general.— For cost reporting periods beginning on or after October 1, 2027, in the case of a hospital that has an approved medical residency training program where a significant portion of such program occurs at a Federally qualified health center (as determined by the Secretary), the Secretary shall increase the otherwise applicable resident limit for such hospital by 3 full-time equivalent residency positions.(B) Definitions.— In this paragraph:(i) Otherwise applicable resident limit.— The term "otherwise applicable resident limit" means, with respect to a hospital, the limit otherwise applicable under subparagraphs (F)(i) and (H) of paragraph (4) on the resident level for the hospital determined without regard to this paragraph but taking into account subparagraphs (A) and (B) of paragraph (7), subparagraphs (A) and (B) of paragraph (8), and paragraphs (9)(A) and (10)(A).(ii) Resident level.— The term "resident level" has the meaning given such term in paragraph (7)(C)(i).

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395ww)

  106. 42 U.S.C. 1395x(aa)(1)(B)changedby H.R. 9877 Sec. 3044(a)

    The bill says: in subparagraph (B), by inserting "such services furnished on or after October 1, 2026, by a behavioral health consultant, peer support specialist, or other behavioral health professional (as such terms are defined by the Secretary)," before "and such services";

    Bill text · Current law (42 U.S.C. 1395x)

  107. 42 U.S.C. 1395x(aa)(1)(C)changedby H.R. 9877 Sec. 3044(a)

    The bill says: in subparagraph (C), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395x)

  108. 42 U.S.C. 1395x(aa)(1)(D)changedby H.R. 9877 Sec. 3044(a)

    The bill says: in subparagraph (D), by striking the comma at the end and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1395x)

  109. 42 U.S.C. 1395x(aa)(1)added (E)by H.R. 9877 Sec. 3044(a)

    (E) case management services furnished on or after October 1, 2026, by a case manager (as defined by the Secretary),

    The bill says: by inserting after subparagraph (D) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  110. 42 U.S.C. 1395x(aa)(3)(A)changedby H.R. 9877 Sec. 3044(a)

    The bill says: in paragraph (3)(A), by striking "(D)" and inserting "(E)".

    Bill text · Current law (42 U.S.C. 1395x)

  111. 42 U.S.C. 1396d(l)(2)(A)changedby H.R. 9877 Sec. 3044(a)

    The bill says: Section 1905(l)(2)(A) of the Social Security Act (42 U.S.C. 1396d(l)(2)(A)) is amended by inserting "and (E)" before "of section".

    Bill text · Current law (42 U.S.C. 1396d)

  112. 42 U.S.C. 1396a(bb)added (7)by H.R. 9877 Sec. 3044(b)

    (7) Study and guidance on payment adjustments.— Not later than October 1, 2027, and not less frequently than annually thereafter, the Secretary shall—(A) conduct a study on any differences in the methods by which State plans adjust the payment amount under paragraph (3) for services furnished during a fiscal year; and(B) based on the results of the study conducted under subparagraph (A), issue guidance to State plans on best practices for adjusting the payment amount under paragraph (3) for services furnished during a fiscal year.

    The bill says: Section 1902(bb) of the Social Security Act (42 U.S.C. 1396a(bb)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396a)

  113. 8 U.S.C. 1357added (i)by H.R. 9877 Sec. 4001(a)

    (i)(1) In order to ensure individuals' access to sensitive locations, this subsection shall apply to any enforcement action by—(A) officers or agents of the Department of Homeland Security, including officers and agents of U.S. Immigration and Customs Enforcement and U.S. Customs and Border Protection; and(B) any individual designated to perform immigration enforcement functions pursuant to a written agreement described in subsection (g).(2)(A) Except as provided in subparagraphs (C) and (D) of paragraph (3), an enforcement action may not take place, be focused on a location, or occur, within 1,000 feet of a sensitive location, except under exigent circumstances.(B) If an immigration enforcement action is taking place under exigent circumstances, and the exigent circumstances permitting the enforcement action cease, the enforcement action shall be discontinued until such exigent circumstances reemerge.(C) If an individual referred to in subparagraph (A) or (B) of paragraph (1) is not certain that exigent circumstances exist, the individual—(i) shall cease the enforcement action immediately;(ii) shall consult with his or her supervisor in real time regarding the existence of exigent circumstances; and(iii) may not continue the enforcement action until the individual's supervisor affirmatively confirms the existence of exigent circumstances.(3)(A) When proceeding with an enforcement action at or near a sensitive location, individuals referred to in subparagraph (A) or (B) of paragraph (1) shall make every effort—(i) to conduct themselves as discreetly as possible, consistent with officer and public safety;(ii) to limit the time spent at the sensitive location; and(iii) to limit the enforcement action to the person or persons for whom prior approval was obtained.(B) If, in the course of an enforcement action that is not initiated at, or focused on, a sensitive location, individuals referred to in subparagraph (A) or (B) of paragraph (1) are led to or near a sensitive location, and no clear exigent circumstance with respect to the sensitive location exists, such individuals shall—(i) cease taking any further enforcement action;(ii) conduct themselves in a discreet manner;(iii) maintain surveillance; and(iv) in the event that uncertainty exists about the existence of exigent circumstances, immediately consult their supervisor in order to determine whether such enforcement action should be discontinued pursuant to paragraph (2)(C).(C) This subsection shall not apply to the transportation of an individual apprehended at or near a land or sea border to a hospital or health care provider for the purpose of providing such individual medical care.(D) This subsection shall not apply to a rare premeditated arrest operation, undertaken with the prior written approval of an appropriate authorizing official, involving the targeted arrest of a terrorist suspect, an individual who poses a clear threat to national security, or an individual who poses an extraordinary danger to public safety.(4) If an enforcement action is carried out in violation of this subsection—(A) no information resulting from the enforcement action may be entered into the record or received into evidence in a removal proceeding resulting from the enforcement action; and(B) the alien who is the subject of such removal proceeding may file a motion for the immediate termination of the removal proceeding.(5)(A) Each official specified in subparagraph (B) shall ensure the employees under the supervision of such official receive annual training in compliance with the requirements of this subsection, section 239, and section 384 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (8 U.S.C. 1367).(B) The officials specified in this subparagraph are the following:(i) The Chief Counsel of U.S. Immigration and Customs Enforcement.(ii) The Field Office Directors of U.S. Immigration and Customs Enforcement.(iii) Each Special Agent in Charge of U.S. Immigration and Customs Enforcement.(iv) Each Chief Patrol Agent of U.S. Customs and Border Protection.(v) The Director of Field Operations of U.S. Customs and Border Protection.(vi) The Director of Air and Marine Operations of U.S. Customs and Border Protection.(vii) The Internal Affairs Special Agent in Charge of U.S. Customs and Border Protection.(6)(A) Not later than 30 days after any enforcement action is taken at a sensitive location by any individual referred to in subparagraph (A) or (B) of paragraph (1), the Secretary of Homeland Security shall provide a report to the Office of the Inspector General of the Department of Homeland Security and the Office for Civil Rights and Civil Liberties of the Department of Homeland Security with respect to each such enforcement action, which shall contain—(i) the date, State, and local political subdivision (such as city, town, or county) in which each enforcement action occurred;(ii) the specific sensitive location site where the enforcement action occurred;(iii) the type of enforcement action that occurred;(iv) the specific department, agency, and officers responsible for the enforcement action;(v) a thorough description of the circumstances which purportedly justified the enforcement action, including—(I) a clear description of the exigent circumstances involved; or(II) a certified copy of the written approval for the immigration arrest that was signed by an appropriate authorizing officer, along with a clear description of the specific and rare threat which justified the premeditated arrest at such sensitive location;(vi) a description of the intended target of the enforcement action;(vii) the number of individuals, if any, arrested or taken into custody through the enforcement action;(viii) the number of collateral arrests, if any, from the enforcement action and the reasons for each such arrest; and(ix) a certification of whether a supervisor was contacted before, during, or after

    The bill says: Section 287 of the Immigration and Nationality Act (8 U.S.C. 1357) is amended by adding at the end the following:

    Bill text · Current law (8 U.S.C. 1357)

  114. 42 U.S.C. 1396arewrittenby H.R. 9877 Sec. 4002(b)

    The bill says: by amending paragraph (46) of subsection (a) to read as follows:

    Bill text · Current law (42 U.S.C. 1396a)

  115. 42 U.S.C. 1396a(e)(13)(A)(i)changedby H.R. 9877 Sec. 4002(b)

    The bill says: in the matter preceding subclause (I), by striking "sections 1902(a)(46)(B) and 1137(d)" and inserting "section 1137(d)"; and

    Bill text · Current law (42 U.S.C. 1396a)

  116. 42 U.S.C. 1396a(e)(13)(A)(i)changedby H.R. 9877 Sec. 4002(b)

    The bill says: by striking subclause (IV) and redesignating subclause (V) as subclause (IV); and

    Bill text · Current law (42 U.S.C. 1396a)

  117. 42 U.S.C. 1396aremovedby H.R. 9877 Sec. 4002(b)

    The bill says: by striking subsection (ee).

    Bill text · Current law (42 U.S.C. 1396a)

  118. 42 U.S.C. 1396b(c)repealedby H.R. 9877 Sec. 4002(b)

    The bill says: Subsection (c) of section 6036 of the Deficit Reduction Act of 2005 (42 U.S.C. 1396b note) is repealed.

    Bill text · Current law (42 U.S.C. 1396b)

  119. 42 U.S.C. 1397ee(c)(9)repealedby H.R. 9877 Sec. 4002(b)

    The bill says: Section 2105(c)(9) of the Social Security Act (42 U.S.C. 1397ee(c)(9)) is repealed.

    Bill text · Current law (42 U.S.C. 1397ee)

  120. 42 U.S.C. 1396b(v)changedby H.R. 9877 Sec. 4003(a)

    (4)(A) Notwithstanding sections 401(a), 402(b), 403, and 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and paragraph (1), payment shall be made to a State under this section for medical assistance furnished to an alien under this title (including an alien described in such paragraph) who meets any of the following conditions:(i) The alien is otherwise eligible for such assistance under the State plan approved under this title (other than the requirement of the receipt of aid or assistance under title IV, supplemental security income benefits under title XVI, or a State supplementary payment) within either or both of the following eligibility categories:(I) Children under 21 years of age, including any optional targeted low-income child (as such term is defined in section 1905(u)(2)(B)).(II) Pregnant persons during pregnancy and during the 12-month period beginning on the last day of the pregnancy.(ii) The alien is lawfully present in the United States.(B) No debt shall accrue under an affidavit of support against any sponsor of an alien who meets the conditions specified in subparagraph (A) on the basis of the provision of medical assistance to such alien under this paragraph and the cost of such assistance shall not be considered as an unreimbursed cost.

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

    Bill text · Current law (42 U.S.C. 1396b)

  121. 42 U.S.C. 1397gg(e)(1)rewrittenby H.R. 9877 Sec. 4003(b)

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

    Bill text · Current law (42 U.S.C. 1397gg)

  122. 8 U.S.C. 1611(b)added (6)by H.R. 9877 Sec. 4003(c)

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

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

    Bill text · Current law (8 U.S.C. 1611)

  123. 8 U.S.C. 1612(a)(2)(D)(ii)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in the clause heading, by striking "Food stamps" and inserting "Supplemental nutrition assistance program"; and

    Bill text · Current law (8 U.S.C. 1612)

  124. 8 U.S.C. 1612(a)(2)(D)(ii)(I)changedby H.R. 9877 Sec. 4003(c)

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

    Bill text · Current law (8 U.S.C. 1612)

  125. 8 U.S.C. 1612(a)(2)(F)(ii)changedby H.R. 9877 Sec. 4003(c)

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

    Bill text · Current law (8 U.S.C. 1612)

  126. 8 U.S.C. 1612(a)(2)(G)(ii)changedby H.R. 9877 Sec. 4003(c)

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

    Bill text · Current law (8 U.S.C. 1612)

  127. 8 U.S.C. 1612(a)(2)(I)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in subparagraph (I), in the subparagraph heading, by striking "Food stamp" and inserting "Supplemental nutrition assistance program";

    Bill text · Current law (8 U.S.C. 1612)

  128. 8 U.S.C. 1612(a)(2)(J)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in subparagraph (J), in the subparagraph heading, by striking "Food stamp" and inserting "Supplemental nutrition assistance program";

    Bill text · Current law (8 U.S.C. 1612)

  129. 8 U.S.C. 1612(a)(2)(K)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in the subparagraph heading, by striking "Food stamp" and inserting "Supplemental nutrition assistance program"; and

    Bill text · Current law (8 U.S.C. 1612)

  130. 8 U.S.C. 1612(a)(2)(K)(i)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in clause (i), by striking subclause (I) and inserting the following:

    Bill text · Current law (8 U.S.C. 1612)

  131. 8 U.S.C. 1612(a)(2)changedby H.R. 9877 Sec. 4003(c)

    (L) Supplemental nutrition assistance program benefits generally.— With respect to eligibility for benefits for the specified Federal program described in paragraph (3)(B), paragraph (1) shall not apply to any individual who is lawfully present in the United States, regardless of—(i) the immigration status of the individual; or(ii) the date of entry by the individual into the United States.

    The bill says: by striking subparagraph (L) and inserting the following:

    Bill text · Current law (8 U.S.C. 1612)

  132. 8 U.S.C. 1612(a)(3)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in the matter preceding subparagraph (A), by striking "For purposes of" and inserting "In"; and

    Bill text · Current law (8 U.S.C. 1612)

  133. 8 U.S.C. 1612(a)(3)changedby H.R. 9877 Sec. 4003(c)

    The bill says: by striking subparagraph (B) and inserting the following:

    Bill text · Current law (8 U.S.C. 1612)

  134. 8 U.S.C. 1613(b)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in the matter preceding paragraph (1), by striking "aliens";

    Bill text · Current law (8 U.S.C. 1613)

  135. 8 U.S.C. 1613(b)(2)(C)changedby H.R. 9877 Sec. 4003(c)

    The bill says: in paragraph (2)(C), by striking "an individual described in clause (i) or (ii)" and inserting "such an individual"; and

    Bill text · Current law (8 U.S.C. 1613)

  136. 8 U.S.C. 1613(b)added (4)by H.R. 9877 Sec. 4003(c)

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

    The bill says: by adding at the end the following:

    Bill text · Current law (8 U.S.C. 1613)

  137. 8 U.S.C. 1613(c)(2)(L)changedby H.R. 9877 Sec. 4003(c)

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

    Bill text · Current law (8 U.S.C. 1613)

  138. 7 U.S.C. 2015(f)(2)renumberedby H.R. 9877 Sec. 4003(c)

    The bill says: by redesignating subparagraphs (B), (C), and (D) as clauses (ii), (iii), and (iv), respectively;

    Bill text · Current law (7 U.S.C. 2015)

  139. 7 U.S.C. 2015(f)(2)changedby H.R. 9877 Sec. 4003(c)

    (B)(i) a citizen

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

    Bill text · Current law (7 U.S.C. 2015)

  140. 7 U.S.C. 2015(f)(2)changedby H.R. 9877 Sec. 4003(c)

    The bill says: by striking "the individual" and inserting "an individual"; and

    Bill text · Current law (7 U.S.C. 2015)

  141. 7 U.S.C. 2015(f)(2)changedby H.R. 9877 Sec. 4003(c)

    The bill says: by striking "The income" and inserting the following:

    Bill text · Current law (7 U.S.C. 2015)

  142. 7 U.S.C. 2015(f)renumberedby H.R. 9877 Sec. 4003(c)

    The bill says: by redesignating paragraph (1) as subparagraph (A) and indenting the subparagraph appropriately;

    Bill text · Current law (7 U.S.C. 2015)

  143. 7 U.S.C. 2015(f)changedby H.R. 9877 Sec. 4003(c)

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

    The bill says: by striking "(f) No individual" and inserting the following:

    Bill text · Current law (7 U.S.C. 2015)

  144. 7 U.S.C. 2015(f)added (3)by H.R. 9877 Sec. 4003(c)

    (3) Clarification of applicability.— Notwithstanding paragraph (1), an individual who is lawfully present in the United States shall not be considered to be ineligible for benefits under that paragraph on the basis of—(A) the immigration status of the individual; or(B) the date of entry by the individual into the United States.

    The bill says: by adding at the end the following:

    Bill text · Current law (7 U.S.C. 2015)

  145. 7 U.S.C. 2014(i)(1)changedby H.R. 9877 Sec. 4003(c)

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

    Bill text · Current law (7 U.S.C. 2014)

  146. 8 U.S.C. 1631(d)changedby H.R. 9877 Sec. 4003(d)

    The bill says: Section 421(d) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1631(d)) is amended by striking paragraph (3) and inserting the following:

    Bill text · Current law (8 U.S.C. 1631)

  147. 7 U.S.C. 2020(e)(2)(B)renumberedby H.R. 9877 Sec. 4003(e)

    The bill says: by redesignating clauses (vi) and (vii) as clauses (vii) and (viii), respectively; and

    Bill text · Current law (7 U.S.C. 2020)

  148. 7 U.S.C. 2020(e)(2)(B)added (vi)by H.R. 9877 Sec. 4003(e)

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

    The bill says: by inserting after clause (v) the following:

    Bill text · Current law (7 U.S.C. 2020)

  149. 26 U.S.C. 36B(b)(3)(A)rewrittenby H.R. 9877 Sec. 4004(a)

    The bill says: Section 36B(b)(3)(A) of the Internal Revenue Code of 1986 is amended to read as follows:

    Bill text · Current law (26 U.S.C. 36B)

  150. 26 U.S.C. 36B(c)(1)changedby H.R. 9877 Sec. 4004(b)

    The bill says: by striking "but does not exceed 400 percent" in subparagraph (A), and

    Bill text · Current law (26 U.S.C. 36B)

  151. 26 U.S.C. 36B(c)(1)removedby H.R. 9877 Sec. 4004(b)

    The bill says: by striking subparagraph (E).

    Bill text · Current law (26 U.S.C. 36B)

  152. 26 U.S.C. 36B(c)(1)added (B)by H.R. 9877 Sec. 4005(a)

    (B) Special rule for certain individuals ineligible for Medicaid due to status.— If— the taxpayer shall, for purposes of the credit under this section, be treated as an applicable taxpayer with a household income which is equal to 100 percent of the poverty line for a family of the size involved.(i) a taxpayer has a household income which is not greater than 100 percent of an amount equal to the poverty line for a family of the size involved,(ii) the taxpayer is a noncitizen who is not eligible for the Medicaid program under title XIX of the Social Security Act by reason of the individual’s immigration status,(iii) the taxpayer is ineligible for minimum essential coverage under section 5000A(f)(1)(A)(ii), and(iv) under the Medicaid eligibility criteria for noncitizens in effect on December 26, 2020, the taxpayer would be ineligible for such minimum essential coverage by reason of the taxpayer’s immigration status,

    The bill says: in subsection (c)(1), by inserting after subparagraph (A) the following:

    Bill text · Current law (26 U.S.C. 36B)

  153. 26 U.S.C. 36Bremovedby H.R. 9877 Sec. 4005(a)

    The bill says: by striking subsection (e).

    Bill text · Current law (26 U.S.C. 36B)

  154. 42 U.S.C. 18071removedby H.R. 9877 Sec. 4005(a)

    The bill says: by striking subsection (e); and

    Bill text · Current law (42 U.S.C. 18071)

  155. 42 U.S.C. 18071renumberedby H.R. 9877 Sec. 4005(a)

    The bill says: by redesignating subsections (f) and (g) as subsections (e) and (f), respectively.

    Bill text · Current law (42 U.S.C. 18071)

  156. 42 U.S.C. 18051(e)(1)(B)changedby H.R. 9877 Sec. 4005(a)

    The bill says: Section 1331(e)(1)(B) of the Patient Protection and Affordable Care Act (42 U.S.C. 18051(e)(1)(B)) is amended by striking "lawfully present in the United States,".

    Bill text · Current law (42 U.S.C. 18051)

  157. 42 U.S.C. 18082removedby H.R. 9877 Sec. 4005(a)

    The bill says: by striking subsection (d); and

    Bill text · Current law (42 U.S.C. 18082)

  158. 42 U.S.C. 18082renumberedby H.R. 9877 Sec. 4005(a)

    The bill says: by redesignating subsection (e) as subsection (d).

    Bill text · Current law (42 U.S.C. 18082)

  159. 26 U.S.C. 5000A(d)removedby H.R. 9877 Sec. 4005(a)

    The bill says: by striking paragraph (3); and

    Bill text · Current law (26 U.S.C. 5000A)

  160. 26 U.S.C. 5000A(d)renumberedby H.R. 9877 Sec. 4005(a)

    The bill says: by redesignating paragraph (4) as paragraph (3).

    Bill text · Current law (26 U.S.C. 5000A)

  161. 42 U.S.C. 18081(a)removedby H.R. 9877 Sec. 4005(b)

    The bill says: by striking paragraph (1); and

    Bill text · Current law (42 U.S.C. 18081)

  162. 42 U.S.C. 18081(a)renumberedby H.R. 9877 Sec. 4005(b)

    The bill says: by redesignating paragraphs (2), (3), and (4) as paragraphs (1), (2), and (3), respectively.

    Bill text · Current law (42 U.S.C. 18081)

  163. 42 U.S.C. 18032(f)changedby H.R. 9877 Sec. 4005(b)

    The bill says: in the heading, by striking "; access limited to citizens and lawful residents"; and

    Bill text · Current law (42 U.S.C. 18032)

  164. 42 U.S.C. 18032(f)removedby H.R. 9877 Sec. 4005(b)

    The bill says: by striking paragraph (3).

    Bill text · Current law (42 U.S.C. 18032)

  165. 42 U.S.C. 1396a(a)(10)(A)(ii)(XXII)changedby H.R. 9877 Sec. 4006(b)

    The bill says: in subclause (XXII), by striking "or" at the end;

    Bill text · Current law (42 U.S.C. 1396a)

  166. 42 U.S.C. 1396a(a)(10)(A)(ii)(XXIII)changedby H.R. 9877 Sec. 4006(b)

    The bill says: in subclause (XXIII), by striking the semicolon and inserting "; or"; and

    Bill text · Current law (42 U.S.C. 1396a)

  167. 42 U.S.C. 1396a(a)(10)(A)(ii)added (XXIV)by H.R. 9877 Sec. 4006(b)

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

    The bill says: by adding at the end the following new subclause:

    Bill text · Current law (42 U.S.C. 1396a)

  168. 42 U.S.C. 1396d(a)changedby H.R. 9877 Sec. 4006(b)

    The bill says: in the matter designated as clause (xvii), by striking "or" at the end;

    Bill text · Current law (42 U.S.C. 1396d)

  169. 42 U.S.C. 1396d(a)changedby H.R. 9877 Sec. 4006(b)

    The bill says: in the matter designated as clause (xviii), by adding "or" at the end; and

    Bill text · Current law (42 U.S.C. 1396d)

  170. 42 U.S.C. 1396d(a)added (xix)by H.R. 9877 Sec. 4006(b)

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

    The bill says: by inserting after the matter designated as clause (xviii) the following:

    Bill text · Current law (42 U.S.C. 1396d)

  171. 42 U.S.C. 1397aaadded 2112Aby H.R. 9877 Sec. 4006(b)

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

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

    Bill text · Current law (42 U.S.C. 1397aa)

  172. 42 U.S.C. 1611(a)addedby H.R. 9877 Sec. 4006(b)

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

    Bill text · Current law (42 U.S.C. 1611)

  173. 42 U.S.C. 1396d(ii)(1)changedby H.R. 9877 Sec. 4009(a)

    The bill says: by striking "8-quarter period" and inserting "40-quarter period"; and

    Bill text · Current law (42 U.S.C. 1396d)

  174. 42 U.S.C. 1396d(ii)(1)changedby H.R. 9877 Sec. 4009(a)

    The bill says: by striking "5 percentage points" and inserting "10 percentage points".

    Bill text · Current law (42 U.S.C. 1396d)

  175. 42 U.S.C. 1308(f)changedby H.R. 9877 Sec. 4101(a)

    The bill says: in subsection (f), in the matter preceding paragraph (1), by striking "subsections (g) and (h)" and inserting "subsections (g), (h), and (j)";

    Bill text · Current law (42 U.S.C. 1308)

  176. 42 U.S.C. 1308(g)(2)changedby H.R. 9877 Sec. 4101(a)

    The bill says: in subsection (g)(2), in the matter preceding subparagraph (A), by inserting "subsection (j) and" after "subject to";

    Bill text · Current law (42 U.S.C. 1308)

  177. 42 U.S.C. 1308(i)removedby H.R. 9877 Sec. 4101(a)

    The bill says: by striking paragraph (4); and

    Bill text · Current law (42 U.S.C. 1308)

  178. 42 U.S.C. 1308(i)renumberedby H.R. 9877 Sec. 4101(a)

    The bill says: by redesignating paragraph (5) as paragraph (4); and

    Bill text · Current law (42 U.S.C. 1308)

  179. 42 U.S.C. 1308added (j)by H.R. 9877 Sec. 4101(a)

    (j) Sunset of medicaid funding limitations for puerto rico, the virgin islands, guam, the northern mariana islands, and american samoa.— Subsections (f) and (g) shall not apply to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa beginning with fiscal year 2027.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1308)

  180. 42 U.S.C. 1396a(j)changedby H.R. 9877 Sec. 4101(a)

    The bill says: Section 1902(j) of the Social Security Act (42 U.S.C. 1396a(j)) is amended by striking ", the limitation in section 1108(f),,".

    Bill text · Current law (42 U.S.C. 1396a)

  181. 42 U.S.C. 1396b(u)removedby H.R. 9877 Sec. 4101(a)

    The bill says: Section 1903(u) of the Social Security Act (42 U.S.C. 1396b(u)) is amended by striking paragraph (4).

    Bill text · Current law (42 U.S.C. 1396b)

  182. 42 U.S.C. 1396d(b)changedby H.R. 9877 Sec. 4101(b)

    The bill says: in subsection (b), in the first sentence, by inserting "for fiscal years before fiscal year 2027" after "American Samoa"; and

    Bill text · Current law (42 U.S.C. 1396d)

  183. 42 U.S.C. 1396d(ff)(2)changedby H.R. 9877 Sec. 4101(b)

    The bill says: in subsection (ff)(2), by striking "2027" and inserting "2026".

    Bill text · Current law (42 U.S.C. 1396d)

  184. 42 U.S.C. 1396r-4(f)(6)added (C)by H.R. 9877 Sec. 4101(c)

    (C) Territories.—(i) Fiscal year 2027.— For fiscal year 2027, the DSH allotment for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa shall bear the same ratio to $300,000,000 as the ratio of the number of individuals who are low-income or uninsured and residing in such respective territory (as estimated from time to time by the Secretary) bears to the sums of the number of such individuals residing in all of the territories.(ii) Subsequent fiscal year.— For each subsequent fiscal year, the DSH allotment for each such territory is subject to an increase in accordance with paragraph (3).

    The bill says: in paragraph (6), by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1396r-4)

  185. 42 U.S.C. 1396r-4(f)(9)addedby H.R. 9877 Sec. 4101(c)

    The bill says: in paragraph (9), by inserting before the period at the end the following: ", and includes, beginning with fiscal year 2027, Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa".

    Bill text · Current law (42 U.S.C. 1396r-4)

  186. 42 U.S.C. 1301(a)(1)changedby H.R. 9877 Sec. 4102(b)

    The bill says: Section 1101(a)(1) of the Social Security Act (42 U.S.C. 1301(a)(1)) is amended by striking the 5th sentence and inserting the following: "Such term when used in title XVI includes Puerto Rico, the United States Virgin Islands, Guam, and American Samoa.".

    Bill text · Current law (42 U.S.C. 1301)

  187. 42 U.S.C. 1308changedby H.R. 9877 Sec. 4102(b)

    The bill says: in the section heading, by striking "; limitation on total payments";

    Bill text · Current law (42 U.S.C. 1308)

  188. 42 U.S.C. 1308removedby H.R. 9877 Sec. 4102(b)

    The bill says: by striking subsection (a); and

    Bill text · Current law (42 U.S.C. 1308)

  189. 42 U.S.C. 1308(c)removedby H.R. 9877 Sec. 4102(b)

    The bill says: in subsection (c), by striking paragraphs (2) and (4) and redesignating paragraphs (3) and (5) as paragraphs (2) and (4), respectively.

    Bill text · Current law (42 U.S.C. 1308)

  190. 42 U.S.C. 1382c(a)(1)(B)(i)(I)changedby H.R. 9877 Sec. 4102(b)

    The bill says: in clause (i)(I), by inserting "or national," after "citizen";

    Bill text · Current law (42 U.S.C. 1382c)

  191. 42 U.S.C. 1382c(a)(1)(B)(i)(II)changedby H.R. 9877 Sec. 4102(b)

    The bill says: in clause (i)(II), by adding "; or" at the end; and

    Bill text · Current law (42 U.S.C. 1382c)

  192. 42 U.S.C. 1382c(a)(1)(B)(ii)changedby H.R. 9877 Sec. 4102(b)

    The bill says: in clause (ii), by inserting "or national" after "citizen".

    Bill text · Current law (42 U.S.C. 1382c)

  193. 42 U.S.C. 1382c(e)changedby H.R. 9877 Sec. 4102(b)

    The bill says: Section 1614(e) of such Act (42 U.S.C. 1382c(e)) is amended by striking "and the District of Columbia" and inserting ", the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, and American Samoa".

    Bill text · Current law (42 U.S.C. 1382c)

  194. 42 U.S.C. 1395y(b)(1)(C)changedby H.R. 9877 Sec. 4103(a)

    The bill says: in the last sentence, by inserting ", and before January 1, 2027" after "prior to such date)"; and

    Bill text · Current law (42 U.S.C. 1395y)

  195. 42 U.S.C. 1395y(b)(1)(C)addedby H.R. 9877 Sec. 4103(a)

    The bill says: by adding at the end the following new sentence: "Effective for items and services furnished on or after January 1, 2027 (with respect to periods beginning on or after the date that is 42 months prior to such date), clauses (i) and (ii) shall be applied by substituting "42-month" for "12-month" each place it appears.".

    Bill text · Current law (42 U.S.C. 1395y)

  196. 42 U.S.C. 18024added (f)by H.R. 9877 Sec. 4104(a)

    (f) Indian.— In this title:(1) In general.— The term Indian means—(A) an Indian, a California Indian, or an Urban Indian (as those terms are defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)); or(B) an individual who is of Indian descent and a member of an Indian community served by a local facility or program of the Indian Health Service.(2) Inclusions.— The term Indian includes the following individuals:(A) A member of a federally recognized Indian Tribe.(B) A resident of an urban center who meets 1 or more of the following criteria:(i) A member of a Tribe, band, or other organized group of Indians, including those Tribes, bands, or groups terminated since 1940 and those recognized as of the date of enactment of the Health Equity and Accountability Act of 2026 or later by the State in which they reside, or being a descendant, in the first or second degree, of any such member.(ii) An Eskimo or Aleut or other Alaska Native.(iii) An individual who is determined to be an Indian under regulations promulgated by the Secretary.(C) An individual who is considered by the Secretary of the Interior to be an Indian for any purpose.(D) An individual who is considered by the Secretary to be an Indian for purposes of eligibility for services provided by the Indian Health Service, including as a California Indian, Eskimo, Aleut, or other Alaska Native.

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

    Bill text · Current law (42 U.S.C. 18024)

  197. 42 U.S.C. 18031(c)(6)(D)changedby H.R. 9877 Sec. 4104(b)

    The bill says: Section 1311(c)(6)(D) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)(D)) is amended by striking "(as defined in section 4 of the Indian Health Care Improvement Act)".

    Bill text · Current law (42 U.S.C. 18031)

  198. 42 U.S.C. 18071(d)(1)changedby H.R. 9877 Sec. 4104(b)

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

    Bill text · Current law (42 U.S.C. 18071)

  199. 42 U.S.C. 18071(d)(2)changedby H.R. 9877 Sec. 4104(b)

    The bill says: in paragraph (2), in the matter preceding subparagraph (A), by striking "(as so defined)".

    Bill text · Current law (42 U.S.C. 18071)

  200. 26 U.S.C. 5000A(e)changedby H.R. 9877 Sec. 4104(b)

    The bill says: Section 5000A(e) of the Internal Revenue Code of 1986 is amended by striking paragraph (3) and inserting the following:

    Bill text · Current law (26 U.S.C. 5000A)

  201. 42 U.S.C. 1395i-2(a)(3)(B)changedby H.R. 9877 Sec. 4105(a)

    The bill says: Section 1818(a)(3)(B) of the Social Security Act (42 U.S.C. 1395i–2(a)(3)(B)) is amended by striking "an alien" and all that follows through "under this section" and inserting "an individual who is lawfully present in the United States".

    Bill text · Current law (42 U.S.C. 1395i-2)

  202. 42 U.S.C. 1395o(a)(2)(B)changedby H.R. 9877 Sec. 4105(b)

    The bill says: Section 1836(a)(2)(B) of the Social Security Act (42 U.S.C. 1395o(a)(2)(B)) is amended by striking "an alien" and all that follows through "under this part" and inserting "an individual who is lawfully present in the United States".

    Bill text · Current law (42 U.S.C. 1395o)

  203. 42 U.S.C. 1395added 1899Dby H.R. 9877 Sec. 4106(a)

    1899D. Medicare Cost Assistance Program.—(a) In general.— Effective beginning January 1, 2027, in the case of a Medicare Cost Assistance Program eligible individual (as defined in subsection (b)(1)), the Secretary shall provide Medicare cost assistance for the following costs incurred with respect to the individual:(1) Premiums under section 1818.(2) Premiums under section 1839.(3) Coinsurance under this title (including coinsurance described in section 1813).(4) Deductibles established under this title (including those described in section 1813 and section 1833(b)).(5) The difference between the amount that is paid under section 1833(a) and the amount that would be paid under such section if any reference to a percent less than 100 percent therein were deemed a reference to "100 percent".(b) Determination of eligibility.—(1) Medicare Cost Assistance Program eligible individual defined.— The term Medicare Cost Assistance Program eligible individual means an individual who—(A) is eligible for, and is receiving, medical assistance for the payment of medicare cost-sharing under a State Medicaid program pursuant to clause (i), (iii), or (iv) of section 1902(a)(10)(E) as of December 31, 2026; or(B)(i) is entitled to hospital insurance benefits under part A (including an individual entitled to such benefits pursuant to an enrollment under section 1818); and(ii) has income at or below 200 percent of the poverty line applicable to a family of the size involved.(2) Joint determination by Commissioner of Social Security for LIS and Medicare cost assistance.—(A) In general.— The determination of whether an individual is a Medicare Cost Assistance Program eligible individual shall be determined by the Commissioner of Social Security (referred to in this section as the "Commissioner") jointly with the determination of whether an individual is a subsidy eligible individual described in section 1860D–14(a)(3). Such determination shall be made with respect to eligibility for Medicare cost assistance under this section and premium and cost-sharing subsidies under section 1860D–14 upon application of an individual for a determination with respect to eligibility for either such assistance or such subsidies. There are authorized to be appropriated to the Social Security Administration such sums as may be necessary for the determination of eligibility under this paragraph.(B) Effective period.— Determinations under this paragraph with respect to eligibility for each of such assistance or such subsidies shall be effective beginning with the month in which the individual applies for a determination described in subparagraph (A) and shall remain in effect until such time as the Secretary determines the individual is no longer eligible as determined under subparagraph (C)(ii).(C) Redeterminations.— With respect to eligibility determinations under this paragraph—(i) redeterminations shall be made at the same time with respect to eligibility for Medicare cost assistance under this section and cost-sharing subsidies under section 1860D–14, but not more frequently than once every 12 months;(ii) a redetermination shall automatically determine that an individual remains eligible for such assistance or subsidies unless—(I) the Commissioner has information indicating that the individual's circumstances have changed such that the individual is no longer eligible for such assistance or subsidies;(II) the Commissioner sends notice to the individual regarding such information that requests a response either confirming or correcting such information; and(III) the individual either confirms such information or fails to provide documentation indicating that such circumstances have not changed within 60 days of receiving the notice described in subclause (II);(iii) the Commissioner shall establish procedures for appeals of such determinations that are similar to the procedures described in the third sentence of section 1631(c)(1)(A); and(iv) judicial review of the final decision of the Commissioner made after a hearing shall be available to the same extent, and with the same limitations, as provided in subsections (g) and (h) of section 205.(D) Treatment of medicaid beneficiaries.— The Secretary shall provide that individuals who are full-benefit dual eligible individuals (as defined in section 1935(c)(6)) or who are recipients of supplemental security income benefits under title XVI shall be treated as a Medicare Cost Assistance Program eligible individual and, in the case of such individual who is a part D eligible individual, a subsidy eligible individual described in section 1860D–14(a)(3).(E) Simplified application form.—(i) In general.— The Secretary shall develop and distribute a simplified application form for use by individuals in applying for Medicare cost assistance under this section and premium and cost-sharing subsidies under section 1860D–14. Such form shall be easily readable based on culturally fluid language for all demographics beyond just the various languages offered. An audio version, digital version, and photo-voice option should also be provided for all learners. The Secretary shall provide for the translation of such application form into at least the 10 languages (other than English) that are most often used by individuals applying for hospital insurance benefits under section 226 or 226A and shall make the translated forms available to the Commissioner of Social Security.(ii) Consultation.— In developing the form under clause (i), the Secretary shall consult with beneficiary groups.(3) Income determinations.— For purposes of applying this section—(A) in the case of an individual who is not treated as a Medicare Cost Assistance Program eligible individual or a subsidy eligible individual under paragraph (2)(D), income shall be determined in the manner described under section 1612 for purposes of the supplemental security income program, except that support and maintenance f

    The bill says: Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by adding at the end the following new section:

    Bill text · Current law (42 U.S.C. 1395)

  204. 42 U.S.C. 1395r(b)addedby H.R. 9877 Sec. 4106(a)

    The bill says: Section 1839(b) of the Social Security Act (42 U.S.C. 1395r(b)) is amended, in the last sentence, by inserting the following before the period: "or, effective beginning January 1, 2027, for individuals who are Medicare Cost Assistance Program eligible individuals (as defined in section 1899D(b)(1)).".

    Bill text · Current law (42 U.S.C. 1395r)

  205. 42 U.S.C. 1395padded (p)by H.R. 9877 Sec. 4106(a)

    (p) Special enrollment period for Medicare Cost Assistance Program eligible individual.—(1) In general.— Effective beginning January 1, 2027, the Secretary shall establish special enrollment periods for Medicare Cost Assistance Program eligible individuals (as defined in section 1899D(b)(1)).(2) Coverage period.— In the case of an individual who enrolls during the special enrollment period provided under paragraph (1), the coverage period under this part shall—(A) begin on the first day of the first month in which the individual applies for a determination under section 1899D(b)(2)(A); and(B) remain in effect until such time as the Secretary determines the individual is no longer eligible as determined under section 1899D(b)(2)(C)(ii).

    The bill says: Section 1837 of the Social Security Act (42 U.S.C. 1395p) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395p)

  206. 42 U.S.C. 1395i-2(g)added (3)by H.R. 9877 Sec. 4106(a)

    (3) Sunset.— This subsection shall not apply on or after January 1, 2027.

    The bill says: Section 1818(g) of the Social Security Act (42 U.S.C. 1395i–2(g)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395i-2)

  207. 42 U.S.C. 1395v(h)added (4)by H.R. 9877 Sec. 4106(a)

    (4) Sunset with respect to qualified medicare beneficiaries.— This subsection shall not apply with respect to qualified medicare beneficiaries on or after January 1, 2027.

    The bill says: Section 1843(h) of the Social Security Act (42 U.S.C. 1395v(h)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395v)

  208. 42 U.S.C. 1320b-14added (d)by H.R. 9877 Sec. 4106(a)

    (d) Public awareness campaign.—(1) In general.— The Commissioner shall conduct a public awareness campaign to educate Medicare beneficiaries on the availability of Medicare cost assistance for low-income individuals under section 1899D.(2) Coordination.— In carrying out the public awareness campaign under paragraph (1), the Commissioner shall coordinate with State health insurance assistance programs described in subsection (a)(1)(A) of section 119 of the Medicare Improvements for Patients and Providers Act of 2008 (42 U.S.C. 1395b–3 note), the Administrator of the Administration for Community Living, and the Administrator of the Centers for Medicare & Medicaid Services.(3) Funding.— There is appropriated to the Commissioner, out of any funds in the Treasury not otherwise appropriated, $10,000,000 for each of fiscal years 2027 through 2031, to provide grants to State health insurance assistance programs to carry out outreach and education activities under the public awareness campaign pursuant to this subsection.

    The bill says: Section 1144 of the Social Security Act (42 U.S.C. 1320b–14) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1320b-14)

  209. 42 U.S.C. 1396a(a)(10)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by inserting "for calendar quarters beginning before January 1, 2027," before "for making" each place it appears in clauses (i), (iii), and (iv) of subparagraph (E); and

    Bill text · Current law (42 U.S.C. 1396a)

  210. 42 U.S.C. 1396a(a)(10)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by inserting "furnished during calendar quarters beginning before January 1, 2027" after "(described in section 1905(p)(3))";

    Bill text · Current law (42 U.S.C. 1396a)

  211. 42 U.S.C. 1396a(a)(10)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking "(XV)" and inserting ", (XV)";

    Bill text · Current law (42 U.S.C. 1396a)

  212. 42 U.S.C. 1396a(a)(10)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking "and (XVIII)" and inserting "(XVIII)";

    Bill text · Current law (42 U.S.C. 1396a)

  213. 42 U.S.C. 1396a(a)(10)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking "and (XIX)" and inserting "(XIX)"; and

    Bill text · Current law (42 U.S.C. 1396a)

  214. 42 U.S.C. 1396a(a)(10)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by inserting ", and (XX) no medical assistance for medicare cost-sharing, other than medical assistance for medicare cost-sharing for qualified disabled and working individuals described in section 1905(s), shall be made available after January 1, 2027" before the semicolon at the end.

    Bill text · Current law (42 U.S.C. 1396a)

  215. 42 U.S.C. 1396d(a)changedby H.R. 9877 Sec. 4106(b)

    The bill says: Section 1905(a) of such Act (42 U.S.C. 1396d(a)) is amended, in the first sentence, by inserting "furnished during calendar quarters beginning before January 1, 2027" after "medicare cost-sharing".

    Bill text · Current law (42 U.S.C. 1396d)

  216. 42 U.S.C. 1396u-3(g)(2)(Q)changedby H.R. 9877 Sec. 4106(b)

    The bill says: in paragraph (2)(Q), by striking "paragraph (4), for each subsequent year" and inserting "paragraphs (4) and (5), for each subsequent year before 2027"; and

    Bill text · Current law (42 U.S.C. 1396u-3)

  217. 42 U.S.C. 1396u-3(g)added (5)by H.R. 9877 Sec. 4106(b)

    (5) Sunset.— No individual shall be selected to be a qualifying individual for any calendar year or period under this section beginning on or after January 1, 2027, and no State allocation shall be made for any fiscal year or period under this section beginning on or after January 1, 2027.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1396u-3)

  218. 42 U.S.C. 1396u-5(a)(2)(A)changedby H.R. 9877 Sec. 4106(b)

    The bill says: in paragraph (2)(A), by striking "make determinations" and inserting "prior to January 1, 2027, make determinations"; and

    Bill text · Current law (42 U.S.C. 1396u-5)

  219. 42 U.S.C. 1396u-5(a)(3)changedby H.R. 9877 Sec. 4106(b)

    The bill says: in paragraph (3), by inserting "prior to January 1, 2027," before "the State shall".

    Bill text · Current law (42 U.S.C. 1396u-5)

  220. 42 U.S.C. 1320b-14(a)(1)(A)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking "sections 1902(a)(10)(E) and 1933" and inserting "section 1902(a)(10)(E) and (prior to January 1, 2027) section 1933";

    Bill text · Current law (42 U.S.C. 1320b-14)

  221. 42 U.S.C. 1320b-14(a)(1)(A)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking "for the transitional assistance under section 1860D–31(f), or" and inserting a comma; and

    Bill text · Current law (42 U.S.C. 1320b-14)

  222. 42 U.S.C. 1320b-14(a)(1)(A)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by inserting ", or for Medicare premium and cost-sharing assistance under section 1899D (in the case of months beginning on or after January 1, 2027)" before the semicolon; and

    Bill text · Current law (42 U.S.C. 1320b-14)

  223. 42 U.S.C. 1320b-14(a)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking paragraph (2) and inserting the following:

    Bill text · Current law (42 U.S.C. 1320b-14)

  224. 42 U.S.C. 1320b-14(b)(1)(A)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking "sections 1902(a)(10)(E) and 1933" and inserting "section 1902(a)(10)(E) and (prior to January 1, 2027) section 1933";

    Bill text · Current law (42 U.S.C. 1320b-14)

  225. 42 U.S.C. 1320b-14(b)(1)(A)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by striking "for transitional assistance under section 1860D–31(f), or"; and

    Bill text · Current law (42 U.S.C. 1320b-14)

  226. 42 U.S.C. 1320b-14(b)(1)(A)changedby H.R. 9877 Sec. 4106(b)

    The bill says: by inserting ", or for Medicare premium and cost-sharing assistance under section 1899D" before the semicolon; and

    Bill text · Current law (42 U.S.C. 1320b-14)

  227. 42 U.S.C. 1320b-14(c)(1)(B)changedby H.R. 9877 Sec. 4106(b)

    The bill says: in paragraph (1)(B), by inserting ", and (beginning January 1, 2027) provide an application for enrollment under the Medicare Savings Program" before the period;

    Bill text · Current law (42 U.S.C. 1320b-14)

  228. 42 U.S.C. 1320b-14(c)(2)changedby H.R. 9877 Sec. 4106(b)

    The bill says: in paragraph (2), in the paragraph header, by inserting "medicare savings program application and" before "lis application"; and

    Bill text · Current law (42 U.S.C. 1320b-14)

  229. 42 U.S.C. 1320b-14(c)(7)changedby H.R. 9877 Sec. 4106(b)

    (A) prior to January 1, 2027, the program of medical assistance for payment of the cost of medicare cost-sharing under the Medicaid program pursuant to sections 1902(a)(10)(E) and 1933; and(B) beginning January 1, 2027, the program for medical assistance for payment of the cost of medicare cost-sharing for qualified disabled and working individuals described in section 1905(s) pursuant to section 1902(a)(10)(E)(ii) and medicare premium and cost-sharing assistance provided under section 1899D.

    The bill says: in paragraph (7), by striking "means the program of medical assistance" and all that follows through the period and inserting “means—

    Bill text · Current law (42 U.S.C. 1320b-14)

  230. 42 U.S.C. 1395w-114(a)(1)changedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking "150 percent" and inserting "200 percent"; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  231. 42 U.S.C. 1395w-114(a)(1)changedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking "and who meets the resources requirement described in paragraph (3)(D) (or, with respect to a plan year beginning on or after January 1, 2024, paragraph (3)(E)) or who is covered under this paragraph under paragraph (3)(B)(i)";

    Bill text · Current law (42 U.S.C. 1395w-114)

  232. 42 U.S.C. 1395w-114(a)removedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking paragraph (2);

    Bill text · Current law (42 U.S.C. 1395w-114)

  233. 42 U.S.C. 1395w-114(a)(3)(A)(i)changedby H.R. 9877 Sec. 4106(c)

    The bill says: in clause (i), by adding "and" at the end;

    Bill text · Current law (42 U.S.C. 1395w-114)

  234. 42 U.S.C. 1395w-114(a)(3)(A)(ii)changedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking "150 percent" and inserting "200 percent"; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  235. 42 U.S.C. 1395w-114(a)(3)(A)(ii)changedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking "; and" at the end and inserting a period; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  236. 42 U.S.C. 1395w-114(a)(3)(A)removedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking clause (iii);

    Bill text · Current law (42 U.S.C. 1395w-114)

  237. 42 U.S.C. 1395w-114(a)(3)changedby H.R. 9877 Sec. 4106(c)

    (B) Determinations.— For provisions relating to joint determinations with respect to eligibility for Medicare cost assistance under section 1899D and premium and cost-sharing subsidies under this section, see section 1899D(b)(2).(C) Income determinations.— For purposes of applying this section—(i) in the case of an individual who is not treated as a Medicare cost-sharing assistance eligible individual and a subsidy eligible individual under section 1899D(b)(2)(D), income shall be determined in the manner described under section 1612 for purposes of the supplemental security income program, except that support and maintenance furnished in kind shall not be counted as income; and(ii) the term poverty line has the meaning given such term in section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)), including any revision required by such section.

    The bill says: by striking subparagraphs (B) and (C) and inserting the following:

    Bill text · Current law (42 U.S.C. 1395w-114)

  238. 42 U.S.C. 1395w-114(a)(3)removedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking subparagraphs (D), (E), and (G); and

    Bill text · Current law (42 U.S.C. 1395w-114)

  239. 42 U.S.C. 1395w-114(a)(4)(A)changedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking "(A) Copayment for lowest income dual eligible individuals.—";

    Bill text · Current law (42 U.S.C. 1395w-114)

  240. 42 U.S.C. 1395w-114(a)(4)(A)renumberedby H.R. 9877 Sec. 4106(c)

    The bill says: by redesignating clauses (i) and (ii) as subparagraphs (A) and (B), respectively and indenting appropriately; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  241. 42 U.S.C. 1395w-114(a)(4)removedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking subparagraph (B); and

    Bill text · Current law (42 U.S.C. 1395w-114)

  242. 42 U.S.C. 1395w-114(c)(1)changedby H.R. 9877 Sec. 4106(c)

    The bill says: in subsection (c)(1), in the second sentence, by striking "subsections (a)(1)(D) and (a)(2)(E)" and inserting "subsection (a)(1)(D)".

    Bill text · Current law (42 U.S.C. 1395w-114)

  243. 42 U.S.C. 1395w-114(a)(1)(D)(i)changedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking "who would be such an institutionalized individual or couple, if the full-benefit dual eligible individual were not"; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  244. 42 U.S.C. 1395w-114(a)(1)(D)(i)changedby H.R. 9877 Sec. 4106(c)

    The bill says: by striking "or subsection (c) or (d) of section 1915 or under a State plan amendment under subsection (i) of such section" and inserting ", section 1115A, section 1915, or under a State plan amendment".

    Bill text · Current law (42 U.S.C. 1395w-114)

  245. 42 U.S.C. 1396d(p)(2)(A)changedby H.R. 9877 Sec. 4107(a)

    shall be—(i) before January 1, 2027, at least the percent provided under subparagraph (B) (but not more than 100 percent) of the official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2))) applicable to a family of the size involved; and(ii) on or after January 1, 2027, equal to 135 percent of the official poverty line (as so defined and revised) applicable to a family of the size involved.

    The bill says: Section 1905(p)(2)(A) of the Social Security Act (42 U.S.C. 1396d(p)(2)(A)) is amended by striking "shall be at least the percent provided under subparagraph (B) (but not more than 100 percent) of the official poverty line" and all that follows through the period at the end and inserting the following:

    Bill text · Current law (42 U.S.C. 1396d)

  246. 42 U.S.C. 1396d(p)(2)(D)added (iii)by H.R. 9877 Sec. 4107(a)

    (iii) In determining income under this subsection, support and maintenance furnished in kind shall not be counted as income.

    The bill says: Section 1905(p)(2)(D) of the Social Security Act (42 U.S.C. 1396d(p)(2)(D)) is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1396d)

  247. 42 U.S.C. 1396a(a)(10)(E)changedby H.R. 9877 Sec. 4107(b)

    The bill says: by adding "and" at the end of clause (ii);

    Bill text · Current law (42 U.S.C. 1396a)

  248. 42 U.S.C. 1396a(a)(10)(E)(iii)changedby H.R. 9877 Sec. 4107(b)

    The bill says: by striking "and 120 percent in 1995 and years thereafter" and inserting "120 percent in 1995 and years thereafter before 2027, and 200 percent in 2027 and years thereafter"; and

    Bill text · Current law (42 U.S.C. 1396a)

  249. 42 U.S.C. 1396a(a)(10)(E)(iii)changedby H.R. 9877 Sec. 4107(b)

    The bill says: by striking "and" at the end; and

    Bill text · Current law (42 U.S.C. 1396a)

  250. 42 U.S.C. 1396a(a)(10)(E)removedby H.R. 9877 Sec. 4107(b)

    The bill says: by striking clause (iv).

    Bill text · Current law (42 U.S.C. 1396a)

  251. 42 U.S.C. 1396d(p)(1)addedby H.R. 9877 Sec. 4107(b)

    The bill says: Section 1905(p)(1) of the Social Security Act (42 U.S.C. 1396d(p)(1)) is amended by adding at and below subparagraph (C) the following flush sentence:

    Bill text · Current law (42 U.S.C. 1396d)

  252. 42 U.S.C. 1396d(b)changedby H.R. 9877 Sec. 4107(b)

    The bill says: The first sentence of section 1905(b) of such Act (42 U.S.C. 1396d(b)) is amended by striking “and section 1933(d)”.

    Bill text · Current law (42 U.S.C. 1396d)

  253. 42 U.S.C. 1396u-3repealedby H.R. 9877 Sec. 4107(b)

    The bill says: Section 1933 of such Act (42 U.S.C. 1396u–3) is repealed.

    Bill text · Current law (42 U.S.C. 1396u-3)

  254. 42 U.S.C. 1396d(b)changedby H.R. 9877 Sec. 4107(c)

    The bill says: in subsection (b), by striking "and (ii)" and inserting "(ii), and (ll)"; and

    Bill text · Current law (42 U.S.C. 1396d)

  255. 42 U.S.C. 1396dadded (ll)by H.R. 9877 Sec. 4107(c)

    (ll) Increased FMAP for expanded medicare cost-Sharing populations.—(1) In general.— Notwithstanding subsection (b), with respect to expenditures described in paragraph (2) the Federal medical assistance percentage shall be equal to 100 percent.(2) Expenditures described.— The expenditures described in this paragraph are expenditures made on or after January 1, 2027, for medical assistance for medicare cost-sharing provided to any individual under clause (i), (ii), or (iii) of section 1902(a)(10)(E) who would not have been eligible for medicare cost-sharing under any such clause under the income or resource eligibility standards in effect on October 1, 2018.

    The bill says: amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1396d)

  256. 42 U.S.C. 1395w-114(a)(3)removedby H.R. 9877 Sec. 4107(d)

    The bill says: by striking subparagraph (D);

    Bill text · Current law (42 U.S.C. 1395w-114)

  257. 42 U.S.C. 1395w-114(a)(3)renumberedby H.R. 9877 Sec. 4107(d)

    The bill says: by redesignating subparagraphs (E) through (G) as subparagraphs (D) through (F), respectively; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  258. 42 U.S.C. 1395w-114(a)(3)changedby H.R. 9877 Sec. 4107(d)

    The bill says: in the heading of subparagraph (D), as so redesignated, by striking "Alternative resource" and inserting "Resource".

    Bill text · Current law (42 U.S.C. 1395w-114)

  259. 42 U.S.C. 1395w-114(a)(3)changedby H.R. 9877 Sec. 4107(d)

    (F) Resource exclusions.— In determining the resources of an individual (and the eligible spouse of the individual, if any) under section 1613 for purposes of subparagraph (D)—(i) no part of the value of any life insurance policy shall be taken into account;(ii) no part of the value of any vehicle shall be taken into account;(iii) there shall be excluded an amount equal to $1,500 each with respect to any individual or eligible spouse of an individual who attests that some of the resources of such individual or spouse will be used to meet the burial and related expenses of such individual or spouse; and(iv) no balance in, or benefits received under, an employee pension benefit plan (as defined in section 3 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002)) shall be taken into account.(G) Family size.— In determining the size of the family of an individual for purposes of determining the income eligibility of such individual under this section, an individual's family shall consist of—(i) the individual;(ii) the individual's spouse who lives in the same household as the individual (if any); and(iii) any other individuals who—(I) are related to the individual whose income eligibility is in question or such individual's spouse who lives in the same household;(II) are living in the same household as such individual; and(III) are dependent on such individual or such individual's spouse who is living in the same household for at least one-half of their financial support.

    The bill says: Section 1860D–14(a)(3) of the Social Security Act (42 U.S.C. 1395w–114(a)(3)), as amended by paragraph (1), is amended by striking subparagraph (F) and inserting the following new subparagraphs:

    Bill text · Current law (42 U.S.C. 1395w-114)

  260. 42 U.S.C. 1395w-114(a)(1)changedby H.R. 9877 Sec. 4107(d)

    The bill says: in paragraph (1), in the matter preceding subparagraph (A), by inserting "(as determined under paragraph (3)(G))" after "family of the size involved"; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  261. 42 U.S.C. 1395w-114(a)(3)(A)changedby H.R. 9877 Sec. 4107(d)

    The bill says: in subparagraph (A), in the matter preceding clause (i), by striking "subparagraph (F)" and inserting "subparagraph (E)";

    Bill text · Current law (42 U.S.C. 1395w-114)

  262. 42 U.S.C. 1395w-114(a)(3)(A)(ii)changedby H.R. 9877 Sec. 4107(d)

    The bill says: in subparagraph (A)(ii), by inserting "(as determined under subparagraph (G))" after "family of the size involved";

    Bill text · Current law (42 U.S.C. 1395w-114)

  263. 42 U.S.C. 1395w-114(a)(3)(A)(iii)changedby H.R. 9877 Sec. 4107(d)

    The bill says: in subparagraph (A)(iii), by striking "or (E)";

    Bill text · Current law (42 U.S.C. 1395w-114)

  264. 42 U.S.C. 1395w-114(a)(3)(B)(v)changedby H.R. 9877 Sec. 4107(d)

    The bill says: in subparagraph (B)(v), in the matter preceding subclause (I), by striking "subparagraph (F)" and inserting "subparagraph (E)"; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  265. 42 U.S.C. 1395w-114(a)(3)(D)(i)changedby H.R. 9877 Sec. 4107(d)

    The bill says: in subparagraph (D)(i), in the matter preceding subclause (I), by striking "subject to the life insurance policy exclusion provided under subparagraph (G)" and inserting "subject to the resource exclusions provided under subparagraph (F)".

    Bill text · Current law (42 U.S.C. 1395w-114)

  266. 42 U.S.C. 1396d(p)(1)(C)rewrittenby H.R. 9877 Sec. 4107(e)

    (C) whose resources (as determined under section 1613 for purposes of the supplemental security income program subject to the resource exclusions under subparagraph (F) of section 1860D–14(a)(3)) do not exceed—(i) in the case of an individual with a spouse, an amount equal to the sum of the first amount specified in subsection (f)(2)(A)(i) of section 1924 (as adjusted under subsection (g) of such section) and the amount specified in subsection (f)(2)(A)(ii)(II) of such section (as so adjusted); or(ii) in the case of an individual who does not have a spouse, an amount equal to ½ of the amount described in clause (i).

    The bill says: Section 1905(p)(1)(C) of the Social Security Act (42 U.S.C. 1396d(p)(1)(C)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1396d)

  267. 42 U.S.C. 1396d(s)(3)rewrittenby H.R. 9877 Sec. 4107(e)

    (3) whose resources (as determined under section 1613 for purposes of the supplemental security income program subject to the resource exclusions under subparagraph (F) of section 1860D–14(a)(3)) do not exceed—(A) in the case of an individual with a spouse, the amount in effect for the year under clause (i) of subsection (p)(1)(C); and(B) in the case of an individual who does not have a spouse, the amount in effect for the year under clause (ii) of subsection (p)(1)(C); and

    The bill says: Section 1905(s)(3) of the Social Security Act (42 U.S.C. 1396d(s)(3)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1396d)

  268. 42 U.S.C. 1395w-114(a)(3)(D)rewrittenby H.R. 9877 Sec. 4107(e)

    The bill says: Clause (i) of section 1860D–14(a)(3)(D) of the Social Security Act (42 U.S.C. 1395w–114(a)(3)(D)), as redesignated and amended by subsection (d), is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1395w-114)

  269. 42 U.S.C. 1396a(e)(8)changedby H.R. 9877 Sec. 4107(f)

    The bill says: Section 1902(e)(8) of the Social Security Act (42 U.S.C. 1396a(e)(8)) is amended by striking "after the end of the month in which the determination first occurs" and inserting "in or after the third month before the month in which the individual makes application for assistance".

    Bill text · Current law (42 U.S.C. 1396a)

  270. 42 U.S.C. 1396d(a)changedby H.R. 9877 Sec. 4107(f)

    The bill says: Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended, in the matter preceding paragraph (1), by striking "or, in the case of medicare cost-sharing with respect to a qualified medicare beneficiary described in subsection (p)(1), if provided after the month in which the individual becomes such a beneficiary".

    Bill text · Current law (42 U.S.C. 1396d)

  271. 42 U.S.C. 1396a(e)(12)renumberedby H.R. 9877 Sec. 4107(f)

    The bill says: by redesignating subparagraphs (A), (B), and (C) as clauses (i), (ii), and (iii) respectively;

    Bill text · Current law (42 U.S.C. 1396a)

  272. 42 U.S.C. 1396a(e)(12)changedby H.R. 9877 Sec. 4107(f)

    The bill says: by inserting "(A)" after "(12)"; and

    Bill text · Current law (42 U.S.C. 1396a)

  273. 42 U.S.C. 1396a(e)(12)added (B)by H.R. 9877 Sec. 4107(f)

    (B) At the option of the State, the plan may provide that an individual who is determined to be eligible for benefits under a State plan approved under this title under any of the following eligibility categories, or who is redetermined to be eligible for such benefits under any of such categories, shall be considered to meet the eligibility requirements met on the date of application and shall remain eligible for those benefits until the end of the 12-month period following the date of the determination or redetermination of eligibility, except that a State may provide for such determinations more frequently, but not more frequently than once every 6 months for an individual:(i) A specified low-income medicare beneficiary described in subsection (a)(10)(E)(iii) of this section who is determined eligible for medicare cost-sharing described in section 1905(p)(3)(A)(ii).(ii) A qualified disabled and working individual described in section 1905(s) who is determined eligible for medicare cost-sharing described in section 1905(p)(3)(A)(i).

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1396a)

  274. 42 U.S.C. 1396a(e)(13)(A)added (iii)by H.R. 9877 Sec. 4107(f)

    (iii) State option to extend express lane eligibility to other populations.—(I) In general.— At the option of the State, the State may apply the provisions of this paragraph with respect to determining eligibility under this title for an eligible individual (as defined in subclause (II)). In applying this paragraph in the case of a State making such an option, any reference in this paragraph to a child with respect to this title (other than a reference to child health assistance) shall be deemed to be a reference to an eligible individual.(II) Eligible individual defined.— In this clause, the term eligible individual means any of the following:(aa) A qualified medicare beneficiary described in section 1905(p)(1) for purposes of determining eligibility for medicare cost-sharing (as defined in section 1905(p)(3)).(bb) A specified low-income medicare beneficiary described in subsection (a)(10)(E)(iii) of this section for purposes of determining eligibility for medicare cost-sharing described in section 1905(p)(3)(A)(ii).(cc) A qualified disabled and working individual described in section 1905(s) for purposes of determining eligibility for medicare cost-sharing described in section 1905(p)(3)(A)(i).

    The bill says: Section 1902(e)(13)(A) of the Social Security Act (42 U.S.C. 1396a(e)(13)(A)) is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1396a)

  275. 42 U.S.C. 1396a(n)added (4)by H.R. 9877 Sec. 4107(g)

    (4) A State plan shall not deny a claim from a provider or supplier with respect to medicare cost-sharing described in subparagraph (B), (C), or (D) of section 1905(p)(3) for an item or service which is eligible for payment under title XVIII on the basis that the provider or supplier does not have a provider agreement in effect under this title or does not otherwise serve all individuals entitled to medical assistance under this title. The State shall create a mechanism through which providers or suppliers that do not otherwise have provider agreements with the State can bill the State for medicare cost-sharing for qualified medicare beneficiaries.

    The bill says: Section 1902(n) of the Social Security Act (42 U.S.C. 1396a(n)) is amended by inserting after paragraph (3)(C) the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396a)

  276. 42 U.S.C. 1396d(p)added (7)by H.R. 9877 Sec. 4107(h)

    (7) Notwithstanding any other provision of law, any medical assistance for some or all medicare cost-sharing under this title shall not be considered income or resources in determining eligibility for, or the amount of assistance or benefits provided under, any other public benefit provided under Federal law or the law of any State or political subdivision thereof.

    The bill says: Section 1905(p) of the Social Security Act (42 U.S.C. 1396d(p)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396d)

  277. 42 U.S.C. 1395yadded (p)by H.R. 9877 Sec. 4107(i)

    (p) Treatment of Qualified Medicare Beneficiaries (QMBs), Specified Low-Income Medicare Beneficiaries (SLMBs), and Other Dual Eligibles.— Nothing in this title shall be construed as authorizing a provider of services or supplier to discriminate (through a private contractual arrangement or otherwise) against an individual who is otherwise entitled to services under this title on the basis that the individual is a qualified medicare beneficiary (as defined in section 1905(p)(1)), a specified low-income medicare beneficiary, or is otherwise eligible for medical assistance for medicare cost-sharing or other benefits under title XIX.

    The bill says: Section 1862 of the Social Security Act (42 U.S.C. 1395y) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395y)

  278. 42 U.S.C. 1396d(b)changedby H.R. 9877 Sec. 4108(a)

    The bill says: The third sentence of section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is amended by striking "for the 8 fiscal year quarters beginning with the first fiscal year quarter beginning after the date of the enactment of the American Rescue Plan Act of 2021," and inserting "and".

    Bill text · Current law (42 U.S.C. 1396d)

  279. 42 U.S.C. 1396d(b)changedby H.R. 9877 Sec. 4109(a)

    The bill says: The third sentence of section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) is amended by striking ", for such 8 fiscal year quarters".

    Bill text · Current law (42 U.S.C. 1396d)

  280. 42 U.S.C. 1396p(a)rewrittenby H.R. 9877 Sec. 4110(1)

    The bill says: by amending paragraph (1) to read as follows:

    Bill text · Current law (42 U.S.C. 1396p)

  281. 42 U.S.C. 1396p(a)removedby H.R. 9877 Sec. 4110(1)

    The bill says: by striking paragraph (2);

    Bill text · Current law (42 U.S.C. 1396p)

  282. 42 U.S.C. 1396p(a)(3)changedby H.R. 9877 Sec. 4110(1)

    The bill says: in paragraph (3), by striking "(1)(B)" and inserting "(1)"; and

    Bill text · Current law (42 U.S.C. 1396p)

  283. 42 U.S.C. 1396p(a)renumberedby H.R. 9877 Sec. 4110(1)

    The bill says: by redesignating paragraph (3) as paragraph (2); and

    Bill text · Current law (42 U.S.C. 1396p)

  284. 42 U.S.C. 1396prewrittenby H.R. 9877 Sec. 4110(2)

    The bill says: by amending subsection (b) to read as follows:

    Bill text · Current law (42 U.S.C. 1396p)

  285. 42 U.S.C. 1395p(i)added (5)by H.R. 9877 Sec. 4111(a)

    (5)(A) In the case of an individual who— there shall be a special enrollment period described in subparagraph (B).(i) at the time the individual first satisfies paragraph (1) or (2) of section 1836(a), is incarcerated; or(ii) has elected not to enroll (or to be deemed enrolled) under this section during the individual’s initial enrollment period;(B) The special enrollment period referred to in subparagraph (A) is the 6-month period beginning on the first day after which the individual is no longer incarcerated.

    The bill says: Section 1837(i) of the Social Security Act (42 U.S.C. 1395p(i)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395p)

  286. 42 U.S.C. 1395r(a)(1)changedby H.R. 9877 Sec. 4111(b)

    The bill says: in paragraph (1), in the second sentence, by striking "and (7)," and inserting "(7), and (8),"; and

    Bill text · Current law (42 U.S.C. 1395r)

  287. 42 U.S.C. 1395r(a)added (8)by H.R. 9877 Sec. 4111(b)

    (8) In the case of an individual whose coverage period includes months in which by reason of custody under penal authority coverage is excluded pursuant to section 1862(a)(3), the premium amount for such months such individual is in custody under penal authority shall be 0.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395r)

  288. 42 U.S.C. 1395i-2(d)(5)added (D)by H.R. 9877 Sec. 4111(c)

    (D) In the case of an individual who is a person who is excluded from coverage pursuant to section 1862(a)(3) by reason of custody under penal authority, the amount of the monthly premium for such individual shall be 0 for any month in which such individual is in custody under penal authority.

    The bill says: Section 1818(d)(5) of the Social Security Act (42 U.S.C. 1395i–2(d)(5)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1395i-2)

  289. 42 U.S.C. 1396a(l)(2)(A)(i)changedby H.R. 9877 Sec. 4113(1)

    The bill says: in clause (i), by striking "and not more than 185 percent";

    Bill text · Current law (42 U.S.C. 1396a)

  290. 42 U.S.C. 1396a(l)(2)(A)(ii)(I)changedby H.R. 9877 Sec. 4113(2)

    The bill says: in subclause (I), by striking "and" after the comma;

    Bill text · Current law (42 U.S.C. 1396a)

  291. 42 U.S.C. 1396a(l)(2)(A)(ii)(II)changedby H.R. 9877 Sec. 4113(2)

    The bill says: in subclause (II), by striking the period at the end and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1396a)

  292. 42 U.S.C. 1396a(l)(2)(A)(ii)added (III)by H.R. 9877 Sec. 4113(2)

    (III) January 1, 2027, is the percentage provided under clause (v).

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1396a)

  293. 42 U.S.C. 1396a(l)(2)(A)added (v)by H.R. 9877 Sec. 4113(3)

    (v) The percentage provided under clause (ii) for medical assistance provided on or after January 1, 2027, with respect to individuals described in subparagraph (A) or (B) of paragraph (1) shall not be less than—(I) the percentage specified for such individuals by the State in an amendment to its State plan (whether approved or not) as of January 1, 2014; or(II) if no such percentage is specified as of January 1, 2014, the percentage established for such individuals under the State’s authorizing legislation or provided for under the State’s appropriations as of that date.

    The bill says: by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1396a)

  294. 42 U.S.C. 1395m(l)(8)(B)changedby H.R. 9877 Sec. 4203(a)

    The bill says: by striking "owned and"; and

    Bill text · Current law (42 U.S.C. 1395m)

  295. 42 U.S.C. 1395m(l)(8)(B)changedby H.R. 9877 Sec. 4203(a)

    The bill says: by inserting "(including when such services are provided by the entity under an arrangement with the hospital)" after "hospital"; and

    Bill text · Current law (42 U.S.C. 1395m)

  296. 42 U.S.C. 1395m(l)(8)changedby H.R. 9877 Sec. 4203(a)

    The bill says: by striking the comma at the end of subparagraph (B) and all that follows and inserting a period.

    Bill text · Current law (42 U.S.C. 1395m)

  297. 42 U.S.C. 1395i-4(c)(2)(B)(iii)changedby H.R. 9877 Sec. 4203(b)

    The bill says: in subparagraph (B)(iii), by striking "provides not more than" and inserting "subject to subparagraph (F), provides not more than"; and

    Bill text · Current law (42 U.S.C. 1395i-4)

  298. 42 U.S.C. 1395i-4(c)(2)added (F)by H.R. 9877 Sec. 4203(b)

    (F) Alternative to 25 inpatient bed limit requirement.—(i) In general.— A State may elect to treat a facility, with respect to the designation of the facility for a cost reporting period, as satisfying the requirement of subparagraph (B)(iii) relating to a maximum number of acute care inpatient beds if the facility elects, in accordance with a method specified by the Secretary and before the beginning of the cost reporting period, to meet the requirement under clause (ii).(ii) Alternate requirement.— The requirement under this clause, with respect to a facility and a cost reporting period, is that the total number of inpatient bed days described in subparagraph (B)(iii) during such period will not exceed 7,300. For purposes of this subparagraph, an individual who is an inpatient in a bed in the facility for a single day shall be counted as one inpatient bed day.(iii) Withdrawal of election.— The option described in clause (i) shall not apply to a facility for a cost reporting period if the facility (for any two consecutive cost reporting periods during the previous 5 cost-reporting periods) was treated under such option and had a total number of inpatient bed days for each of such two cost reporting periods that exceeded the number specified in such clause.

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395i-4)

  299. 42 U.S.C. 254b(r)(4)(A)changedby H.R. 9877 Sec. 4205(1)

    The bill says: in subparagraph (A), by striking "primary health care services" each place it appears and inserting "primary health care and other mental, dental, and physical health services"; and

    Bill text · Current law (42 U.S.C. 254b)

  300. 42 U.S.C. 254b(r)(4)(B)(i)changedby H.R. 9877 Sec. 4205(2)

    The bill says: in clause (i), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 254b)

  301. 42 U.S.C. 254b(r)(4)(B)(ii)changedby H.R. 9877 Sec. 4205(2)

    The bill says: in clause (ii), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 254b)

  302. 42 U.S.C. 254b(r)(4)(B)added (iii)by H.R. 9877 Sec. 4205(2)

    (iii) in the case of a rural health clinic described in such subparagraph—(I) that such clinic provides, to the extent possible, enabling services, such as transportation and language assistance (including translation and interpretation); and(II) that the primary health care and other services described in such subparagraph are subject to full reimbursement according to the prospective payment system for Federally qualified health center services under section 1834(o) of the Social Security Act.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 254b)

  303. 2 U.S.C. 602added (h)by H.R. 9877 Sec. 4207

    (h) Scoring of preventive health savings.—(1) Determination by the Director.— Upon a request by the chairman or ranking minority member of the Committee on the Budget of the Senate, or by the chairman or ranking minority member of the Committee on the Budget of the House of Representatives, the Director shall determine if a proposed measure would result in reductions in budget outlays in budgetary outyears through the use of preventive health and preventive health services.(2) Projections.— If the Director determines that a measure would result in substantial reductions in budget outlays as described in paragraph (1), the Director—(A) shall include, in any projection prepared by the Director, a description and estimate of the reductions in budget outlays in the budgetary outyears and a description of the basis for such conclusions; and(B) may prepare a budget projection that includes some or all of the budgetary outyears, notwithstanding the time periods for projections described in subsection (e) and sections 308, 402, and 424.(3) Definitions.— As used in this subsection—(A) the term budgetary outyears means the 2 consecutive 10-fiscal-year periods beginning with the first fiscal year that is 10 years after the budget year provided for in the most recently agreed to concurrent resolution on the budget; and(B) the term preventive health means an action that focuses on the health of the public, individuals, and defined populations in order to protect, promote, and maintain health, wellness, and functional ability, and prevent disease, disability, and premature death that is demonstrated by credible and publicly available epidemiological projection models, incorporating clinical trials or observational studies in humans, to avoid future health care costs.

    The bill says: Section 202 of the Congressional Budget and Impoundment Control Act of 1974 (2 U.S.C. 602) is amended by adding at the end the following:

    Bill text · Current law (2 U.S.C. 602)

  304. 38 U.S.C. 7308added 7308Aby H.R. 9877 Sec. 4210(a)

    7308A. Office of Minority Health.—(a) Establishment.— There is established in the Department within the Office of the Under Secretary for Health an office to be known as the "Office of Minority Health" (in this section referred to as the Office).(b) Head.—(1) In general.— The Director of the Office of Minority Health shall be the head of the Office.(2) Appointment.— The Director of the Office of Minority Health shall be appointed by the Under Secretary for Health from among individuals qualified to perform the duties of the position.(c) Functions.— The functions of the Office are as follows:(1) To establish short-range and long-range goals and objectives and coordinate all other activities within the Veterans Health Administration that relate to disease prevention, health promotion, health care services delivery, health and health care education, health care quality, and health care research concerning veterans who are members of a racial or ethnic minority group.(2) To support research, demonstrations, and evaluations to test new and innovative models for the discharge of activities described in paragraph (1).(3) To increase knowledge and understanding of health risk factors for veterans who are members of a racial or ethnic minority group.(4) To develop mechanisms that support better health care information dissemination, education, prevention, and services delivery to veterans from disadvantaged backgrounds, including veterans who are members of a racial or ethnic minority group.(5) To enter into contracts or agreements with appropriate public and nonprofit private entities to develop and carry out programs to provide bilingual or interpretive services to assist veterans who are members of a racial or ethnic minority group and who lack proficiency in speaking the English language in accessing and receiving health care services through the Veterans Health Administration.(6) To carry out programs to improve access to health care services through the Veterans Health Administration for veterans with limited proficiency in speaking the English language, including the development and evaluation of demonstration and pilot projects for that purpose.(7) To advise the Under Secretary for Health on matters relating to the development, implementation, and evaluation of health professions education in decreasing disparities in health care outcomes between veterans who are members of a racial or ethnic minority group and other veterans, including cultural competency as a method of eliminating such health disparities.(8) To perform such other functions and duties as the Secretary or the Under Secretary for Health considers appropriate.(d) Definitions.— In this section:(1) The term racial or ethnic minority group means any of the following:(A) American Indians (including Alaska Natives, Eskimos, and Aleuts).(B) Asian Americans.(C) Native Hawaiians and Pacific Islanders.(D) Blacks.(E) Hispanics.(2) The term Hispanic means individuals whose origin is from Mexico, Puerto Rico, Cuba, Central or South America, or any other Spanish-speaking country.

    The bill says: Subchapter I of chapter 73 of title 38, United States Code, is amended by inserting after section 7308 the following new section:

    Bill text · Current law (38 U.S.C. 7308)

  305. 42 U.S.C. 11705(h)(1)changedby H.R. 9877 Sec. 4212(a)

    The bill says: Section 6(h)(1) of the Native Hawaiian Health Care Improvement Act (42 U.S.C. 11705(h)(1)) is amended by striking "may be necessary for fiscal years 1993 through 2019" and inserting "are necessary".

    Bill text · Current law (42 U.S.C. 11705)

  306. 42 U.S.C. 11706(b)changedby H.R. 9877 Sec. 4212(b)

    The bill says: Section 7(b) of the Native Hawaiian Health Care Improvement Act (42 U.S.C. 11706(b)) is amended by striking "may be necessary for fiscal years 1993 through 2019" and inserting "are necessary".

    Bill text · Current law (42 U.S.C. 11706)

  307. 42 U.S.C. 11709(c)changedby H.R. 9877 Sec. 4212(c)

    The bill says: Section 10(c) of the Native Hawaiian Health Care Improvement Act (42 U.S.C. 11709(c)) is amended by striking "may be necessary for fiscal years 1993 through 2019" and inserting "are necessary".

    Bill text · Current law (42 U.S.C. 11709)

  308. 42 U.S.C. 1395xadded (ppp)by H.R. 9877 Sec. 4221(a)

    (ppp) Rural Community Hospital; Rural Community Hospital Services.—(1) The term rural community hospital means a hospital (as defined in subsection (e)) that—(A) is located in a rural area (as defined in section 1886(d)(2)(D)) or treated as being so located pursuant to section 1886(d)(8)(E);(B) subject to paragraph (2), has less than 51 acute care inpatient beds, as reported in its most recent cost report;(C) makes available 24-hour emergency care services;(D) subject to paragraph (3), has a provider agreement in effect with the Secretary and is open to the public as of January 1, 2010; and(E) applies to the Secretary for such designation.(2) For purposes of paragraph (1)(B), beds in a psychiatric or rehabilitation unit of the hospital which is a distinct part of the hospital shall not be counted.(3) Paragraph (1)(D) shall not be construed to prohibit any of the following from qualifying as a rural community hospital:(A) A replacement facility (as defined by the Secretary in regulations in effect on January 1, 2012) with the same service area (as defined by the Secretary in regulations in effect on such date).(B) A facility obtaining a new provider number pursuant to a change of ownership.(C) A facility which has a binding written agreement with an outside, unrelated party for the construction, reconstruction, lease, rental, or financing of a building as of January 1, 2012.(4) Nothing in this subsection shall be construed as prohibiting a critical access hospital from qualifying as a rural community hospital if the critical access hospital meets the conditions otherwise applicable to hospitals under subsection (e) and section 1866.(5) Nothing in this subsection shall be construed as prohibiting a rural community hospital participating in the demonstration program under section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (42 U.S.C. 1395ww note; Public Law 108–173) from qualifying as a rural community hospital if the rural community hospital meets the conditions otherwise applicable to hospitals under subsection (e) and section 1866.

    The bill says: Section 1861 of the Social Security Act (42 U.S.C. 1395x), as amended by section 2007(b)(1), is amended by adding at the end of the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  309. 42 U.S.C. 1395fadded (m)by H.R. 9877 Sec. 4221(b)

    (m) Payment for Inpatient Services Furnished in Rural Community Hospitals.— The amount of payment under this part for inpatient hospital services furnished in a rural community hospital, other than such services furnished in a psychiatric or rehabilitation unit of the hospital which is a distinct part, is, at the election of the hospital in the application referred to in section 1861(ppp)(1)(E)—(1) 101 percent of the reasonable costs of providing such services, without regard to the amount of the customary or other charge, or(2) the amount of payment provided for under the prospective payment system for inpatient hospital services under section 1886(d).

    The bill says: Section 1814 of the Social Security Act (42 U.S.C. 1395f) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395f)

  310. 42 U.S.C. 1395madded (bb)by H.R. 9877 Sec. 4221(b)

    (bb) Payment for outpatient services furnished in rural community hospitals.— The amount of payment under this part for outpatient services furnished in a rural community hospital is, at the election of the hospital in the application referred to in section 1861(ppp)(1)(E)—(1) 101 percent of the reasonable costs of providing such services, without regard to the amount of the customary or other charge and any limitation under section 1861(v)(1)(U), or(2) the amount of payment provided for under the prospective payment system for covered OPD services under section 1833(t).

    The bill says: Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395m)

  311. 42 U.S.C. 1395x(v)(1)(T)changedby H.R. 9877 Sec. 4221(b)

    The bill says: Section 1861(v)(1)(T) of the Social Security Act (42 U.S.C. 1395x(v)(1)(T)) is amended in the matter preceding clause (i) by inserting "(other than for a rural community hospital)" after "In determining such reasonable costs for hospitals".

    Bill text · Current law (42 U.S.C. 1395x)

  312. 42 U.S.C. 1395f(b)changedby H.R. 9877 Sec. 4221(d)

    The bill says: Section 1814(b) of the Social Security Act (42 U.S.C. 1395f(b)) is amended in the matter preceding paragraph (1) by inserting "other than inpatient hospital services furnished by a rural community hospital," after "critical access hospital services,".

    Bill text · Current law (42 U.S.C. 1395f)

  313. 42 U.S.C. 1395l(a)changedby H.R. 9877 Sec. 4221(d)

    The bill says: by striking "and" at the end of paragraph (10);

    Bill text · Current law (42 U.S.C. 1395l)

  314. 42 U.S.C. 1395l(a)changedby H.R. 9877 Sec. 4221(d)

    The bill says: by striking the period at the end of paragraph (11) and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1395l)

  315. 42 U.S.C. 1395l(a)added (12)by H.R. 9877 Sec. 4221(d)

    (12) in the case of outpatient services furnished by a rural community hospital, the amounts described in section 1834(bb).

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1395l)

  316. 42 U.S.C. 1395zchangedby H.R. 9877 Sec. 4221(d)

    The bill says: Section 1863 of the Social Security Act (42 U.S.C. 1395z) is amended by striking "and (dd)(2)" and inserting "(dd)(2), and (ppp)(1)".

    Bill text · Current law (42 U.S.C. 1395z)

  317. 42 U.S.C. 1395cc(a)(2)(A)changedby H.R. 9877 Sec. 4221(d)

    The bill says: Section 1866(a)(2)(A) of the Social Security Act (42 U.S.C. 1395cc(a)(2)(A)) is amended by inserting "section 1834(bb)(2)," after "section 1833(b),".

    Bill text · Current law (42 U.S.C. 1395cc)

  318. 42 U.S.C. 254crewrittenby H.R. 9877 Sec. 4223

    330A. Rural health care services outreach, rural health network development, Delta rural disparities and health systems development, and small rural health care provider quality improvement grant programs.—(a) Purpose.— The purpose of this section is to provide for grants—(1) under subsection (b), to promote rural health care services outreach;(2) under subsection (c), to provide for the planning and implementation of integrated health care networks in rural areas;(3) under subsection (d), to assist rural communities in the Delta Region to reduce health disparities and to promote and enhance health system development; and(4) under subsection (e), to provide for the planning and implementation of small rural health care provider quality improvement activities.(b) Rural health care services outreach grants.—(1) Grants.— The Director of the Office of Rural Health Policy of the Health Resources and Services Administration (referred to in this section as the "Director") may award grants to eligible entities to promote rural health care services outreach by expanding the delivery of health care services to include new and enhanced services in rural areas. The Director may award the grants for periods of not more than 3 years.(2) Eligibility.— To be eligible to receive a grant under this subsection for a project, an entity—(A) shall be a rural public or rural nonprofit private entity, a facility that qualifies as a rural health clinic under title XVIII of the Social Security Act, a public or nonprofit entity existing exclusively to provide services to migrant and seasonal farm workers in rural areas, or a Tribal government whose grant-funded activities will be conducted within federally recognized Tribal areas;(B) shall represent a consortium composed of members—(i) that include 3 or more independently owned health care entities; and(ii) that may be nonprofit or for-profit entities; and(C) shall not previously have received a grant under this subsection for the same or a similar project, unless the entity is proposing to expand the scope of the project or the area that will be served through the project.(3) Applications.— To be eligible to receive a grant under this subsection, an eligible entity shall prepare and submit to the Director an application at such time, in such manner, and containing such information as the Director may require, including—(A) a description of the project that the eligible entity will carry out using the funds provided under the grant;(B) a description of the manner in which the project funded under the grant will meet the health care needs of rural populations in the local community or region to be served;(C) a plan for quantifying how health care needs will be met through identification of the target population and benchmarks of service delivery or health status, such as—(i) quantifiable measurements of health and health care status improvement for projects focusing on health promotion; or(ii) benchmarks of increased access to primary and end-of-life care, including tracking factors such as the number and type of primary and end-of-life care visits, identification of a medical home, or other general measures of such access;(D) a description of how the local community or region to be served will be involved in the development and ongoing operations of the project;(E) a plan for sustaining the project after Federal support for the project has ended;(F) a description of how the project will be evaluated;(G) the administrative capacity to submit annual performance data electronically as specified by the Director; and(H) other such information as the Director determines to be appropriate.(c) Rural health network development grants.—(1) Grants.—(A) In general.— The Director may award rural health network development grants to eligible entities to promote, through planning and implementation, the development of integrated health care networks that have combined the functions of the entities participating in the networks in order to—(i) achieve efficiencies and economies of scale;(ii) expand access to, coordinate, and improve the quality of the health care delivery system through development of organizational efficiencies;(iii) implement health information technology to achieve efficiencies, reduce medical errors, and improve quality;(iv) coordinate care and manage chronic and terminal illness; and(v) strengthen the rural health care system as a whole and across all facets of the health care delivery system, including end-of-life care, in such a manner as to show a quantifiable return on investment to the participants in the network.(B) Grant periods.— The Director may award such a rural health network development grant—(i) for a period of 3 years for implementation activities; or(ii) for a period of 1 year for planning activities to assist in the initial development of an integrated health care network, if the proposed participants in the network do not have a history of collaborative efforts and a 3-year grant would be inappropriate.(2) Eligibility.— To be eligible to receive a grant under this subsection, an entity—(A) shall be a rural public or rural nonprofit private entity, a facility that qualifies as a rural health clinic under title XVIII of the Social Security Act, a public or nonprofit entity existing exclusively to provide services to migrant and seasonal farm workers in rural areas, or a Tribal government whose grant-funded activities will be conducted within federally recognized Tribal areas;(B) shall represent a network composed of participants—(i) that include 3 or more independently owned health care entities; and(ii) that may be nonprofit or for-profit entities; and(C) shall not previously have received a grant under this subsection (other than a 1-year grant for planning activities) for the same or a similar project.(3) Applications.— To be eligible to receive a grant under this subsection, an eligible entity, in

    The bill says: Section 330A of the Public Health Service Act (42 U.S.C. 254c) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 254c)

  319. 5 U.S.C. 5315changedby H.R. 9877 Sec. 4231(b)

    The bill says: Section 5315 of title 5, United States Code, is amended, in the matter relating to the Assistant Secretaries of Health and Human Services, by striking "(6)" and inserting "(7), one of whom shall be the Assistant Secretary of the Indian Health Service".

    Bill text · Current law (5 U.S.C. 5315)

  320. 5 U.S.C. 5316changedby H.R. 9877 Sec. 4231(c)

    The bill says: Section 5316 of title 5, United States Code, is amended by striking "Director, Indian Health Service, Department of Health and Human Services.".

    Bill text · Current law (5 U.S.C. 5316)

  321. 42 U.S.C. 1396d(a)(9)rewrittenby H.R. 9877 Sec. 4232

    (9) clinic services furnished by or under the direction of a physician, without regard to whether the clinic itself is administered by a physician, including—(A) such services furnished outside the clinic by clinic personnel to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address; and(B) such services furnished outside the clinic by any Indian Health Service facility, a health program or facility operated by a tribe or tribal organization under the Indian Self-Determination Act (Public Law 93–638), or an urban Indian organization receiving funds under title V of the Indian Health Care Improvement Act;

    The bill says: Section 1905(a)(9) of the Social Security Act (42 U.S.C. 1396d(a)(9)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1396d)

  322. 25 U.S.C. 1660dchangedby H.R. 9877 Sec. 4233

    (b) Requirement.— The Secretary and the Secretary of Veterans Affairs shall ensure that the Service, other agencies and offices of the Department, and the Department of Veterans Affairs confer, to the maximum extent practicable, with urban Indian organizations in carrying out—(1) this Act; and(2) other provisions of law relating to Indian health care.

    The bill says: Section 514 of the Indian Health Care Improvement Act (25 U.S.C. 1660d) is amended by striking subsection (b) and inserting the following:

    Bill text · Current law (25 U.S.C. 1660d)

  323. 42 U.S.C. 18031(c)(1)(B)addedby H.R. 9877 Sec. 4241(a)

    The bill says: Section 1311(c)(1)(B) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)(1)(B)) is amended by inserting before the semicolon the following: "and the ability of such provider to provide care in a language other than English either through the provider speaking such language or by the provider having a qualified interpreter for an individual with limited English proficiency (as defined in section 3400 of such Act) who speaks such language available during office hours".

    Bill text · Current law (42 U.S.C. 18031)

  324. 42 U.S.C. 18031(c)(1)(C)changedby H.R. 9877 Sec. 4242(a)

    The bill says: by inserting "(i)" after "(C)"; and

    Bill text · Current law (42 U.S.C. 18031)

  325. 42 U.S.C. 18031(c)(1)(C)added (ii)by H.R. 9877 Sec. 4242(a)

    (ii) not later than January 1, 2027, increase the percentage of essential community providers as described in clause (i) included in its network by 10 percent annually (based on the level in the plan for 2023) until 90 percent of all federally qualified health centers and 75 percent of all other such essential community providers in the contract service area are in-network; and(iii) include at least one essential community provider in each of the essential community provider categories described in section 156.235(a)(2)(ii)(B) of title 45, Code of Federal Regulations (as in effect on the date of enactment of the Health Equity and Accountability Act of 2026), in each county in the service area, where available;

    The bill says: by adding at the end the following new clauses:

    Bill text · Current law (42 U.S.C. 18031)

  326. 42 U.S.C. 18031(e)(3)added (E)by H.R. 9877 Sec. 4242(b)

    (E) Data on essential community providers.— The Secretary shall require qualified health plans to submit annually to the Secretary data on the percentage of essential community providers as described in clause (ii) of subsection (c)(1)(C), by county, that contract with each qualified health plan offered in that county and the percentage of such essential community providers, by category as described in clause (iii) of such subsection, that contract with each qualified health plan offered in that county. Such data shall be made available to the general public.

    The bill says: Section 1311(e)(3) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(e)(3)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 18031)

  327. 42 U.S.C. 1395w-22(d)(1)changedby H.R. 9877 Sec. 4242(c)

    The bill says: by striking "and" at the end of subparagraph (D);

    Bill text · Current law (42 U.S.C. 1395w-22)

  328. 42 U.S.C. 1395w-22(d)(1)changedby H.R. 9877 Sec. 4242(c)

    The bill says: by striking the period at the end of subparagraph (E) and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1395w-22)

  329. 42 U.S.C. 1395w-22(d)(1)added (F)by H.R. 9877 Sec. 4242(c)

    (F) the plan meets the requirements of clauses (ii) and (iii) of section 1311(c)(1)(C) of the Patient Protection and Affordable Care Act (relating to inclusion in networks of essential community providers).

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395w-22)

  330. 42 U.S.C. 1396u-2(b)(5)changedby H.R. 9877 Sec. 4242(c)

    The bill says: by striking ", and" at the end of subparagraph (A) and inserting a semicolon;

    Bill text · Current law (42 U.S.C. 1396u-2)

  331. 42 U.S.C. 1396u-2(b)(5)changedby H.R. 9877 Sec. 4242(c)

    The bill says: by striking the period at the end of subparagraph (B) and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1396u-2)

  332. 42 U.S.C. 1396u-2(b)(5)added (C)by H.R. 9877 Sec. 4242(c)

    (C) meets the requirements of clauses (ii) and (iii) of section 1311(c)(1)(C) of the Patient Protection and Affordable Care Act (relating to inclusion in networks of essential community providers) with respect to services offered in the service area involved.

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1396u-2)

  333. 25 U.S.C. 1616l(d)changedby H.R. 9877 Sec. 4251(b)

    (2) Requirements; exclusion.— Subject to paragraphs (3) and (4), in establishing a national program under paragraph (1), the Secretary—(A) shall not reduce the amounts provided for the Community Health Aide Program described in subsections (a) and (b);(B) shall exclude dental health aide therapist services from services covered under that Program; and(C) shall include urban Indian organizations.

    The bill says: by striking paragraph (2) and inserting the following:

    Bill text · Current law (25 U.S.C. 1616l)

  334. 25 U.S.C. 1616l(d)(3)changedby H.R. 9877 Sec. 4251(b)

    The bill says: in the paragraph heading, by striking "or tribal organization" and inserting ", tribal organization, or urban Indian organization"; and

    Bill text · Current law (25 U.S.C. 1616l)

  335. 25 U.S.C. 1616l(d)(3)changedby H.R. 9877 Sec. 4251(b)

    The bill says: in each of subparagraphs (A) and (B), by striking "or tribal organization" and inserting ", tribal organization, or urban Indian organization"; and

    Bill text · Current law (25 U.S.C. 1616l)

  336. 25 U.S.C. 1616l(e)changedby H.R. 9877 Sec. 4251(b)

    The bill says: in subsection (e), by striking "or a tribal organization" and inserting "a tribal organization, or an urban Indian organization".

    Bill text · Current law (25 U.S.C. 1616l)

  337. 42 U.S.C. 1395x(s)(2)(JJ)changedby H.R. 9877 Sec. 4251(c)

    The bill says: in subparagraph (JJ), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395x)

  338. 42 U.S.C. 1395x(s)(2)(KK)changedby H.R. 9877 Sec. 4251(c)

    The bill says: in subparagraph (KK), by inserting "and" at the end; and

    Bill text · Current law (42 U.S.C. 1395x)

  339. 42 U.S.C. 1395x(s)(2)added (LL)by H.R. 9877 Sec. 4251(c)

    (LL) dental and oral health services (as defined in subsection (qqq));

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  340. 42 U.S.C. 1395xadded (qqq)by H.R. 9877 Sec. 4251(c)

    (qqq) Dental and oral health services.—(1) The term dental and oral health services means services (as defined by the Secretary) that are necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions, including—(A) routine diagnostic and preventive care such as dental cleanings, exams, and x-rays;(B) basic dental services such as fillings and extractions;(C) major dental services such as root canals, crowns, and dentures;(D) emergency dental care; and(E) other necessary services related to dental and oral health (as defined by the Secretary).(2) For purposes of paragraph (1), such term shall include mobile and portable oral health services (as defined by the Secretary) that—(A) are provided for the purpose of overcoming mobility, transportation, and access barriers for individuals; and(B) satisfy the standards and certification requirements established under section 1902(a)(82) for the State in which the services are provided.

    The bill says: Section 1861 of the Social Security Act (42 U.S.C. 1395x), as amended by sections 2007(b) and 4221(a), is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  341. 42 U.S.C. 1395l(a)(1)changedby H.R. 9877 Sec. 4251(c)

    The bill says: by striking "and" before "(HH)"; and

    Bill text · Current law (42 U.S.C. 1395l)

  342. 42 U.S.C. 1395l(a)(1)addedby H.R. 9877 Sec. 4251(c)

    The bill says: by inserting before the semicolon at the end the following: "and (II) with respect to dental and oral health services (as defined in section 1861(qqq)), the amount paid shall be (i) in the case of such services that are preventive, 100 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848, and (ii) in the case of all other such services, 80 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848".

    Bill text · Current law (42 U.S.C. 1395l)

  343. 42 U.S.C. 1395w-4(j)(3)changedby H.R. 9877 Sec. 4251(c)

    The bill says: Section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w–4(j)(3)) is amended by inserting ", (2)(LL)," after "(including administration of the health risk assessment)".

    Bill text · Current law (42 U.S.C. 1395w-4)

  344. 42 U.S.C. 1395x(s)(8)changedby H.R. 9877 Sec. 4251(c)

    The bill says: by striking "(other than dental)" and inserting "(including dentures)"; and

    Bill text · Current law (42 U.S.C. 1395x)

  345. 42 U.S.C. 1395x(s)(8)changedby H.R. 9877 Sec. 4251(c)

    The bill says: by striking "internal body".

    Bill text · Current law (42 U.S.C. 1395x)

  346. 42 U.S.C. 1395y(a)removedby H.R. 9877 Sec. 4251(c)

    The bill says: Section 1862(a) of the Social Security Act (42 U.S.C. 1395y) is amended by striking paragraph (12).

    Bill text · Current law (42 U.S.C. 1395y)

  347. 42 U.S.C. 1396a(a)(10)(A)changedby H.R. 9877 Sec. 4251(d)

    The bill says: Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by inserting "(10)," before "(13)(B),".

    Bill text · Current law (42 U.S.C. 1396a)

  348. 42 U.S.C. 1396a(a)(10)(C)(iv)changedby H.R. 9877 Sec. 4251(d)

    The bill says: Section 1902(a)(10)(C)(iv) of such Act (42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by inserting "(10)," before "(13)(B)".

    Bill text · Current law (42 U.S.C. 1396a)

  349. 42 U.S.C. 1396u-7(b)(5)changedby H.R. 9877 Sec. 4251(d)

    The bill says: Section 1937(b)(5) of the Social Security Act (42 U.S.C. 1396u–7(b)(5)) is amended by striking the period at the end and inserting ", and beginning January 1, 2028, coverage of dental and oral health services (as such term is defined in section 1905(mm)).".

    Bill text · Current law (42 U.S.C. 1396u-7)

  350. 42 U.S.C. 1396a(j)changedby H.R. 9877 Sec. 4251(d)

    (1) in the case of a State other than the 50 States and the District of Columbia, the requirement under subsection (a)(10)(A) to provide the care and services listed in paragraph (10) of section 1905(a) shall be optional; and(2) the Secretary

    The bill says: by striking "this title, the Secretary" and inserting “this title—

    Bill text · Current law (42 U.S.C. 1396a)

  351. 42 U.S.C. 1396a(j)changedby H.R. 9877 Sec. 4251(d)

    The bill says: by striking the second comma after "section 1108(f)".

    Bill text · Current law (42 U.S.C. 1396a)

  352. 42 U.S.C. 1396d(a)(13)(B)changedby H.R. 9877 Sec. 4251(d)

    The bill says: in subparagraph (B), by striking "; and" and inserting a semicolon;

    Bill text · Current law (42 U.S.C. 1396d)

  353. 42 U.S.C. 1396d(a)(13)(C)changedby H.R. 9877 Sec. 4251(d)

    The bill says: in subparagraph (C), by striking the semicolon at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1396d)

  354. 42 U.S.C. 1396d(a)(13)added (D)by H.R. 9877 Sec. 4251(d)

    (D) at State option, such items and services related to dental and oral health services (as defined in subsection (mm)) that are in addition to those identified in such subsection (mm) as the State may specify;

    The bill says: by inserting after subparagraph (C) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1396d)

  355. 42 U.S.C. 1308(f)changedby H.R. 9877 Sec. 4251(d)

    The bill says: in subsection (f), in the matter preceding paragraph (1), by striking "(h), and (j)" and inserting "(h), (j), and (k)"; and

    Bill text · Current law (42 U.S.C. 1308)

  356. 42 U.S.C. 1308added (k)by H.R. 9877 Sec. 4251(d)

    (k) Exclusion from caps of amounts attributable to increased FMAP for coverage of dental and oral health services.— Any additional amount paid to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa for expenditures for medical assistance that is attributable to an increase in the Federal medical assistance percentage applicable to such expenditures under section 1905(nn) shall not be taken into account for purposes of applying payment limits under subsections (f) and (g).

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1308)

  357. 42 U.S.C. 256g-1added 340G–2by H.R. 9877 Sec. 4252

    340G–2. Oral health literacy and awareness.—(a) Campaign.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a public education campaign (referred to in this subsection as the "campaign") across all relevant programs of the Health Resources and Services Administration (including the health center program, oral health workforce programs, maternal and child health programs, the Ryan White HIV/AIDS Program, and rural health programs) to increase oral health literacy and awareness.(b) Strategies.— In carrying out the campaign, the Secretary shall identify oral health literacy and awareness strategies that are evidence based and focused on oral health care education, including education on prevention of oral disease such as early childhood and other caries, periodontal disease, and oral cancer.(c) Focus.— The Secretary shall design the campaign to communicate directly with specific populations, including children, pregnant women, parents, the elderly, individuals with disabilities, and ethnic and racial minority populations, including Indians, Alaska Natives, and Native Hawaiians, in a culturally and linguistically appropriate manner.(d) Outcomes.— In carrying out the campaign, the Secretary shall include a process for measuring outcomes and effectiveness.(e) Report to Congress.— Not later than 3 years after the date of enactment of this section, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on the outcomes and effectiveness of the campaign.(f) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $750,000 for each of fiscal years 2027 through 2031.

    The bill says: The Public Health Service Act is amended by inserting after section 340G–1 of such Act (42 U.S.C. 256g–1) the following:

    Bill text · Current law (42 U.S.C. 256g-1)

  358. 42 U.S.C. 1397cc(c)(6)(A)changedby H.R. 9877 Sec. 4253(a)

    The bill says: in subparagraph (A), by inserting ", subject to subparagraph (D)," after "shall include";

    Bill text · Current law (42 U.S.C. 1397cc)

  359. 42 U.S.C. 1397cc(c)(6)(B)changedby H.R. 9877 Sec. 4253(a)

    The bill says: in subparagraph (B), by striking "A State" and inserting "Subject to subparagraph (D), a State"; and

    Bill text · Current law (42 U.S.C. 1397cc)

  360. 42 U.S.C. 1397cc(c)(6)added (D)by H.R. 9877 Sec. 4253(a)

    (D) No lifetime or annual limits on dental benefits.— A State shall not establish lifetime or annual limits on the dollar value of benefits for dental services provided under the State child health plan to a targeted low-income child, and, in the case that the State elects to provide pregnancy-related assistance pursuant to section 2112, to a targeted low-income pregnant woman (as defined in section 2112(d)), including benefits for such services that are provided through dental coverage that is otherwise equivalent to a benchmark dental package described in subparagraph (C).

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1397cc)

  361. 42 U.S.C. 1397jj(b)(5)changedby H.R. 9877 Sec. 4253(b)

    The bill says: in the paragraph header, by striking "Option" and inserting "Requirement";

    Bill text · Current law (42 U.S.C. 1397jj)

  362. 42 U.S.C. 1397jj(b)(5)(A)changedby H.R. 9877 Sec. 4253(b)

    The bill says: in subparagraph (A), by striking "may waive" and inserting "shall waive"; and

    Bill text · Current law (42 U.S.C. 1397jj)

  363. 42 U.S.C. 1397jj(b)(5)(C)rewrittenby H.R. 9877 Sec. 4253(b)

    The bill says: in subparagraph (C), to read as follows:

    Bill text · Current law (42 U.S.C. 1397jj)

  364. 42 U.S.C. 1315a(a)(1)changedby H.R. 9877 Sec. 4302(b)

    The bill says: The second sentence of section 1115A(a)(1) of the Social Security Act (42 U.S.C. 1315a(a)(1)) is amended by inserting "and improve health equity" after "expenditures".

    Bill text · Current law (42 U.S.C. 1315a)

  365. 42 U.S.C. 1315a(a)changedby H.R. 9877 Sec. 4305(1)

    The bill says: in the last sentence of paragraph (1), by inserting "advance health equity and" before "improve the coordination"; and

    Bill text · Current law (42 U.S.C. 1315a)

  366. 42 U.S.C. 1315a(a)changedby H.R. 9877 Sec. 4305(1)

    The bill says: by inserting "(including the Office of Minority Health of the Centers for Medicare & Medicaid Services, the Office of Rural Health Policy of the Health Resources and Services Administration, and the Office on Women’s Health of the Department of Health and Human Services)" after "relevant Federal agencies"; and

    Bill text · Current law (42 U.S.C. 1315a)

  367. 42 U.S.C. 1315a(a)changedby H.R. 9877 Sec. 4305(1)

    The bill says: by striking "experts with expertise in medicine" and inserting "experts with expertise in medicine, the causes of health disparities and the social determinants of health, and";

    Bill text · Current law (42 U.S.C. 1315a)

  368. 42 U.S.C. 1315a(b)(2)(A)addedby H.R. 9877 Sec. 4305(2)

    The bill says: by inserting the following after the first sentence: "Prior to selecting a model under this paragraph, the Secretary shall consult with the Office of Minority Health of the Centers for Medicare & Medicaid Services, the Office of Rural Health Policy of the Health Resources and Services Administration, and the Office on Women’s Health of the Department of Health and Human Services to ensure that models under consideration address health disparities and social determinants of health as appropriate for populations to be cared for under the model.";

    Bill text · Current law (42 U.S.C. 1315a)

  369. 42 U.S.C. 1315a(b)(2)(A)changedby H.R. 9877 Sec. 4305(2)

    The bill says: by inserting "and, for models for which testing begins on or after January 1, 2027, address health equity as well as improving access to care received by individuals receiving benefits under such title" after "applicable title"; and

    Bill text · Current law (42 U.S.C. 1315a)

  370. 42 U.S.C. 1315a(b)(2)(A)addedby H.R. 9877 Sec. 4305(2)

    The bill says: by adding at the end the following: "The models selected under this subparagraph shall include the social determinants of health payment model described in subsection (h), the testing of which shall begin not later than December 31, 2027."; and

    Bill text · Current law (42 U.S.C. 1315a)

  371. 42 U.S.C. 1315a(b)(2)(C)added (ix)by H.R. 9877 Sec. 4305(2)

    (ix) Whether the model will affect access to care from providers and suppliers caring for high risk patients or operating in underserved areas.(x) Whether the model has the potential to reduce health disparities, including minority and rural health disparities.

    The bill says: in subparagraph (C), by adding at the end the following new clauses:

    Bill text · Current law (42 U.S.C. 1315a)

  372. 42 U.S.C. 1315a(b)(3)(B)(i)changedby H.R. 9877 Sec. 4305(2)

    The bill says: in clause (i), by inserting "or health equity" after "quality of care";

    Bill text · Current law (42 U.S.C. 1315a)

  373. 42 U.S.C. 1315a(b)(3)(B)(ii)changedby H.R. 9877 Sec. 4305(2)

    The bill says: in clause (ii), by inserting "or increasing health inequities" after "quality of care"; and

    Bill text · Current law (42 U.S.C. 1315a)

  374. 42 U.S.C. 1315a(b)(3)(B)(iii)changedby H.R. 9877 Sec. 4305(2)

    The bill says: in clause (iii), by inserting "or health equity" after "quality of care"; and

    Bill text · Current law (42 U.S.C. 1315a)

  375. 42 U.S.C. 1315a(b)(4)(A)(i)changedby H.R. 9877 Sec. 4305(2)

    The bill says: in clause (i), by striking "; and" and inserting a semicolon;

    Bill text · Current law (42 U.S.C. 1315a)

  376. 42 U.S.C. 1315a(b)(4)(A)(ii)changedby H.R. 9877 Sec. 4305(2)

    The bill says: in clause (ii), by striking the period and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1315a)

  377. 42 U.S.C. 1315a(b)(4)(A)added (iii)by H.R. 9877 Sec. 4305(2)

    (iii) for models for which testing begins on or after January 1, 2027, the extent to which the model improves health equity.

    The bill says: by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1315a)

  378. 42 U.S.C. 1315a(c)(1)(A)changedby H.R. 9877 Sec. 4305(3)

    The bill says: in subparagraph (A), by inserting "or, beginning on or after January 1, 2027, increasing health inequities" before the semicolon; and

    Bill text · Current law (42 U.S.C. 1315a)

  379. 42 U.S.C. 1315a(c)(1)(B)changedby H.R. 9877 Sec. 4305(3)

    The bill says: in subparagraph (B), by inserting "or, beginning on or after January 1, 2027, health equity" after "patient care"; and

    Bill text · Current law (42 U.S.C. 1315a)

  380. 42 U.S.C. 1315a(c)(3)changedby H.R. 9877 Sec. 4305(3)

    The bill says: in paragraph (3), by inserting "or increase health disparities experienced by beneficiaries, including low-income, minority, or rural beneficiaries, or that such expansion would improve health equity" before the period;

    Bill text · Current law (42 U.S.C. 1315a)

  381. 42 U.S.C. 1315a(g)added (1)by H.R. 9877 Sec. 4305(4)

    For reports submitted after the date of enactment of the Health Equity and Accountability Act of 2026, each such report shall include information on the following:(1) The interventions that address social determinants of health, health disparities, or health equity in payment models selected by the CMI for testing under this section.(2) Estimated Federal savings achieved through reducing disparities, including rural and minority health disparities, improving health equity, or addressing social determinants of health.(3) The effectiveness of interventions in mitigating negative health outcomes and higher costs associated with social determinants of health within models selected by the Center for Medicare and Medicaid Innovation for testing.(4) Other areas determined appropriate by the Secretary.

    The bill says: in subsection (g), by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1315a)

  382. 42 U.S.C. 1315aadded (h)by H.R. 9877 Sec. 4305(5)

    (h) Social determinants of health payment model.—(1) In general.— The social determinants of health payment model described in this subsection is a payment model that tests each of the payment and service delivery innovations described in paragraph (2) in a region determined appropriate by the Secretary.(2) Payment and service delivery innovations described.— For purposes of paragraph (1), the payment and service delivery innovations described in this clause are the following:(A) Payment and service delivery innovations for behavioral health services, focusing on gathering actionable data to address the higher costs associated with beneficiaries with diagnosed behavioral conditions.(B) Payment and service delivery innovations targeting conditions or comorbidities of individuals entitled or enrolled under the Medicare program under title XVIII and enrolled under a State plan under the Medicaid program under title XIX to increase capacity in underserved areas.(C) Payment and service delivery innovations targeting conditions or comorbidities of applicable individuals to increase capacity in underserved areas.(D) Payment and service delivery innovations targeted on Medicaid eligible pregnant and postpartum women, up to 1 year after delivery.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1315a)

  383. 42 U.S.C. 1395ww(b)(3)(B)(viii)added (XIII)by H.R. 9877 Sec. 4502(a)

    (XIII)(aa) Effective for payments beginning with fiscal year 2027, in expanding the number of measures under subclause (III), the Secretary shall adopt measures that relate to equitable health care furnished by hospitals in inpatient settings.(bb) In carrying out this subclause, the Secretary shall solicit input and recommendations from individuals and groups representing communities of color and other protected classes and ensure measures adopted pursuant to this subclause account for social determinants of health, as defined in section 4505(e)(10) of the Health Equity and Accountability Act of 2026.(cc) For purposes of this subclause, the term equitable health care refers to the principle that high-quality care should be provided to all individuals and health care treatment and services should not vary on account of the real or perceived race, national origin, sex (including sexual orientation and gender identity), disability, or age of an individual, as well as any other factor that the Secretary determines would be useful for determining a pattern of provision of inequitable health care.

    The bill says: Section 1886(b)(3)(B)(viii) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(B)(viii)) is amended by adding at the end the following new subclause:

    Bill text · Current law (42 U.S.C. 1395ww)

  384. 42 U.S.C. 1395ww(o)(2)(B)added (iv)by H.R. 9877 Sec. 4502(b)

    (iv) Inclusion of equitable health care measures.— Beginning in fiscal year 2027, measures selected under subparagraph (A) shall include the equitable health care measures described in subsection (b)(3)(B)(viii)(XIII).

    The bill says: Section 1886(o)(2)(B) of the Social Security Act (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1395ww)

  385. 42 U.S.C. 1320a-7(b)added (18)by H.R. 9877 Sec. 4503

    (18) Provision of inequitable health care.—(A) In general.— Subject to subparagraph (B), any health care provider that the Secretary determines has engaged in a pattern of providing inequitable health care (as defined in section 4505(e)(7) of the Health Equity and Accountability Act of 2026) on the basis of race, national origin, sex (including sexual orientation and gender identity), disability, or age of an individual.(B) Exception.— For purposes of carrying out subparagraph (A), the Secretary shall not exclude any health care provider from participation in the Medicare program under title XVIII or the Medicaid program under title XIX if the exclusion of such health care provider would result in increased difficulty in access to health care services for underserved or low-income communities.

    The bill says: Section 1128(b) of the Social Security Act (42 U.S.C. 1320a–7(b)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1320a-7)

  386. 42 U.S.C. 1395x(s)(2)(JJ)changedby H.R. 9877 Sec. 4701(a)

    The bill says: in subparagraph (JJ), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395x)

  387. 42 U.S.C. 1395x(s)(2)(KK)changedby H.R. 9877 Sec. 4701(a)

    The bill says: in subparagraph (KK), by inserting "and" after the semicolon; and

    Bill text · Current law (42 U.S.C. 1395x)

  388. 42 U.S.C. 1395x(s)(2)added (LL)by H.R. 9877 Sec. 4701(a)

    (LL) qualified acupuncturist services (as defined in subsection (ppp)(1));

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  389. 42 U.S.C. 1395xadded (ppp)by H.R. 9877 Sec. 4701(a)

    (ppp) Qualified acupuncturist services.—(1) In general.— The term qualified acupuncturist services means such services furnished by a qualified acupuncturist (as defined in paragraph (2)), and such services and supplies furnished as an incident to services furnished by the qualified acupuncturist, as the qualified acupuncturist is legally authorized to perform under State law.(2) Qualified acupuncturist defined.— For purposes of this subsection, the term qualified acupuncturist means— In specifying requirements under subparagraph (A), the Secretary may use the same requirements as those established by a certification authority described in such subparagraph.(A) an individual who is licensed as an acupuncturist by a State or, in the case of an individual in a State that does not provide for such licensure, meets such criteria (such as certification through an appropriate nationally recognized certification authority for acupuncturists) as the Secretary may specify; or(B) a physician who is legally authorized to perform acupuncture as part of the practice of medicine and surgery by the State in which the physician performs such function or action.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  390. 42 U.S.C. 1395w-4(j)(3)changedby H.R. 9877 Sec. 4701(b)

    The bill says: Section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w–4(j)(3)) is amended by inserting "(2)(LL)," before "(3),".

    Bill text · Current law (42 U.S.C. 1395w-4)

  391. 42 U.S.C. 1395l(a)(2)(B)(i)changedby H.R. 9877 Sec. 4701(b)

    The bill says: in clause (i), by inserting "and in the case of qualified acupuncturist services," after "1999,";

    Bill text · Current law (42 U.S.C. 1395l)

  392. 42 U.S.C. 1395l(a)(2)(B)(ii)changedby H.R. 9877 Sec. 4701(b)

    The bill says: in clause (ii), by inserting "or in the case of qualified acupuncturist services," after "1999,"; and

    Bill text · Current law (42 U.S.C. 1395l)

  393. 42 U.S.C. 1395l(a)(2)(B)(iii)changedby H.R. 9877 Sec. 4701(b)

    The bill says: in clause (iii), by inserting "(other than qualified acupuncturist services)" after "such services".

    Bill text · Current law (42 U.S.C. 1395l)

  394. 42 U.S.C. 1395u(b)(18)(C)added (ix)by H.R. 9877 Sec. 4701(b)

    (ix) A qualified acupuncturist (as defined in section 1861(ppp)(2)).

    The bill says: Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1395u)

  395. 42 U.S.C. 1395x(b)(4)changedby H.R. 9877 Sec. 4701(b)

    The bill says: Section 1861(b)(4) of the Social Security Act (42 U.S.C. 1395x(b)(4)) is amended by inserting "qualified acupuncturist services," after "qualified psychologist services,".

    Bill text · Current law (42 U.S.C. 1395x)

  396. 21 U.S.C. 862achangedby H.R. 9877 Sec. 4702(1)

    The bill says: in the section heading, by striking "and benefits";

    Bill text · Current law (21 U.S.C. 862a)

  397. 21 U.S.C. 862a(a)(1)changedby H.R. 9877 Sec. 4702(2)

    The bill says: in paragraph (1), by striking ", or" and all that follows through "that Act" in paragraph (2) and inserting "(42 U.S.C. 601 et seq.)"; and

    Bill text · Current law (21 U.S.C. 862a)

  398. 21 U.S.C. 862a(a)changedby H.R. 9877 Sec. 4702(2)

    The bill says: in the matter preceding paragraph (1), by striking "for—" and all that follows through "assistance" in paragraph (1) and inserting "for assistance";

    Bill text · Current law (21 U.S.C. 862a)

  399. 21 U.S.C. 862a(b)changedby H.R. 9877 Sec. 4702(3)

    The bill says: in the subsection heading, by striking "and benefits";

    Bill text · Current law (21 U.S.C. 862a)

  400. 21 U.S.C. 862a(b)removedby H.R. 9877 Sec. 4702(3)

    The bill says: by striking paragraph (2); and

    Bill text · Current law (21 U.S.C. 862a)

  401. 21 U.S.C. 862a(b)(1)changedby H.R. 9877 Sec. 4702(3)

    The bill says: in paragraph (1), by striking the paragraph designation and heading and all that follows through "The amount" and inserting "The amount";

    Bill text · Current law (21 U.S.C. 862a)

  402. 21 U.S.C. 862a(c)changedby H.R. 9877 Sec. 4702(4)

    The bill says: in subsection (c), by striking "or benefits"; and

    Bill text · Current law (21 U.S.C. 862a)

  403. 21 U.S.C. 862a(e)changedby H.R. 9877 Sec. 4702(5)

    The bill says: in the subsection heading, by striking "Definitions" and inserting "Definition";

    Bill text · Current law (21 U.S.C. 862a)

  404. 21 U.S.C. 862a(e)(1)changedby H.R. 9877 Sec. 4702(5)

    The bill says: in paragraph (1), by striking ", and" and all that follows through "that Act" in paragraph (2) and inserting "(42 U.S.C. 601 et seq.)"; and

    Bill text · Current law (21 U.S.C. 862a)

  405. 21 U.S.C. 862a(e)changedby H.R. 9877 Sec. 4702(5)

    The bill says: in the matter preceding paragraph (1), by striking "it—" and all that follows through "in section 419(5)" and inserting "the term in section 419(5)".

    Bill text · Current law (21 U.S.C. 862a)

  406. 42 U.S.C. 1395w-23(n)(1)(B)changedby H.R. 9877 Sec. 4703(a)

    The bill says: in paragraph (1)(B), by striking "subsequent year" and inserting "subsequent year, subject to paragraph (6),"; and

    Bill text · Current law (42 U.S.C. 1395w-23)

  407. 42 U.S.C. 1395w-23(n)added (6)by H.R. 9877 Sec. 4703(a)

    (6) Average geographic adjustment floor.— For 2027 and subsequent years, when calculating the adjusted average per capita cost under section 1876(a)(4) for the purposes of establishing the base payment amount specified in paragraph (2)(E), the average geographic adjustment shall not be less than 0.70 for any area. For the purposes of the previous sentence, the Secretary may define the term "average geographic adjustment" under subparagraph (A) by program instruction or otherwise.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395w-23)

  408. 42 U.S.C. 1395w-24(a)(6)added (C)by H.R. 9877 Sec. 4703(b)

    (C) Ensuring increased payments support care.— With respect to the increase in blended benchmark amount attributable to the application of section 1853(n)(6), no less than 50 percent shall be directed toward payment for basic benefits as defined in section 1852(a)(1)(B).

    The bill says: Section 1854(a)(6) of the Social Security Act (42 U.S.C. 1395w–24(a)(6)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395w-24)

  409. 42 U.S.C. 1395cc(a)(1)(X)changedby H.R. 9877 Sec. 4704(a)

    The bill says: in subparagraph (X), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395cc)

  410. 42 U.S.C. 1395cc(a)(1)(Y)changedby H.R. 9877 Sec. 4704(a)

    The bill says: in subparagraph (Y), by striking the period at the end and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1395cc)

  411. 42 U.S.C. 1395cc(a)(1)added (Z)by H.R. 9877 Sec. 4704(a)

    (Z) beginning January 1, 2027, in the case of a hospital, critical access hospital, or rural emergency hospital, to comply with the requirements described in subsection (l)(1).

    The bill says: by inserting after subparagraph (Y) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395cc)

  412. 42 U.S.C. 1395ccadded (l)by H.R. 9877 Sec. 4704(a)

    (l) Discharge plan requirements for pregnant individuals.—(1) In general.— For purposes of subsection (a)(1)(Z), the requirements described in this paragraph are, with respect to a hospital, critical access hospital, or rural emergency hospital, that the hospital—(A) provides for the development and implementation of a discharge plan meeting the standards under paragraph (2) with respect to any individual (whether or not eligible for benefits under this title) admitted to the hospital who—(i) is identified as pregnant;(ii) is experiencing signs or symptoms consistent with labor, which may include contractions; and(iii) is expected to be discharged from the hospital, critical access hospital, or rural emergency hospital prior to delivery, as determined based on the documented clinical judgment of the treating physician or practitioner at the time that such discharge is contemplated;(B) includes such discharge plan in the individual’s medical record; and(C) provides for such discharge plan to be discussed with the individual (or the individual’s representative) prior to discharge.(2) Discharge plan standards.— A discharge plan for an individual described in paragraph (1)(A) meets the standards under this paragraph if such plan includes at least the following information:(A) A clinical justification for the discharge.(B) An assessment of travel distance and time between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.(C) Verification of reliable transportation between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.(D) Identification of a back-up hospital or facility at which such individual may obtain labor and delivery services.(E) Confirmation that the plan was reviewed and approved by a qualified medical professional (as defined by the Secretary through regulations).(F) Confirmation that the individual (or the individual’s representative) has received the information described in subparagraphs (A) through (D), that such information was provided in the primary language of such individual (or representative), and that such individual (or representative) confirmed their understanding of such information.(3) Rule of construction.— Nothing in this subsection shall be construed as limiting or otherwise affecting the discharge planning requirements otherwise applicable to a hospital, critical access hospital, or rural emergency hospital under this title.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395cc)

  413. 42 U.S.C. 294s(c)(1)(A)changedby H.R. 9877 Sec. 4704(b)

    The bill says: in subparagraph (A), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 294s)

  414. 42 U.S.C. 294s(c)(1)renumberedby H.R. 9877 Sec. 4704(b)

    The bill says: by redesignating subparagraph (B) as subparagraph (C); and

    Bill text · Current law (42 U.S.C. 294s)

  415. 42 U.S.C. 294s(c)(1)added (B)by H.R. 9877 Sec. 4704(b)

    (B) shall use the grant funds to provide racial bias training as part of such training program; and

    The bill says: by inserting after subparagraph (A) the following:

    Bill text · Current law (42 U.S.C. 294s)

  416. 42 U.S.C. 294srenumberedby H.R. 9877 Sec. 4704(b)

    The bill says: by redesignating subsections (d) and (e) as subsections (e) and (f), respectively;

    Bill text · Current law (42 U.S.C. 294s)

  417. 42 U.S.C. 294sadded (d)by H.R. 9877 Sec. 4704(b)

    (d) Minimum performance milestones.—(1) Establishment.— Beginning with the grants awarded under this section for fiscal year 2027, the Secretary shall establish minimum performance milestones that grant recipients must meet during a fiscal year as a condition of remaining eligible for funding through such a grant for any subsequent fiscal year.(2) Milestones related to percent of staff trained.— The minimum performance milestones referred to in paragraph (1) shall include milestones related to the percent of all staff of the grant recipient that are trained, or that receive refresher training, with support from a grant under this section.

    The bill says: by inserting after subsection (c) the following:

    Bill text · Current law (42 U.S.C. 294s)

  418. 42 U.S.C. 294s(e)changedby H.R. 9877 Sec. 4704(b)

    The bill says: in the subsection heading, by striking "report" and inserting "reports";

    Bill text · Current law (42 U.S.C. 294s)

  419. 42 U.S.C. 294s(e)(1)(B)changedby H.R. 9877 Sec. 4704(b)

    The bill says: in paragraph (1)(B), by striking "the report described in paragraph (2)" and inserting "the reports described in paragraphs (2) and (3)"; and

    Bill text · Current law (42 U.S.C. 294s)

  420. 42 U.S.C. 294s(e)added (3)by H.R. 9877 Sec. 4704(b)

    (3) Subsequent reports.— Not later than January 1, 2027, and annually thereafter, the Secretary shall submit to Congress, and make publicly available, a report that includes—(A) updates to the information described in subparagraphs (A) through (C) of paragraph (2); and(B) additional information regarding the grants under this section, including—(i) a list of the entities receiving such grants;(ii) the number and amount of such grants;(iii) whether training supported by such grants was delivered in-person, virtually, asynchronously, or through some other format; and(iv) descriptions of the geographical coverage of such grants, the number of providers trained under such grants, and patient-level metrics linked to such training (such as changes in clinical outcomes, patient experience, and racial disparities).

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 294s)

  421. 42 U.S.C. 238added 249by H.R. 9877 Sec. 4705(c)

    249 Duties of pharmacies to ensure provision of contraception and medication related to contraception.—(a) In General.— Subject to subsection (c), a pharmacy that receives drugs or devices approved, cleared, or authorized by the Food and Drug Administration in interstate commerce shall maintain compliance with the following:(1) If a customer requests a contraceptive or a medication related to a contraceptive that is in stock, the pharmacy shall ensure that the contraceptive or the medication related to a contraceptive is provided to the customer without delay.(2) If a customer requests a contraceptive or a medication related to a contraceptive that is not in stock and the pharmacy in the normal course of business stocks contraception or the medication related to contraception, the pharmacy shall immediately inform the customer that the contraceptive or the medication related to a contraceptive is not in stock and without delay offer the customer the following options:(A) If the customer prefers to obtain the contraceptive or the medication related to a contraceptive through a referral or transfer, the pharmacy shall—(i) locate a pharmacy of the customer’s choice or the closest pharmacy confirmed to have the contraceptive or the medication related to a contraceptive in stock; and(ii) refer the customer or transfer the prescription to that pharmacy.(B) If the customer prefers for the pharmacy to order the contraceptive or the medication related to a contraceptive, the pharmacy shall obtain the contraceptive or the medication related to a contraceptive under the pharmacy’s standard procedure for expedited ordering of medication and notify the customer when the contraceptive or the medication related to a contraceptive arrives.(3) The pharmacy shall ensure that—(A) it does not operate an environment in which customers are intimidated, threatened, or harassed in the delivery of services relating to a request for contraception or a medication related to contraception;(B) its employees do not interfere with or obstruct the delivery of services relating to a request for contraception or a medication related to contraception;(C) its employees do not intentionally misrepresent or deceive customers about the availability of contraception or a medication related to contraception or its mechanism of action;(D) its employees do not breach medical confidentiality with respect to a request for contraception or a medication related to contraception or threaten to breach such confidentiality; or(E) its employees do not refuse to return a valid, lawful prescription for contraception or a medication related to contraception upon customer request.(b) Contraceptives or medication related to a contraceptive not ordinarily stocked.— Nothing in subsection (a)(2) shall be construed to require any pharmacy to comply with such subsection if the pharmacy does not ordinarily stock contraceptives or medication related to a contraceptive in the normal course of business.(c) Refusals Pursuant to Standard Pharmacy Practice.— This section does not prohibit a pharmacy from refusing to provide a contraceptive or a medication related to a contraceptive to a customer in accordance with any of the following:(1) If it is unlawful to dispense the contraceptive or the medication related to a contraceptive to the customer without a valid, lawful prescription and no such prescription is presented.(2) If the customer is unable to pay for the contraceptive or the medication related to a contraceptive.(3) If the employee of the pharmacy refuses to provide the contraceptive or the medication related to a contraceptive on the basis of a professional clinical judgment.(d) Relation to other laws.—(1) Rule of construction.— Nothing in this section shall be construed to invalidate or limit rights, remedies, procedures, or legal standards under title VII of the Civil Rights Act of 1964.(2) Certain claims.— The Religious Freedom Restoration Act of 1993 shall not provide a claim concerning, or a defense to a claim under, this section, or provide a basis for challenging the application or enforcement of this section.(e) Preemption.— This section does not preempt any provision of State law or any professional obligation made applicable by a State board or other entity responsible for licensing or discipline of pharmacies or pharmacists, to the extent that such State law or professional obligation provides protections for customers that are greater than the protections provided by this section.(f) Enforcement.—(1) Civil penalty.— A pharmacy that violates a requirement of subsection (a) is liable to the United States for a civil penalty in an amount not exceeding $1,000 per day of violation, not to exceed $100,000 for all violations adjudicated in a single proceeding.(2) Private cause of action.— Any person aggrieved as a result of a violation of a requirement of subsection (a) may, in any court of competent jurisdiction, commence a civil action against the pharmacy involved to obtain appropriate relief, including actual and punitive damages, injunctive relief, and a reasonable attorney’s fee and cost.(3) Limitations.— A civil action under paragraph (1) or (2) may not be commenced against a pharmacy after the expiration of the 5-year period beginning on the date on which the pharmacy allegedly engaged in the violation involved.(g) Definitions.— In this section:(1) The term contraception or contraceptive means any drug or device approved, cleared, or authorized by the Food and Drug Administration to prevent pregnancy.(2) The term employee means a person hired, by contract or any other form of an agreement, by a pharmacy.(3) The term medication related to contraception or medication related to a contraceptive means any drug or device approved, cleared, or authorized by the Food and Drug Administration that a medical professional determines necessary to use before or in conjunction with contraception or a contraceptive.

    The bill says: Part B of title II of the Public Health Service Act (42 U.S.C. 238 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 238)

  422. 42 U.S.C. 1396w-4(a)changedby H.R. 9877 Sec. 4706(1)

    The bill says: in subsection (a), by inserting "(and, beginning January 1, 2027, to eligible individuals with sickle cell disease (as defined in subsection (c)(5)))" after "chronic conditions";

    Bill text · Current law (42 U.S.C. 1396w-4)

  423. 42 U.S.C. 1396w-4(c)(1)changedby H.R. 9877 Sec. 4706(2)

    The bill says: in paragraph (1), by inserting "and each eligible individual with sickle cell disease" after "chronic conditions"; and

    Bill text · Current law (42 U.S.C. 1396w-4)

  424. 42 U.S.C. 1396w-4(c)added (5)by H.R. 9877 Sec. 4706(2)

    (5) Special rule relating to sickle cell disease health homes.—(A) In general.— Beginning January 1, 2027, the Secretary may approve a State plan amendment under this section that is designed to provide health home services primarily to eligible individuals with sickle cell disease (in this section referred to as a sickle cell disease-focused State plan amendment).(B) Requirement to provide dental and vision services.— In the case of a sickle cell disease-focused State plan amendment approved by the Secretary on or after January 1, 2027, a State shall ensure the provision of dental and vision services to eligible individuals with sickle cell disease who are enrolled in such health home. Such requirement shall apply irrespective of existing requirements related to comparability or whether or not the State provides dental or vision services to other Medicaid beneficiaries.(C) Report requirements.—(i) In general.— In the case of a State with a sickle cell disease-focused State plan amendment, such State shall, at the end of the first 8 fiscal year quarters that such State plan amendment is in effect, submit to the Secretary a report on the following, with respect to eligible individuals with sickle cell disease provided health home services under such State plan amendment:(I) The quality of health care provided to such individuals, with a focus on outcomes relevant to the recovery of each such individual.(II) The access of such individuals to health care.(III) The total expenditures of such individuals for health care.(ii) Applicable measures.— For purposes of the report required under this subparagraph, the Secretary shall specify all applicable measures for determining quality of health care provided to eligible individuals with sickle cell disease, access to health care by such individuals, and expenditures on health care by such individuals.(D) Best practices.— Not later than June 30, 2027, the Secretary shall make publicly available on the website of the Centers for Medicare & Medicaid Services best practices for designing and implementing a sickle cell disease-focused State plan amendment, based on clinical practice guidelines for sickle cell disease developed by medical specialty societies and in consultation with sickle cell disease providers and patient advocacy organizations.(E) Definitions.— For purposes of this section:(i) Eligible individual with sickle cell disease.— The term eligible individual with sickle cell disease means, with respect to a State, an individual who satisfies all of the following:(I) The individual is eligible for medical assistance under the State plan or under a waiver of such plan.(II) The individual has sickle cell disease.(III) The individual may or may not have previously received health home services under any other State plan amendment approved for the State under this section by the Secretary.(ii) Sickle cell disease.— The term sickle cell disease means an inherited blood disorder affecting red blood cells that occurs when an individual has inherited a sickle cell gene from each parent, as identified by a newborn screening or other genetic test.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396w-4)

  425. 42 U.S.C. 1396w-4(h)(3)changedby H.R. 9877 Sec. 4706(3)

    The bill says: in paragraph (3), by inserting "or an eligible individual with sickle cell disease" after "chronic conditions"; and

    Bill text · Current law (42 U.S.C. 1396w-4)

  426. 42 U.S.C. 1396w-4(h)(5)changedby H.R. 9877 Sec. 4706(3)

    The bill says: in paragraph (5), by inserting "or a health home for eligible individuals with sickle cell disease" after "chronic conditions".

    Bill text · Current law (42 U.S.C. 1396w-4)

  427. 42 U.S.C. 1395ww(d)(9)(D)(iii)rewrittenby H.R. 9877 Sec. 4801

    (iii) Subparagraph (F) (relating to disproportionate share payments), including application of subsection (r), except that for this purpose—(I) the sum described in clause (ii) of this subparagraph shall be substituted for the sum referred to in paragraph (5)(F)(ii)(I); and(II) for discharges occurring on or after October 1, 2026, subclause (I) of paragraph (5)(F)(vi) shall be applied by substituting for the numerator described in such subclause the number of subsection (d) Puerto Rico hospital’s patient days for the cost reporting period involved which were made up of patients who (for such days) were entitled to benefits under part A of this title and were—(aa) entitled to supplementary security income benefits (excluding any State supplementation) under title XVI;(bb) eligible for medical assistance under a State plan under title XIX; or(cc) receiving aid or assistance under any plan of the State approved under title I, X, XIV, or XVI.

    The bill says: Section 1886(d)(9)(D)(iii) of the Social Security Act (42 U.S.C. 1395ww(d)(9)(D)(iii)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1395ww)

  428. 42 U.S.C. 1395ww(b)(3)added (M)by H.R. 9877 Sec. 4802

    (M)(i) For each cost reporting period beginning on or after October 1, 2026, in the case of a hospital located in a territory of the United States, there shall be substituted for the target amount otherwise determined under subparagraph (A) the rebased target amount (as defined in clause (ii)), if such substitution results in an amount of payment under this section to the hospital for such period that is greater than the amount of payment that would be made under this section to the hospital for such period if this subparagraph were not to apply.(ii) For purposes of this subparagraph, the term rebased target amount has the meaning given the term target amount in subparagraph (A), except that—(I) for a cost reporting period beginning on or after October 1, 2026, and before September 30, 2031, there shall be substituted for the preceding 12-month cost reporting period the 12-month cost reporting period beginning during fiscal year 2017;(II) for a cost reporting period beginning on or after October 1, 2031, there shall be substituted for the preceding 12-month cost reporting period the cost reporting period for which the target amount determined under subparagraph (A) is the highest among the 5 cost reporting periods for which the Secretary has the most recent settled cost reports;(III) any reference in subparagraph (A)(i) to the "first such cost reporting period" is deemed a reference to the first cost reporting period following the 12-month cost reporting period beginning during fiscal year 2017; and(IV) the applicable percentage increase shall only be applied under subparagraph (B)(ii) for cost reporting periods beginning on or after October 1, 2026.

    The bill says: Section 1886(b)(3) of the Social Security Act (42 U.S.C. 1395ww(b)(3)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395ww)

  429. 42 U.S.C. 1395r(b)changedby H.R. 9877 Sec. 4811(a)

    The bill says: Section 1839(b) of the Social Security Act (42 U.S.C. 1395r(b)) is amended in the second sentence by inserting "or months occurring in the 5-year period beginning on the date on which the individual becomes entitled to benefits under part A if such individual was residing in Puerto Rico as of such date and such date is after the date that is 4 years before the date of the enactment of the Health Equity and Accountability Act of 2026" before the period at the end of such sentence.

    Bill text · Current law (42 U.S.C. 1395r)

  430. 42 U.S.C. 1395w-23(n)(1)changedby H.R. 9877 Sec. 4821(1)

    The bill says: in paragraph (1), by striking "and (5)" and inserting "(5), and (6)";

    Bill text · Current law (42 U.S.C. 1395w-23)

  431. 42 U.S.C. 1395w-23(n)(4)changedby H.R. 9877 Sec. 4821(2)

    The bill says: in paragraph (4), by striking "In no case" and inserting "Subject to paragraph (6), in no case"; and

    Bill text · Current law (42 U.S.C. 1395w-23)

  432. 42 U.S.C. 1395w-23(n)added (6)by H.R. 9877 Sec. 4821(3)

    (6) Special rules for blended benchmark amount for territories.—(A) In general.— Subject to paragraph (2), the blended benchmark amount for an area in a territory for a year (beginning with 2027) shall not be less than 80 percent of the national average of the base payment amounts specified in subparagraph (2)(E) for such year for areas within the 50 States and the District of Columbia.(B) Limitation.— In no case shall the blended benchmark amount for an area in a territory for a year under subparagraph (A) exceed the lowest blended benchmark amount for any area within the 50 States and the District of Columbia for such year.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395w-23)

  433. 42 U.S.C. 1395w-114(a)(3)(B)(v)(I)changedby H.R. 9877 Sec. 4831(a)

    The bill says: in subclause (I), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395w-114)

  434. 42 U.S.C. 1395w-114(a)(3)(B)(v)(II)changedby H.R. 9877 Sec. 4831(a)

    The bill says: in subclause (II), by striking the period and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1395w-114)

  435. 42 U.S.C. 1395w-114(a)(3)(B)(v)added (III)by H.R. 9877 Sec. 4831(a)

    (III) with respect to plan years beginning on or after January 1, 2027, shall provide that any part D eligible individual who is enrolled for medical assistance under the State Medicaid plan of a territory (as defined in section 1935(f)) under title XIX (or a waiver of such a plan) shall be treated as a subsidy eligible individual described in paragraph (1).

    The bill says: by inserting after subclause (II) the following new subclause:

    Bill text · Current law (42 U.S.C. 1395w-114)

  436. 42 U.S.C. 1395w-114(a)(3)(F)addedby H.R. 9877 Sec. 4831(a)

    The bill says: in subparagraph (F), by adding at the end the following new sentence: "The previous sentence shall not apply with respect to eligibility determinations for premium and cost-sharing subsidies under this section made on or after January 1, 2027.".

    Bill text · Current law (42 U.S.C. 1395w-114)

  437. 42 U.S.C. 1395w-141(j)(2)(D)addedby H.R. 9877 Sec. 4831(a)

    The bill says: Section 1860D–31(j)(2)(D) of the Social Security Act (42 U.S.C. 1395w–141(j)(2)(D)) is amended by adding at the end the following new sentence: "The previous sentence shall not apply with respect to amounts made available to a State under this paragraph on or after January 1, 2026.".

    Bill text · Current law (42 U.S.C. 1395w-141)

  438. 42 U.S.C. 1396u-5(e)(1)(A)addedby H.R. 9877 Sec. 4831(b)

    The bill says: in paragraph (1)(A), by inserting after "such State" the following: "before January 1, 2027"; and

    Bill text · Current law (42 U.S.C. 1396u-5)

  439. 42 U.S.C. 1396u-5(e)(3)(A)addedby H.R. 9877 Sec. 4831(b)

    The bill says: in subparagraph (A), in the matter preceding clause (i), by inserting after "a year" the following: "(before 2027)"; and

    Bill text · Current law (42 U.S.C. 1396u-5)

  440. 42 U.S.C. 1396u-5(e)(3)(B)(iii)changedby H.R. 9877 Sec. 4831(b)

    The bill says: in subparagraph (B)(iii), by striking "a subsequent year" and inserting "each of fiscal years 2010 through 2026".

    Bill text · Current law (42 U.S.C. 1396u-5)

  441. 42 U.S.C. 1396u-5added (f)by H.R. 9877 Sec. 4831(b)

    (f) Territory defined.— In this section, the term territory means Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.

    The bill says: Section 1935 of the Social Security Act (42 U.S.C. 1396u–5) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1396u-5)

  442. 42 U.S.C. 18031added 1314by H.R. 9877 Sec. 4843

    1314 Access to coverage for individuals in certain areas without any available exchange plans.—(a) In general.—(1) Coverage through dc exchange.— Not later than 3 months after the date of enactment of this section, the Secretary, in consultation with the Secretary of the Treasury and the Director of the Office of Personnel Management, shall establish a mechanism to ensure that, for any plan year beginning on or after the date described in subsection (c), any individual described in paragraph (2) has access to health insurance coverage which is at least as broad as the coverage available to Members of Congress and congressional staff (as defined in section 1312(d)(3)(D)) through the Exchange operating in the District of Columbia. Such individuals shall be eligible for any premium tax credit under section 36B of the Internal Revenue Code of 1986, reduced cost sharing under section 1402, and advance determination and payment of such credits or such reductions under section 1412 to be administered by the Secretary, in consultation with the Secretary of the Treasury and the Director of the Office of Personnel Management. The District of Columbia, its residents, and small businesses shall be held harmless from any increased costs resulting from the enactment of this section.(2) Individual described.— An individual described in this paragraph is any individual who—(A) is not eligible to enroll in an employer-sponsored health plan (excluding such a plan that would not be considered minimum essential coverage due to the application of subparagraph (C) of section 36B(c)(2) of the Internal Revenue Code of 1986 if such subparagraph applied to such plan); and(B) is a bona fide resident of any possession of the United States (as determined under section 937(a) of such Code) in which the Secretary certifies that no qualified health plan is offered through an Exchange established under this title.(3) Possession of the united states.— For purposes of this section, the term possession of the United States shall include such possessions as are specified in section 937(a)(1) of the Internal Revenue Code of 1986.(b) Treatment of possessions.—(1) Payments to possessions.—(A) Mirror code possession.— The Secretary of the Treasury shall periodically (but not less frequently than annually) pay to each possession of the United States with a mirror code tax system amounts equal to the loss to that possession by reason of the application of this section (determined without regard to paragraph (2)) with respect to taxable years beginning after the date described in subsection (c). Such amounts shall be determined by the Secretary of the Treasury based on information provided by the government of the respective possession.(B) Other possessions.— The Secretary of the Treasury shall periodically (but not less frequently than annually) pay to each possession of the United States which does not have a mirror code tax system amounts estimated by the Secretary of the Treasury as being equal to the aggregate benefits that would have been provided to residents of such possession by reason of the application of this section for any taxable years beginning after the date described in subsection (c) if a mirror code tax system had been in effect in such possession. The preceding sentence shall not apply with respect to any possession of the United States unless such possession has a plan, which has been approved by the Secretary of the Treasury, under which such possession will promptly distribute such payments to the residents of such possession.(2) Coordination with credit allowed against united states income taxes.— No credit shall be allowed against United States income taxes for any taxable year under section 36B of the Internal Revenue Code of 1986 to any person—(A) to whom a credit is allowed against taxes imposed by the possession by reason of this section (determined without regard to this paragraph) for such taxable year, or(B) who is eligible for a payment under a plan described in paragraph (1)(B) with respect to such taxable year.(3) Mirror code tax system.— For purposes of this subsection, the term mirror code tax system means, with respect to any possession of the United States, the income tax system of such possession if the income tax liability of the residents of such possession under such system is determined by reference to the income tax laws of the United States as if such possession were the United States.(4) Treatment of payments.— For purposes of section 1324(b)(2) of title 31, United States Code, or any similar rule of law, the payments under this subsection shall be treated in the same manner as a refund due from the credit allowed under section 36B of the Internal Revenue Code of 1986.(c) Date described.— The date described in this subsection is the date on which the Secretary establishes the mechanism described in subsection (a)(1).

    The bill says: Part 2 of subtitle D of title I of the Patient Protection and Affordable Care Act (42 U.S.C. 18031 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 18031)

  443. 42 U.S.C. 280hadded 399Z–3by H.R. 9877 Sec. 5001

    399Z–3. Grants to promote health for underserved communities.—(a) Grants Authorized.— The Secretary, in collaboration with the Administrator of the Health Resources and Services Administration and other Federal officials determined appropriate by the Secretary, may award grants to eligible entities—(1) to promote health for medically underserved communities, such as racial and ethnic minority women, racial and ethnic minority children, adolescents, and lesbian, gay, bisexual, transgender, queer, nonbinary, gender-nonconforming, or questioning communities; and(2) to strengthen health outreach initiatives in medically underserved communities, including linguistically isolated populations.(b) Use of Funds.— Grants awarded pursuant to subsection (a) may be used to support the activities of community health workers, including such activities—(1) to provide education and outreach regarding enrollment in health insurance including the State Children’s Health Insurance Program under title XXI of the Social Security Act, Medicare under title XVIII of such Act, and Medicaid under title XIX of such Act;(2) to provide education and outreach in a community setting regarding health problems prevalent among medically underserved communities, and especially among racial and ethnic minority women, racial and ethnic minority children, adolescents, and lesbian, gay, bisexual, transgender, queer, nonbinary, gender-nonconforming, or questioning communities;(3) to provide education and experiential learning opportunities and target risk factors and healthy behaviors that impede or contribute to achieving positive health outcomes, including—(A) healthy nutrition;(B) physical activity;(C) overweight or obesity;(D) tobacco use, including the use of e-cigarettes and vaping;(E) alcohol and substance use;(F) injury and violence;(G) sexual health;(H) mental health;(I) musculoskeletal health and arthritis;(J) prenatal and postnatal care;(K) dental and oral health;(L) understanding informed consent;(M) stigma; and(N) environmental hazards;(4) to promote community wellness and awareness; and(5) to provide education and refer target populations to appropriate health care agencies and community-based programs and organizations in order to increase access to quality health care services, including preventive health services.(c) Application.—(1) In general.— Each eligible entity that desires to receive a grant under subsection (a) shall submit an application to the Secretary at such time, in such manner, and accompanied by such additional information as the Secretary may require.(2) Contents.— Each application submitted pursuant to paragraph (1) shall—(A) describe the activities for which assistance under this section is sought;(B) contain an assurance that, with respect to each community health worker program receiving funds under the grant awarded, such program provides in-language training and supervision to community health workers to enable such workers to provide authorized program activities in (at least) the most commonly used languages within a particular geographic region;(C) contain an assurance that the applicant will evaluate the effectiveness of community health worker programs receiving funds under the grant;(D) contain an assurance that each community health worker program receiving funds under the grant will provide culturally competent services in the linguistic context most appropriate for the individuals served by the program;(E) contain a plan to document and disseminate project descriptions and results to other States and organizations as identified by the Secretary; and(F) describe plans to enhance the capacity of individuals to utilize health services and health-related social services under Federal, State, and local programs by—(i) assisting individuals in establishing eligibility under the programs and in receiving the services or other benefits of the programs; and(ii) providing other services, as the Secretary determines to be appropriate, which may include transportation and translation services.(d) Priority.— In awarding grants under subsection (a), the Secretary shall give priority to those applicants—(1) who propose to target geographic areas that—(A)(i) have a high percentage of residents who are uninsured or underinsured (if the targeted geographic area is located in a State that has elected to make medical assistance available under section 1902(a)(10)(A)(i)(VIII) of the Social Security Act to individuals described in such section);(ii) have a high percentage of underinsured residents in a particular geographic area (if the targeted geographic area is located in a State that has not so elected); or(iii) have a high number of households experiencing extreme poverty; and(B) have a high percentage of families for whom English is not their primary language or including smaller limited English-proficient communities within the region that are not otherwise reached by linguistically appropriate health services;(2) with experience in providing health or health-related social services to individuals who are underserved with respect to such services; and(3) with documented community activity and experience with community health workers.(e) Collaboration with academic institutions.— The Secretary shall encourage community health worker programs receiving funds under this section to collaborate with academic institutions, including minority-serving institutions. Nothing in this section shall be construed to require such collaboration.(f) Quality assurance and cost-Effectiveness.— The Secretary shall establish guidelines for ensuring the quality of the training and supervision of community health workers under the programs funded under this section and for ensuring the cost-effectiveness of such programs.(g) Monitoring.— The Secretary shall monitor community health worker programs identified in approved applications and shall determine whether such progra

    The bill says: Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280h)

  444. 42 U.S.C. 280gadded 399V–8by H.R. 9877 Sec. 5101

    399V–8. Pregnancy intention screening initiative demonstration program.—(a) Program establishment.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish a demonstration program to facilitate the clinical adoption of pregnancy intention screening initiatives by health care and social services providers.(b) Grants.— The Secretary may carry out the demonstration program through awarding grants to eligible entities to implement pregnancy intention screening initiatives, collect data, and evaluate such initiatives.(c) Eligible entities.— To be eligible for a grant under this section, an entity shall—(1) provide non-directive, comprehensive, medically accurate information; and(2) be a community-based organization, voluntary health organization, public health department, community health center, or other interested public or private primary, behavioral, or other health care or social service provider or organization.(d) Pregnancy intention screening initiative.— For purposes of this section, the term pregnancy intention screening initiative means any initiative by an eligible entity to routinely screen people with respect to their pregnancy intentions and goals to either prevent unintended pregnancies or improve the likelihood of healthy pregnancies, in order to better provide health care that meets the contraceptive or pre-pregnancy needs and goals of such people.(e) Evaluation.—(1) In general.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall, by grant or contract, and after consultation as described in paragraph (2), conduct an evaluation of the demonstration program, with respect to pregnancy intention screening initiatives, conducted under this section. Such evaluation shall include:(A) Assessment of the implementation of pregnancy intention screening protocols among a diverse group of patients and providers, including collecting data on the experiences and outcomes for diverse patient populations in a variety of clinical settings.(B) Analysis of outcome measures that will facilitate effective and widespread adoption of such protocols by health care providers for inquiring about and responding to pregnancy goals of people with both contraceptive and pre-pregnancy care.(C) Consideration of health inequities among the population served.(D) Assessment of the equitable and voluntary application of such initiatives to minority and medically underserved communities.(E) Assessment of the training, capacity, and ongoing technical assistance needed for providers to effectively implement such pregnancy intention screening protocols.(F) Assessment of whether referral systems for selected protocols follow evidence-based standards that ensure access to comprehensive health services and appropriate follow-up care.(G) Measuring through rigorous methods the effect of such initiatives on key health outcomes.(2) Consultation with independent, expert advisory panel.— In conducting the evaluation under paragraph (1), the Director of the Centers for Disease Control and Prevention shall consult with physicians, physician assistants, advanced practice registered nurses, nurse midwives, and other health care providers who specialize in women’s health, and other experts in public health, clinical practice, program evaluation, and research.(3) Report.— Not later than one year after the last day of the demonstration program under this section, the Director of the Centers for Disease Control and Prevention shall—(A) submit to Congress a report on the results of the evaluation conducted under paragraph (1); and(B) make the report publicly available.(f) Funding.—(1) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2027 through 2031.(2) Limitation.— Not more than 20 percent of funds appropriated to carry out this section pursuant to paragraph (1) for a fiscal year may be used for purposes of the evaluation under subsection (e).

    The bill says: Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280g)

  445. 42 U.S.C. 1396d(a)(4)changedby H.R. 9877 Sec. 5201(b)

    The bill says: by striking "; and (D)" and inserting "; (D)";

    Bill text · Current law (42 U.S.C. 1396d)

  446. 42 U.S.C. 1396d(a)(4)changedby H.R. 9877 Sec. 5201(b)

    The bill says: by striking "; and (E)" and inserting "; (E)";

    Bill text · Current law (42 U.S.C. 1396d)

  447. 42 U.S.C. 1396d(a)(4)changedby H.R. 9877 Sec. 5201(b)

    The bill says: by striking "; and (F)" and inserting "; (F)"; and

    Bill text · Current law (42 U.S.C. 1396d)

  448. 42 U.S.C. 1396d(a)(4)changedby H.R. 9877 Sec. 5201(b)

    The bill says: by striking the semicolon at the end and inserting "; and (G) oral health services for pregnant and postpartum women (as defined in subsection (nn));"; and

    Bill text · Current law (42 U.S.C. 1396d)

  449. 42 U.S.C. 1396dadded (nn)by H.R. 9877 Sec. 5201(b)

    (nn) Oral health services for pregnant and postpartum women.—(1) In general.— For purposes of this title, the term oral health services for pregnant and postpartum women means dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions that are furnished to a woman during pregnancy (or during the 1-year period beginning on the last day of the pregnancy).(2) Coverage requirements.— To satisfy the requirement to provide oral health services for pregnant and postpartum women, a State shall, at a minimum, provide coverage for preventive, diagnostic, periodontal, and restorative care consistent with recommendations for perinatal oral health care and dental care during pregnancy from the American Academy of Pediatric Dentistry and the American College of Obstetricians and Gynecologists.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1396d)

  450. 42 U.S.C. 1397cc(c)(6)(A)changedby H.R. 9877 Sec. 5201(b)

    The bill says: by inserting "or a targeted low-income pregnant woman" after "targeted low-income child"; and

    Bill text · Current law (42 U.S.C. 1397cc)

  451. 42 U.S.C. 1397cc(c)(6)(A)changedby H.R. 9877 Sec. 5201(b)

    The bill says: by inserting ", and, in the case of a targeted low-income child who is pregnant or a targeted low-income pregnant woman, satisfy the coverage requirements specified in section 1905(nn)" after "emergency conditions"; and

    Bill text · Current law (42 U.S.C. 1397cc)

  452. 42 U.S.C. 1397cc(c)(6)(B)changedby H.R. 9877 Sec. 5201(b)

    The bill says: in subparagraph (B), by inserting "(but only if, in the case of a targeted low-income child who is pregnant or a targeted low-income pregnant woman, the benchmark dental benefit package satisfies the coverage requirements specified in section 1905(nn))" after "subparagraph (C)".

    Bill text · Current law (42 U.S.C. 1397cc)

  453. 42 U.S.C. 1396a(a)(89)changedby H.R. 9877 Sec. 5201(b)

    The bill says: in paragraph (89), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1396a)

  454. 42 U.S.C. 1396a(a)(90)(C)changedby H.R. 9877 Sec. 5201(b)

    The bill says: in paragraph (90)(C), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1396a)

  455. 42 U.S.C. 1396a(a)added (91)by H.R. 9877 Sec. 5201(b)

    (91) provide that the State plan is in compliance with subsection (e)(16).

    The bill says: by inserting after paragraph (90)(C) the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396a)

  456. 42 U.S.C. 1396a(e)(16)(A)changedby H.R. 9877 Sec. 5201(b)

    The bill says: in subparagraph (A), by striking "At the option of the State, the State plan (or waiver of such State plan) may provide" and inserting "A State plan (or waiver of such State plan) shall provide";

    Bill text · Current law (42 U.S.C. 1396a)

  457. 42 U.S.C. 1396a(e)(16)(B)changedby H.R. 9877 Sec. 5201(b)

    The bill says: in subparagraph (B), in the matter preceding clause (i), by striking "by a State making an election under this paragraph" and inserting "under a State plan (or a waiver of such State plan)"; and

    Bill text · Current law (42 U.S.C. 1396a)

  458. 42 U.S.C. 1396a(e)(16)removedby H.R. 9877 Sec. 5201(b)

    The bill says: by striking subparagraph (C).

    Bill text · Current law (42 U.S.C. 1396a)

  459. 42 U.S.C. 1397gg(e)(1)(J)rewrittenby H.R. 9877 Sec. 5201(b)

    The bill says: Section 2107(e)(1)(K) of the Social Security Act (42 U.S.C. 1397gg(e)(1)(J)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1397gg)

  460. 42 U.S.C. 1397ll(d)(2)(A)changedby H.R. 9877 Sec. 5201(b)

    The bill says: Section 2112(d)(2)(A) of the Social Security Act (42 U.S.C. 1397ll(d)(2)(A)) is amended by striking "the month in which the 60-day period" and all that follows through "pursuant to section 2107(e)(1),".

    Bill text · Current law (42 U.S.C. 1397ll)

  461. 42 U.S.C. 1396a(l)added (5)by H.R. 9877 Sec. 5201(b)

    (5) During the period that begins on the date of enactment of this paragraph and ends on the date that is 5 years after such date of enactment, as a condition for receiving any Federal payments under section 1903(a) for calendar quarters occurring during such period, a State shall not have in effect, with respect to women who are eligible for medical assistance under the State plan or under a waiver of such plan on the basis of being pregnant or having been pregnant, eligibility standards, methodologies, or procedures under the State plan or waiver that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan or waiver that are in effect on the date of enactment of this paragraph.

    The bill says: Section 1902(l) of the Social Security Act (42 U.S.C. 1396a(l)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396a)

  462. 42 U.S.C. 1397ee(d)added (4)by H.R. 9877 Sec. 5201(b)

    (4) In eligibility standards for targeted low-income pregnant women.— During the period that begins on the date of enactment of this paragraph and ends on the date that is 5 years after such date of enactment, as a condition of receiving payments under subsection (a) and section 1903(a), a State that elects to provide assistance to women on the basis of being pregnant (including pregnancy-related assistance provided to targeted low-income pregnant women (as defined in section 2112(d)), pregnancy-related assistance provided to women who are eligible for such assistance through application of section 1903(v)(4)(A)(i) under section 2107(e)(1), or any other assistance under the State child health plan (or a waiver of such plan) which is provided to women on the basis of being pregnant) shall not have in effect, with respect to such women, eligibility standards, methodologies, or procedures under such plan (or waiver) that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) that are in effect on the date of enactment of this paragraph.

    The bill says: Section 2105(d) of the Social Security Act (42 U.S.C. 1397ee(d)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397ee)

  463. 42 U.S.C. 1397ee(c)added (13)by H.R. 9877 Sec. 5201(b)

    (13) Enhanced payment for extended assistance provided to pregnant women.— Notwithstanding subsection (b), the enhanced FMAP, with respect to payments under subsection (a) for expenditures under the State child health plan (or a waiver of such plan) for assistance provided under the plan (or waiver) to a woman who is eligible for such assistance on the basis of being pregnant (including pregnancy-related assistance provided to a targeted low-income pregnant woman (as defined in section 2112(d)), pregnancy-related assistance provided to a woman who is eligible for such assistance through application of section 1903(v)(4)(A)(i) under section 2107(e)(1), or any other assistance under the plan (or waiver) provided to a woman who is eligible for such assistance on the basis of being pregnant) during the 305-day period that begins on the 60th day after the last day of her pregnancy (including any such assistance provided during the month in which such period ends), shall be equal to—(A) during the first 20-quarter period for which this subsection is in effect with respect to a State, 100 percent; and(B) with respect to a State, during each quarter thereafter, 90 percent.

    The bill says: Section 2105(c) of the Social Security Act (42 U.S.C. 1397ee(c)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397ee)

  464. 42 U.S.C. 280gadded 399V–9by H.R. 9877 Sec. 5201(b)

    399V–9. Regional centers of excellence addressing implicit bias and cultural competency in patient-provider interactions education.—(a) In general.— Not later than one year after the date of enactment of this section, the Secretary, in consultation with such other agency heads as the Secretary determines appropriate, shall award cooperative agreements for the establishment or support of regional centers of excellence addressing implicit bias, cultural competency, and respectful care practices in patient-provider interactions education for the purpose of enhancing and improving how health care professionals are educated in implicit bias and delivering culturally competent health care.(b) Eligibility.— To be eligible to receive a cooperative agreement under subsection (a), an entity shall—(1) be a public or other nonprofit entity specified by the Secretary that provides educational and training opportunities for students and health care professionals, which may be a health system, teaching hospital, community health center, medical school, school of public health, school of nursing, dental school, social work school, school of professional psychology, or any other health professional school or program at an institution of higher education (as defined in section 101 of the Higher Education Act of 1965) focused on the prevention, treatment, or recovery of health conditions that contribute to maternal mortality and the prevention of maternal mortality and severe maternal morbidity;(2) demonstrate community engagement and participation, such as through partnerships with home visiting and case management programs and community-based organizations serving minority populations;(3) demonstrate engagement with groups engaged in the implementation of health care professional training in implicit bias and delivering culturally competent care, such as departments of public health, perinatal quality collaboratives, hospital systems, and health care professional groups, in order to obtain input on resources needed for effective implementation strategies; and(4) provide to the Secretary such information, at such time and in such manner, as the Secretary may require.(c) Diversity.— In awarding a cooperative agreement under subsection (a), the Secretary shall take into account any regional differences among eligible entities and make an effort to ensure geographic diversity among award recipients.(d) Dissemination of information.—(1) Public availability.— The Secretary shall make publicly available on the internet website of the Department of Health and Human Services information submitted to the Secretary under subsection (b)(4).(2) Evaluation.— The Secretary shall evaluate each regional center of excellence established or supported pursuant to subsection (a) and disseminate the findings resulting from each such evaluation to the appropriate public and private entities.(3) Distribution.— The Secretary shall share evaluations and overall findings with State departments of health and other relevant State level offices to inform State and local best practices.(e) Maternal mortality defined.— In this section, the term maternal mortality means death of a woman that occurs during pregnancy or within the one-year period following the end of such pregnancy.(f) Authorization of appropriations.— For purposes of carrying out this section, there is authorized to be appropriated $5,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) (as amended by section 5101) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280g)

  465. 42 U.S.C. 1786(d)(3)(A)(ii)changedby H.R. 9877 Sec. 5201(b)

    (ii) Women.—(I) Breastfeeding women.— A State

    The bill says: by striking the clause designation and heading and all that follows through "A State" and inserting the following:

    Bill text · Current law (42 U.S.C. 1786)

  466. 42 U.S.C. 1786(d)(3)(A)(ii)(I)changedby H.R. 9877 Sec. 5201(b)

    The bill says: in subclause (I) (as so designated), by striking "1 year" and all that follows through "earlier" and inserting "2 years postpartum"; and

    Bill text · Current law (42 U.S.C. 1786)

  467. 42 U.S.C. 1786(d)(3)(A)(ii)added (II)by H.R. 9877 Sec. 5201(b)

    (II) Postpartum women.— A State may elect to certify a postpartum woman for a period of 2 years.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1786)

  468. 42 U.S.C. 243added 320Cby H.R. 9877 Sec. 5201(d)

    320C. Grants for rural obstetric mobile health units.—(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration (referred to in this section as the "Secretary"), shall establish a pilot program under which the Secretary shall make grants to States—(1) to purchase and equip rural mobile health units for the purpose of providing pre-conception, pregnancy, postpartum, and obstetric emergency services in rural and underserved communities;(2) to train providers including obstetrician-gynecologists, certified nurse-midwives, nurse practitioners, nurses, and midwives to operate and provide obstetric services, including training and planning for obstetric emergencies, in such mobile health units; and(3) to address access issues, including social determinants of health and wrap-around clinical and community services including nutrition, housing, lactation services, and transportation support and referrals.(b) No sharing of data with law enforcement.— As a condition of receiving a grant under this section, a State shall submit to the Secretary an assurance that the State will not make available to Federal or State law enforcement any personally identifiable information regarding any pregnant or postpartum individual collected pursuant to such grant.(c) Grant duration.— The period of a grant under this section shall not exceed 5 years.(d) Implementing and reporting.—(1) In general.— States that receive pilot grants under this section shall—(A) implement the program funded by the pilot grants; and(B) not later than 3 years after the date of enactment of this section, and not later than 6 years after such date of enactment, submit to the Secretary a report that describes the results of such program, including—(i) relevant information and relevant quantitative indicators of the programs’ success in improving the standard of care and maternal health outcomes for individuals in rural and underserved communities seen for pre-conception, pregnancy, or postpartum visits in the rural mobile health units, stratified by the categories of data specified in paragraph (2);(ii) relevant qualitative evaluations from individuals receiving pre-conception, pregnant, or postpartum care from rural mobile health units, including measures of patient-reported experience of care and measures of patient-reported issues with access to care without the rural mobile health unit pilot; and(iii) strategies to sustain such programs beyond the duration of the grant and expand such programs to other rural and underserved communities.(2) Categories of data.— The categories of data specified in this paragraph are the following:(A) Race, ethnicity, sex, gender, gender identity, primary language, age, geography, insurance status, disability status.(B) Number of visits provided for preconception, prenatal, or postpartum care.(C) Number of repeat visits provided for preconception, prenatal, or postpartum care.(D) Number of screenings or tests provided for smoking, substance use, hypertension, sexually-transmitted diseases, diabetes, HIV, depression, intimate partner violence, pap smears, and pregnancy.(3) Data privacy protection.— The reports referred to in paragraph (1)(B) shall not contain any personally identifiable information regarding any pregnant or postpartum individual.(e) Evaluation.— The Secretary shall conduct an evaluation of the pilot program under this section to determine the impact of the pilot program with respect to—(1) the effectiveness of the grants awarded under this section to improve maternal health outcomes in rural and underserved communities, with data stratified by race, ethnicity, primary language, socioeconomic status, geography, insurance type, and other factors as the Secretary determines appropriate;(2) spending on maternity care by States participating in the pilot program;(3) to the extent practicable, qualitative and quantitative measures of patient experience; and(4) any other areas of assessment that the Secretary determines relevant.(f) Report.— Not later than one year after the completion of the pilot program under this section, the Secretary shall submit to Congress, and make publicly available, a report that describes—(1) the results of the evaluation conducted under subsection (e); and(2) a recommendation regarding whether the pilot program should be continued after fiscal year 2031 and expanded on a national basis.(g) Authorization of appropriations.— There is authorized to be appropriated to the Secretary to carry out this section $10,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 243)

  469. 42 U.S.C. 1395cc(a)(1)(X)changedby H.R. 9877 Sec. 5201(e)

    The bill says: in subparagraph (X), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395cc)

  470. 42 U.S.C. 1395cc(a)(1)(Y)(ii)(V)changedby H.R. 9877 Sec. 5201(e)

    The bill says: in subparagraph (Y)(ii)(V), by striking the period and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1395cc)

  471. 42 U.S.C. 1395cc(a)(1)added (Z)by H.R. 9877 Sec. 5201(e)

    (Z) beginning 180 days after the date of the enactment of this subparagraph, in the case of a hospital, not less than 90 days prior to the closure of any obstetric unit of the hospital, to submit to the Secretary a notification which shall include—(i) a report analyzing the impact the closure will have on the community;(ii) steps the hospital will take to identify other health care providers that can alleviate any service gaps as a result of the closure; and(iii) any additional information as may be required by the Secretary.

    The bill says: by inserting after subparagraph (Y) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395cc)

  472. 26 U.S.C. 5701(g)changedby H.R. 9877 Sec. 5201(g)

    The bill says: Section 5701(g) of the Internal Revenue Code of 1986 is amended by striking "$24.78" and inserting "$49.56".

    Bill text · Current law (26 U.S.C. 5701)

  473. 26 U.S.C. 5701(f)changedby H.R. 9877 Sec. 5201(g)

    The bill says: Section 5701(f) of the Internal Revenue Code of 1986 is amended by striking "$2.8311 cents" and inserting "$49.56".

    Bill text · Current law (26 U.S.C. 5701)

  474. 26 U.S.C. 5701(e)(1)changedby H.R. 9877 Sec. 5201(g)

    The bill says: in paragraph (1), by striking "$1.51" and inserting "$26.84";

    Bill text · Current law (26 U.S.C. 5701)

  475. 26 U.S.C. 5701(e)(2)changedby H.R. 9877 Sec. 5201(g)

    The bill says: in paragraph (2), by striking "50.33 cents" and inserting "$10.74"; and

    Bill text · Current law (26 U.S.C. 5701)

  476. 26 U.S.C. 5701(e)added (3)by H.R. 9877 Sec. 5201(g)

    (3) Smokeless tobacco sold in discrete single-use units.— On discrete single-use units, $100.66 per thousand.

    The bill says: by adding at the end the following:

    Bill text · Current law (26 U.S.C. 5701)

  477. 26 U.S.C. 5701(a)changedby H.R. 9877 Sec. 5201(g)

    The bill says: Paragraph (1) of section 5701(a) of the Internal Revenue Code of 1986 is amended by striking "$50.33" and inserting "$100.66".

    Bill text · Current law (26 U.S.C. 5701)

  478. 26 U.S.C. 5701(a)changedby H.R. 9877 Sec. 5201(g)

    The bill says: Paragraph (2) of section 5701(a) of the Internal Revenue Code of 1986 is amended by striking "52.75 percent" and all that follows through the period and inserting the following: "$49.56 per pound and a proportionate tax at the like rate on all fractional parts of a pound but not less than 10.066 cents per cigar.".

    Bill text · Current law (26 U.S.C. 5701)

  479. 26 U.S.C. 5702addedby H.R. 9877 Sec. 5201(g)

    The bill says: Subsection (o) of section 5702 of the Internal Revenue Code of 1986 is amended by adding at the end the following: "Such term includes processed tobacco that is removed for delivery or delivered to a person other than a person with a permit provided under section 5713, but does not include removals of processed tobacco for exportation.".

    Bill text · Current law (26 U.S.C. 5702)

  480. 26 U.S.C. 5701added (i)by H.R. 9877 Sec. 5201(g)

    (i) Other tobacco products.— Any product not otherwise described under this section that has been determined to be a tobacco product by the Food and Drug Administration through its authorities under the Family Smoking Prevention and Tobacco Control Act shall be taxed at a level of tax equivalent to the tax rate for cigarettes on an estimated per use basis as determined by the Secretary.

    The bill says: Section 5701 of the Internal Revenue Code of 1986 is amended by adding at the end the following new subsection:

    Bill text · Current law (26 U.S.C. 5701)

  481. 26 U.S.C. 5702rewrittenby H.R. 9877 Sec. 5201(g)

    (c) Tobacco products.— The term tobacco products means—(1) cigars, cigarettes, smokeless tobacco, pipe tobacco, and roll-your-own tobacco, and(2) any other product subject to tax pursuant to section 5701(i).

    The bill says: Subsection (c) of section 5702 of the Internal Revenue Code of 1986 is amended to read as follows:

    Bill text · Current law (26 U.S.C. 5702)

  482. 42 U.S.C. 1396added 1949by H.R. 9877 Sec. 5202(b)

    1949 Maternity Care Home Demonstration Project.—(a) In general.— Not later than 1 year after the date of the enactment of this section, the Secretary shall establish a demonstration project (in this section referred to as the demonstration project) under which the Secretary shall provide grants to States to enter into arrangements with eligible entities to implement or expand a maternity care home model for eligible individuals.(b) Goals of demonstration project.— The goals of the demonstration project are the following:(1) To improve—(A) maternity and infant care outcomes;(B) birth equity;(C) health equity for—(i) Black, Indigenous, and other people of color;(ii) lesbian, gay, bisexual, transgender, queer, non-binary, and gender nonconforming individuals;(iii) individuals with disabilities; and(iv) other underserved populations;(D) communication by maternity, infant care, oral health services, and social services providers;(E) integration of perinatal support services, including community health workers, doulas, social workers, public health nurses, peer lactation counselors, lactation consultants, childbirth educators, peer mental health workers, and others, into health care entities and organizations;(F) care coordination between maternity, infant care, oral health services, and social services providers within the community;(G) the quality and safety of maternity and infant care;(H) the experience of individuals receiving maternity care, including by increasing the ability of an individual to develop and follow their own birthing plans; and(I) access to adequate prenatal and postpartum care, including—(i) prenatal care that is initiated in a timely manner;(ii) not fewer than 5 post-pregnancy visits to a maternity care provider; and(iii) interpregnancy care.(2) To provide coordinated, evidence-based, respectful, culturally and linguistically appropriate, and person-centered maternity care management.(3) To decrease—(A) severe and preventable maternal morbidity and maternal mortality;(B) overall health care spending;(C) unnecessary emergency department visits;(D) inequities in maternal and infant care outcomes, including racial, economic, disability, gender-based, and geographical inequities;(E) racial, gender, economic, and other discrimination among health care professionals;(F) racism, discrimination, disrespect, and abuse in maternity care settings;(G) the rate of cesarean deliveries for low-risk pregnancies;(H) the rate of pre-term births and infants born with low birth weight; and(I) the rate of avoidable maternal and newborn hospitalizations and admissions to intensive care units.(c) Consultation.— In designing and implementing the demonstration project the Secretary shall consult with stakeholders, including—(1) States;(2) organizations representing relevant health care professionals, including oral health services professionals;(3) organizations (including reproductive justice and birth justice organizations led by people of color) that represent consumers of maternal health care, including consumers of maternal health care who are disproportionately impacted by poor maternal health outcomes;(4) representatives with experience implementing other maternity care home models, including representatives from the Center for Medicare and Medicaid Innovation;(5) community-based health care professionals, including doulas, lactation consultants, and other stakeholders;(6) experts in promoting health equity and combating racial bias in health care settings; and(7) Black, Indigenous, and other maternal health care consumers of color who have experienced severe maternal morbidity.(d) Application and selection of States.—(1) In general.— A State seeking to participate in the demonstration project shall submit an application to the Secretary at such time and in such manner as the Secretary shall require.(2) Selection of States.—(A) In general.— The Secretary shall select at least 10 States to participate in the demonstration project.(B) Selection requirements.— In selecting States to participate in the demonstration project, the Secretary shall—(i) ensure that there is geographic and regional diversity in the areas in which activities will be carried out under the project;(ii) ensure that States with significant inequities in maternal and infant health outcomes, including severe maternal morbidity, and other inequities based on race, income, or access to maternity care, are included; and(iii) ensure that at least 1 territory is included.(e) Grants.—(1) In general.— Subject to the availability of appropriations, the Secretary shall award 1 grant for each year of the demonstration project to each State that is selected to participate in the demonstration project.(2) Use of grant funds.— A State may use funds received under this section to—(A) award grants or make payments to eligible entities as part of an arrangement described in subsection (f)(2);(B) provide financial incentives to health care professionals, including community-based health care workers and community-based doulas, who participate in the State's maternity care home model;(C) provide adequate training for health care professionals, including community-based health care workers, doulas, and care coordinators, who participate in the State's maternity care home model, which may include training for cultural humility and antiracism, racial bias, health equity, reproductive and birth justice, trauma-informed care, home visiting skills, and respectful communication and listening skills, particularly in regards to maternal health;(D) pay for personnel and administrative expenses associated with designing, implementing, and operating the State's maternity care home model;(E) pay for items and services that are furnished under the State's maternity care home model and for which payment is otherwise unavailable under this title;(F) pay for services and materials to ensure culturall

    The bill says: Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended by inserting the following new section after section 1948:

    Bill text · Current law (42 U.S.C. 1396)

  483. 42 U.S.C. 1396a(a)(13)(B)changedby H.R. 9877 Sec. 5202(c)

    The bill says: in subparagraph (B), by striking "; and" and inserting a semicolon;

    Bill text · Current law (42 U.S.C. 1396a)

  484. 42 U.S.C. 1396a(a)(13)(C)changedby H.R. 9877 Sec. 5202(c)

    The bill says: in subparagraph (C), by striking the semicolon and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1396a)

  485. 42 U.S.C. 1396a(a)(13)added (D)by H.R. 9877 Sec. 5202(c)

    (D) payment for primary care services (as defined in subsection (jj)(1)) furnished in the period that begins on the first day of the first month that begins after the date of enactment of this subparagraph by a provider described in subsection (jj)(2)—(i) at a rate that is not less than 100 percent of the payment rate that applies to such services and the provider of such services under part B of title XVIII;(ii) in the case of items and services that are not items and services provided under such part, at a rate to be established by the Secretary; and(iii) in the case of items and services that are furnished in rural areas (as defined in section 1886(d)(2)(D)), health professional shortage areas (as defined in section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A))), or medically underserved areas (according to a designation under section 330(b)(3)(A) of the Public Health Service Act (42 U.S.C. 254b(b)(3)(A))), at the rate otherwise applicable to such items or services under clause (i) or (ii) increased, at the Secretary's discretion, by not more than 25 percent;

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1396a)

  486. 42 U.S.C. 1396a(a)(13)(C)changedby H.R. 9877 Sec. 5202(c)

    The bill says: Section 1902(a)(13)(C) of the Social Security Act (42 U.S.C. 1396a(a)(13)(C)) is amended by striking "subsection (jj)" and inserting "subsection (jj)(1)".

    Bill text · Current law (42 U.S.C. 1396a)

  487. 42 U.S.C. 1396d(dd)changedby H.R. 9877 Sec. 5202(c)

    The bill says: by striking "Notwithstanding" and inserting the following:

    Bill text · Current law (42 U.S.C. 1396d)

  488. 42 U.S.C. 1396d(dd)changedby H.R. 9877 Sec. 5202(c)

    The bill says: by striking "section 1902(a)(13)(C)" and inserting "subparagraph (C) of section 1902(a)(13)";

    Bill text · Current law (42 U.S.C. 1396d)

  489. 42 U.S.C. 1396d(dd)changedby H.R. 9877 Sec. 5202(c)

    The bill says: by inserting "or for services described in subparagraph (D) of section 1902(a)(13) furnished during an additional period specified in paragraph (2)," after "2015,";

    Bill text · Current law (42 U.S.C. 1396d)

  490. 42 U.S.C. 1396d(dd)changedby H.R. 9877 Sec. 5202(c)

    The bill says: by striking "under such section" and inserting "under subparagraph (C) or (D) of section 1902(a)(13), as applicable"; and

    Bill text · Current law (42 U.S.C. 1396d)

  491. 42 U.S.C. 1396d(dd)added (2)by H.R. 9877 Sec. 5202(c)

    (2) Additional periods.— For purposes of paragraph (1), an additional period includes the period that begins on the first day of the first month that begins after the date of enactment of this paragraph.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1396d)

  492. 42 U.S.C. 1396a(jj)renumberedby H.R. 9877 Sec. 5202(c)

    The bill says: by redesignating paragraphs (1) and (2) as clauses (i) and (ii), respectively, and realigning the left margins accordingly;

    Bill text · Current law (42 U.S.C. 1396a)

  493. 42 U.S.C. 1396a(jj)changedby H.R. 9877 Sec. 5202(c)

    (1) In general.—(A) Definition.— For purposes of subparagraphs (C) and (D) of subsection (a)(13)

    The bill says: by striking "For purposes of subsection (a)(13)(C)" and inserting the following:

    Bill text · Current law (42 U.S.C. 1396a)

  494. 42 U.S.C. 1396a(jj)added (B)by H.R. 9877 Sec. 5202(c)

    (B) Exclusions.— Such term does not include any services described in subparagraph (A) if such services are provided in an emergency department of a hospital.(2) Additional providers.— For purposes of subparagraph (D) of subsection (a)(13), a provider described in this paragraph is any of the following:(A) A physician with a primary specialty designation of family medicine, general internal medicine, pediatric medicine, or obstetrics and gynecology.(B) An advanced practice clinician, as defined by the Secretary, that works under the supervision of—(i) a physician that satisfies the criteria specified in subparagraph (A);(ii) a nurse practitioner or a physician assistant (as such terms are defined in section 1861(aa)(5)(A)) who is working in accordance with State law; or(iii) or a certified nurse-midwife (as defined in section 1861(gg)) or a certified professional midwife who is working in accordance with State law.(C) A rural health clinic, federally qualified health center, health center that receives funding under title X of the Public Health Service Act, or other health clinic that receives reimbursement on a fee schedule applicable to a physician.(D) An advanced practice clinician supervised by a physician described in subparagraph (A), another advanced practice clinician, or a certified nurse-midwife.(E) A midwife who is working in accordance with State law.

    The bill says: by inserting after clause (ii) (as so redesignated) the following:

    Bill text · Current law (42 U.S.C. 1396a)

  495. 42 U.S.C. 1396b(m)(2)(A)(xii)changedby H.R. 9877 Sec. 5202(c)

    (xii) such contract, and the entity complies with the applicable requirements of section 1396u–2 of this title; and

    The bill says: in clause (xii), by striking "and" after the semicolon;

    Bill text · Current law (42 U.S.C. 1396b)

  496. 42 U.S.C. 1396b(m)(2)(A)changedby H.R. 9877 Sec. 5202(c)

    …(other than covered outpatient drugs that under subsection (j)(1) of section 1396r–8 of this title are not subject to the requirements of that section) and such other data as the Secretary determines necessary to carry out this subsection.; and

    The bill says: by realigning the left margin of clause (xiii) so as to align with the left margin of clause (xii) and by striking the period at the end of clause (xiii) and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1396b)

  497. 42 U.S.C. 1396b(m)(2)(A)added (xiv)by H.R. 9877 Sec. 5202(c)

    (xiv) such contract provides that (I) payments to providers specified in section 1902(a)(13)(D) for primary care services (as defined in section 1902(jj)(1)) that are furnished during a year or period (as specified in section 1902(a)(13)(D) and section 1905(dd)) are at least equal to the amounts set forth and required by the Secretary by regulation; (II) the entity shall, upon request, provide documentation to the State, sufficient to enable the State and the Secretary to ensure compliance with subclause (I); and (III) the Secretary shall approve payments described in subclause (I) that are furnished through an agreed upon capitation, partial capitation, or other value-based payment arrangement if the capitation, partial capitation, or other value-based payment arrangement is based on a reasonable methodology and the entity provides documentation to the State sufficient to enable the State and the Secretary to ensure compliance with subclause (I).

    The bill says: by inserting after clause (xiii) the following:

    Bill text · Current law (42 U.S.C. 1396b)

  498. 42 U.S.C. 1396u-2(f)changedby H.R. 9877 Sec. 5202(c)

    The bill says: by striking "section 1902(a)(13)(C)" and inserting "subsections (C) and (D) of section 1902(a)(13)"; and

    Bill text · Current law (42 U.S.C. 1396u-2)

  499. 42 U.S.C. 1396u-2(f)changedby H.R. 9877 Sec. 5202(c)

    The bill says: by inserting ", and clause (xiv) of section 1903(m)(2)(A)" before the period.

    Bill text · Current law (42 U.S.C. 1396u-2)

  500. 42 U.S.C. 1786(b)(10)changedby H.R. 9877 Sec. 5203(d)

    The bill says: Section 17(b)(10) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)(10)) is amended by striking "six" and inserting "24".

    Bill text · Current law (42 U.S.C. 1786)

  501. 42 U.S.C. 293added 743by H.R. 9877 Sec. 5204(c)

    743 Respectful maternity care training for all employees in maternity care settings.—(a) Grants.— The Secretary shall award grants for programs to reduce and prevent bias, racism, and discrimination in maternity care settings and to advance respectful, culturally congruent, trauma-informed care.(b) Special consideration.— In awarding grants under subsection (a), the Secretary shall give special consideration to applications for programs that would—(1) apply to all maternity care providers and any employees who interact with pregnant and postpartum individuals in the provider setting, including front desk employees, sonographers, schedulers, health care professionals, hospital or health system administrators, security staff, and other employees;(2) emphasize periodic, as opposed to one-time, trainings for all birthing professionals and employees described in paragraph (1);(3) address implicit bias, racism, and cultural humility;(4) be delivered in ongoing education settings for providers maintaining their licenses, with a preference for trainings that provide continuing education units;(5) include trauma-informed care best practices and an emphasis on shared decision making between providers and patients;(6) include antiracism training and programs;(7) be delivered in undergraduate programs that funnel into health professions schools;(8) be delivered in settings that apply to providers of the special supplemental nutrition program for women, infants, and children under section 17 of the Child Nutrition Act of 1966;(9) integrate bias training in obstetric emergency simulation trainings or related trainings;(10) include training for emergency department employees and emergency medical technicians on recognizing warning signs for severe pregnancy-related complications;(11) offer training to all maternity care providers on the value of racially, ethnically, and professionally diverse maternity care teams to provide culturally congruent care; or(12) be based on one or more programs designed by a historically Black college or university or other minority-serving institution.(c) Application.— To seek a grant under subsection (a), an entity shall submit an application at such time, in such manner, and containing such information as the Secretary may require.(d) Reporting to Secretary.— Each recipient of a grant under this section shall annually submit to the Secretary a report on the status of activities conducted using the grant, including, as applicable, a description of the impact of training provided through the grant on patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families.(e) Dissemination of findings.— Based on the annual reports submitted pursuant to subsection (d), the Secretary—(1) shall produce an annual report on the findings resulting from programs funded through this section;(2) shall disseminate such report to all recipients of grants under this section and to the public; and(3) may include in such report findings on best practices for improving patient outcomes and patient experience for pregnant and postpartum individuals from racial and ethnic minority groups and their families in maternity care settings.(f) Definitions.— In this section:(1) Culturally congruent.— The term culturally congruent means in agreement with the preferred cultural values, beliefs, world view, language, and practices of the health care consumer and other stakeholders.(2) Maternity care provider.— The term maternity care provider means a health care provider who—(A) is a physician, physician assistant, midwife who meets at a minimum the international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives, nurse practitioner, or clinical nurse specialist; and(B) has a focus on maternal or perinatal health.(3) Postpartum.— The term postpartum means the one-year period beginning on the last day of an individual’s pregnancy.(4) Racial and ethnic minority group.— The term racial and ethnic minority group has the meaning given such term in section 1707(g)(1).(g) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $5,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Part B of title VII of the Public Health Service Act (42 U.S.C. 293 et seq.) (as amended by section 3002), is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 293)

  502. 42 U.S.C. 294fadded 758by H.R. 9877 Sec. 5205(b)

    758 Perinatal workforce grants.—(a) In general.— The Secretary shall award grants to entities to establish or expand programs described in subsection (b) to grow and diversify the perinatal workforce.(b) Use of funds.— Recipients of grants under this section shall use the grants to grow and diversify the perinatal workforce by—(1) establishing schools or programs that provide education and training to individuals seeking appropriate licensing or certification as—(A) physician assistants who will complete clinical training in the field of maternal and perinatal health; or(B) perinatal health workers; and(2) expanding the capacity of existing schools or programs described in paragraph (1), for the purposes of increasing the number of students enrolled in such schools or programs, including by awarding scholarships for students.(c) Prioritization.— In awarding grants under this section, the Secretary shall give priority to any entity that—(1) has demonstrated a commitment to recruiting and retaining students and faculty from racial and ethnic minority groups;(2) has developed a strategy to recruit and retain a diverse pool of students into the perinatal workforce program or school supported by funds received through the grant, particularly from racial and ethnic minority groups and other underserved populations;(3) has developed a strategy to recruit and retain students who plan to practice in a health professional shortage area designated under section 332;(4) has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic inequities in maternal health outcomes, to the extent practicable; and(5) includes in the standard curriculum for all students within the perinatal workforce program or school a bias, racism, or discrimination training program that includes training on implicit bias and racism.(d) Reporting.— As a condition on receipt of a grant under this section for a perinatal workforce program or school, an entity shall agree to submit to the Secretary an annual report on the activities conducted through the grant, including—(1) the number and demographics of students participating in the program or school;(2) the extent to which students in the program or school are entering careers in—(A) health professional shortage areas designated under section 332; and(B) areas with significant racial and ethnic inequities in maternal health outcomes, to the extent such data are available; and(3) whether the program or school has included in the standard curriculum for all students a bias, racism, or discrimination training program that includes explicit and implicit bias, and if so the effectiveness of such training program.(e) Period of grants.— The period of a grant under this section shall not exceed 5 years.(f) Application.— To seek a grant under this section, an entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including any information necessary for prioritization under subsection (c).(g) Technical assistance.— The Secretary shall provide, directly or by contract, technical assistance to entities seeking or receiving a grant under this section on the development, use, evaluation, and post-grant period sustainability of the perinatal workforce programs or schools proposed to be, or being, established or expanded through the grant.(h) Report by the Secretary.— Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to the Congress, and post on the internet website of the Department of Health and Human Services, a report on the effectiveness of the grant program under this section at—(1) recruiting students from racial and ethnic minority groups;(2) increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health, and perinatal health workers, from racial and ethnic minority groups and other underserved populations;(3) increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health, and perinatal health workers, working in health professional shortage areas designated under section 332; and(4) increasing the number of physician assistants who will complete clinical training in the field of maternal and perinatal health, and perinatal health workers, working in areas with significant racial and ethnic inequities in maternal health outcomes, to the extent such data are available.(i) Definition of racial and ethnic minority group.— In this section, the term racial and ethnic minority group has the meaning given such term in section 1707(g).(j) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $15,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Title VII of the Public Health Service Act is amended by inserting after section 757 (42 U.S.C. 294f) the following:

    Bill text · Current law (42 U.S.C. 294f)

  503. 42 U.S.C. 296jadded 812by H.R. 9877 Sec. 5205(c)

    812 Perinatal nursing workforce grants.—(a) In general.— The Secretary shall award grants to schools of nursing to grow and diversify the perinatal nursing workforce.(b) Use of funds.— Recipients of grants under this section shall use the grants to grow and diversify the perinatal nursing workforce by providing scholarships to students seeking to become—(1) nurse practitioners whose education includes a focus on maternal and perinatal health; or(2) clinical nurse specialists whose education includes a focus on maternal and perinatal health.(c) Prioritization.— In awarding grants under this section, the Secretary shall give priority to any school of nursing that—(1) has developed a strategy to recruit and retain a diverse pool of students seeking to enter careers focused on maternal and perinatal health, particularly students from racial and ethnic minority groups and other underserved populations;(2) has developed a partnership with a practice setting in a health professional shortage area designated under section 332 for the clinical placements of the school’s students;(3) has developed a strategy to recruit and retain students who plan to practice in an area with significant racial and ethnic inequities in maternal health outcomes, to the extent practicable; and(4) includes in the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health a bias, racism, or discrimination training program that includes education on implicit bias and racism.(d) Reporting.— As a condition on receipt of a grant under this section, a school of nursing shall agree to submit to the Secretary an annual report on the activities conducted through the grant, including, to the extent practicable—(1) the number and demographics of students in the school of nursing seeking to enter careers focused on maternal and perinatal health;(2) the extent to which such students are preparing to enter careers in—(A) health professional shortage areas designated under section 332; and(B) areas with significant racial and ethnic inequities in maternal health outcomes, to the extent such data are available; and(3) whether the standard curriculum for all students seeking to enter careers focused on maternal and perinatal health includes a bias, racism, or discrimination training program that includes education on implicit bias and racism.(e) Period of grants.— The period of a grant under this section shall be up to 5 years.(f) Application.— To seek a grant under this section, an entity shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require, including any information necessary for prioritization under subsection (c).(g) Technical assistance.— The Secretary shall provide, directly or by contract, technical assistance to schools of nursing seeking or receiving a grant under this section on the processes of awarding and evaluating scholarships through the grant.(h) Report by the Secretary.— Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to the Congress, and post on the internet website of the Department of Health and Human Services, a report on the effectiveness of the grant program under this section at—(1) recruiting students from racial and ethnic minority groups and other underserved populations;(2) increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health from racial and ethnic minority groups and other underserved populations;(3) increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in health professional shortage areas designated under section 332; and(4) increasing the number of nurse practitioners and clinical nurse specialists entering careers focused on maternal and perinatal health working in areas with significant racial and ethnic inequities in maternal health outcomes, to the extent such data are available.(i) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $15,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Title VIII of the Public Health Service Act is amended by inserting after section 811 (42 U.S.C. 296j) the following:

    Bill text · Current law (42 U.S.C. 296j)

  504. 42 U.S.C. 247b-12(d)added (9)by H.R. 9877 Sec. 5206(b)

    (9) Grants to promote representative community engagement in maternal mortality review committees.—(A) In general.— The Secretary may, using funds made available pursuant to subparagraph (C), provide assistance to an applicable maternal mortality review committee of a State, Indian tribe, tribal organization, or Urban Indian organization (as such terms are defined in section 4 of the Indian Health Care Improvement Act)—(i) to select for inclusion in the membership of such a committee community members from the State, Indian tribe, tribal organization, or Urban Indian organization by—(I) prioritizing community members who can increase the diversity of the committee’s membership with respect to race and ethnicity, location, and professional background, including members with non-clinical experiences; and(II) to the extent applicable, using funds reserved under subsection (g), to address barriers to maternal mortality review committee participation for community members, including through providing required training, reducing transportation barriers, providing compensation, and providing other supports as may be necessary;(ii) to establish initiatives to conduct outreach and community engagement efforts within communities throughout the State or Indian tribe to seek input from community members on the work of such maternal mortality review committee, with a particular focus on outreach to people who are members of minority groups; and(iii) to release public reports assessing—(I) the pregnancy-related death and pregnancy-associated death review processes of the maternal mortality review committee, with a particular focus on the maternal mortality review committee’s sensitivity to the unique circumstances of pregnant and postpartum individuals from racial and ethnic minority groups (as such term is defined in section 1707(g)(1)) who have suffered pregnancy-related deaths; and(II) the impact of the use of funds made available pursuant to paragraph (C) on increasing the diversity of the maternal mortality review committee membership and promoting community engagement efforts throughout the State or Indian tribe.(B) Technical assistance.— The Secretary shall provide (either directly through the Department of Health and Human Services or by contract) technical assistance to any maternal mortality review committee receiving a grant under this paragraph on best practices for increasing the diversity of the maternal mortality review committee’s membership and for conducting effective community engagement throughout the State or Indian tribe.(C) Authorization of appropriations.— In addition to any funds made available under subsection (g), there are authorized to be appropriated to carry out this paragraph $10,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Section 317K(d) of the Public Health Service Act (42 U.S.C. 247b–12(d)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 247b-12)

  505. 42 U.S.C. 247b-12(g)changedby H.R. 9877 Sec. 5206(b)

    The bill says: by striking "2026 through 2030" and inserting "2027 through 2031"; and

    Bill text · Current law (42 U.S.C. 247b-12)

  506. 42 U.S.C. 247b-12(g)addedby H.R. 9877 Sec. 5206(b)

    The bill says: by adding at the end the following: "Of the amount made available under the preceding sentence for a fiscal year, not less than $1,500,000 shall be reserved for grants awarded under subsection (d)(9) to Indian tribes, tribal organizations, or Urban Indian organizations (as such terms are defined in section 4 of the Indian Health Care Improvement Act).".

    Bill text · Current law (42 U.S.C. 247b-12)

  507. 42 U.S.C. 247b-12(d)(3)(A)(i)renumberedby H.R. 9877 Sec. 5206(c)

    The bill says: by redesignating subclauses (II) and (III) as subclauses (V) and (VI), respectively; and

    Bill text · Current law (42 U.S.C. 247b-12)

  508. 42 U.S.C. 247b-12(d)(3)(A)(i)added (II)by H.R. 9877 Sec. 5206(c)

    (II) to the extent practicable, reviewing cases of severe maternal morbidity, according to the most up-to-date indicators;(III) to the extent practicable, reviewing deaths during pregnancy or up to 1 year after the end of a pregnancy from suicide, overdose, or other death from a mental health condition or substance use disorder attributed to, or aggravated by, pregnancy or childbirth complications;(IV) to the extent practicable, consulting with local community-based organizations representing pregnant and postpartum individuals from demographic groups disproportionately impacted by poor maternal health outcomes to ensure that, in addition to clinical factors, non-clinical factors that might have contributed to a pregnancy-related death are appropriately considered;

    The bill says: by inserting after subclause (I) the following:

    Bill text · Current law (42 U.S.C. 247b-12)

  509. 42 U.S.C. 1315a(b)(2)(B)added (xxviii)by H.R. 9877 Sec. 5209(b)

    (xxviii) Focusing on title XIX, providing for the adoption of and use of telehealth tools that allow for screening, monitoring, and management of common health complications with respect to an individual receiving medical assistance during such individual’s pregnancy and for not more than a 1-year period beginning on the last day of the pregnancy.

    The bill says: Section 1115A(b)(2)(B) of the Social Security Act (42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1315a)

  510. 42 U.S.C. 254c-20added 330N–1by H.R. 9877 Sec. 5209(c)

    330N–1. Expanding capacity for maternal health outcomes.—(a) Establishment.— Beginning not later than 1 year after the date of enactment of this section, the Secretary shall award grants to eligible entities to evaluate, develop, and expand the use of technology-enabled collaborative learning and capacity building models and improve maternal health outcomes—(1) in health professional shortage areas;(2) in areas with high rates of maternal mortality and severe maternal morbidity;(3) in areas with significant racial and ethnic inequities in maternal health outcomes; and(4) for medically underserved populations and American Indians and Alaska Natives, including Indian Tribes, Tribal organizations, and Urban Indian organizations.(b) Use of Funds.—(1) Required uses.— Recipients of grants under this section shall use the grants to—(A) train maternal health care providers, students, and other similar professionals through models that include—(i) methods to increase safety and health care quality;(ii) training to increase awareness of, and eliminate implicit bias, racism, and discrimination in, the provision of health care;(iii) best practices in screening for and, as needed, evaluating and treating maternal mental health conditions and substance use disorders;(iv) training on best practices in maternity care for pregnant and postpartum individuals during the COVID–19 public health emergency or future public health emergencies;(v) methods to screen for social determinants of maternal health risks in the prenatal and postpartum periods; and(vi) the use of remote patient monitoring tools for pregnancy-related complications described in section 1115A(b)(2)(B)(xxviii) of the Social Security Act;(B) evaluate and collect information on the effect of such models on—(i) access to, and quality of, care;(ii) outcomes with respect to the health of an individual; and(iii) the experience of individuals who receive pregnancy-related health care;(C) develop qualitative and quantitative measures to identify best practices for the expansion and use of such models;(D) study the effect of such models on patient outcomes and maternity care providers; and(E) conduct any other activity, as determined by the Secretary.(2) Permissible uses.— Recipients of grants under this section may use grants to support—(A) the use and expansion of technology-enabled collaborative learning and capacity building models, including hardware and software that—(i) enable distance learning and technical support; and(ii) support the secure exchange of electronic health information; and(B) maternity care providers, students, and other similar professionals in the provision of maternity care through such models.(c) Application.—(1) In general.— An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require.(2) Assurance.— An application under paragraph (1) shall include an assurance that such entity shall collect information on, and assess the effect of, the use of technology-enabled collaborative learning and capacity building models, including with respect to—(A) maternal health outcomes;(B) access to maternal health care services;(C) quality of maternal health care; and(D) retention of maternity care providers serving areas and populations described in subsection (a).(d) Limitations.—(1) Number.— The Secretary may not award more than 1 grant under this section to an eligible entity.(2) Duration.— A grant awarded under this section shall be for a 5-year period.(e) Access to broadband.— In administering grants under this section, the Secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable, high-speed internet for grantees.(f) Technical assistance.— The Secretary shall provide (either directly or by contract) technical assistance to eligible entities, including recipients of grants under subsection (a), on the development, use, and sustainability of technology-enabled collaborative learning and capacity building models to expand access to maternal health care services provided by such entities, including—(1) in health professional shortage areas;(2) in areas with high rates of maternal mortality and severe maternal morbidity or significant racial and ethnic inequities in maternal health outcomes; and(3) for medically underserved populations or American Indians and Alaska Natives.(g) Research and evaluation.— The Secretary, in consultation with experts, shall develop a strategic plan to research and evaluate the evidence for such models.(h) Reporting.—(1) Eligible entities.— An eligible entity that receives a grant under subsection (a) shall submit to the Secretary a report, at such time, in such manner, and containing such information as the Secretary may require.(2) Secretary.— Not later than 4 years after the date of enactment of this section, the Secretary shall submit to the Congress, and make available on the website of the Department of Health and Human Services, a report that includes—(A) a description of grants awarded under subsection (a) and the purpose and amounts of such grants;(B) a summary of—(i) the evaluations conducted under subsection (b)(1)(B);(ii) any technical assistance provided under subsection (f); and(iii) the activities conducted under subsection (a); and(C) a description of any significant findings with respect to—(i) patient outcomes; and(ii) best practices for expanding, using, or evaluating technology-enabled collaborative learning and capacity building models.(i) Authorization of appropriations.— There is authorized to be appropriated to carry out this section, $6,000,000 for each of fiscal years 2027 through 2031.(j) Definitions.— In this section:(1) Eligible entity.—(A) In general.— The term eligible entity means an entity that provides, or supports the pro

    The bill says: Title III of the Public Health Service Act is amended by inserting after section 330N (42 U.S.C. 254c–20) the following:

    Bill text · Current law (42 U.S.C. 254c-20)

  511. 42 U.S.C. 294kadded 760Aby H.R. 9877 Sec. 5213(a)

    760A. Midwifery schools and programs.—(a) In general.— The Secretary may award grants to institutions of higher education (as defined in subsections (a) and (b) of section 101 of the Higher Education Act of 1965) for the following:(1) Direct support of students in an accredited midwifery school or program.(2) Establishment or expansion of an accredited midwifery school or program.(3) Securing, preparing, or providing support for increasing the number of qualified preceptors for training the students of an accredited midwifery school or program.(b) Special considerations.— In awarding grants under subsection (a), the Secretary shall give special consideration to any institution of higher education that—(1) agrees to prioritize students who plan to practice in a health professional shortage area designated under section 332; and(2) demonstrates a focus on increasing racial and ethnic minority representation in midwifery education.(c) Restriction.— The Secretary shall not provide any assistance under this section to be used with respect to a midwifery school or program within a school of nursing (as defined in section 801).(d) Authorization of appropriations.—(1) In general.— There is authorized to be appropriated to carry out this section $15,000,000 for the period of fiscal years 2027 through 2031.(2) Allocation.— Of the amounts made available to carry out this section for any fiscal year, the Secretary shall use—(A) 50 percent to award grants for purposes specified in subsection (a)(1);(B) 25 percent to award grants for purposes specified in subsection (a)(2); and(C) 25 percent to award grants for purposes specified in subsection (a)(3).

    The bill says: Title VII of the Public Health Service Act is amended by inserting after section 760 (42 U.S.C. 294k) the following:

    Bill text · Current law (42 U.S.C. 294k)

  512. 42 U.S.C. 295p(1)(A)changedby H.R. 9877 Sec. 5213(a)

    The bill says: by inserting ""midwifery school or program"," before "and "school of chiropractic"";

    Bill text · Current law (42 U.S.C. 295p)

  513. 42 U.S.C. 295p(1)(A)changedby H.R. 9877 Sec. 5213(a)

    The bill says: by inserting "a degree or certificate in midwifery or an equivalent degree or certificate," before "and a degree of doctor of chiropractic or an equivalent degree"; and

    Bill text · Current law (42 U.S.C. 295p)

  514. 42 U.S.C. 295p(1)(A)changedby H.R. 9877 Sec. 5213(a)

    The bill says: by striking "any such school" and inserting "any such school or program".

    Bill text · Current law (42 U.S.C. 295p)

  515. 42 U.S.C. 295p(1)(E)changedby H.R. 9877 Sec. 5213(a)

    The bill says: Section 799B(1)(E) of the Public Health Service Act (42 U.S.C. 295p(1)(E)) is amended by inserting "a midwifery school or program," before "or a graduate program in health administration".

    Bill text · Current law (42 U.S.C. 295p)

  516. 42 U.S.C. 243added 317H–1by H.R. 9877 Sec. 5214

    317H–1. Gestational diabetes.—(a) Understanding and monitoring gestational diabetes.—(1) In general.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, in consultation with the Diabetes Mellitus Interagency Coordinating Committee established under section 429 and representatives of appropriate national health organizations, shall develop a multisite gestational diabetes research project within the diabetes program of the Centers for Disease Control and Prevention to expand and enhance surveillance data and public health research on gestational diabetes.(2) Areas to be addressed.— The research project developed under paragraph (1) shall address—(A) procedures to establish accurate and efficient systems for the collection of gestational diabetes data within each State and commonwealth, territory, or possession of the United States;(B) the progress of collaborative activities with the National Vital Statistics System, the National Center for Health Statistics, and State health departments with respect to the standard birth certificate, in order to improve surveillance of gestational diabetes;(C) postpartum methods of tracking individuals with gestational diabetes after delivery as well as targeted interventions proven to lower the incidence of type 2 diabetes in that population;(D) variations in the distribution of diagnosed and undiagnosed gestational diabetes, and of impaired fasting glucose tolerance and impaired fasting glucose, within and among groups of pregnant individuals; and(E) factors and culturally sensitive interventions that influence risks and reduce the incidence of gestational diabetes and related complications during childbirth, including cultural, behavioral, racial, ethnic, geographic, demographic, socioeconomic, and genetic factors.(3) Report.— Not later than 2 years after the date of enactment of this section, and annually thereafter, the Secretary shall generate a report on the findings and recommendations of the research project including prevalence of gestational diabetes in the multisite area and disseminate the report to the appropriate Federal and non-Federal agencies.(b) Expansion of gestational diabetes research.—(1) In General.— The Secretary shall expand and intensify public health research regarding gestational diabetes. Such research may include—(A) developing and testing novel approaches for improving postpartum diabetes testing or screening and for preventing type 2 diabetes in individuals who can become pregnant with a history of gestational diabetes; and(B) conducting public health research to further understanding of the epidemiologic, socioenvironmental, behavioral, translation, and biomedical factors and health systems that influence the risk of gestational diabetes and the development of type 2 diabetes in individuals who can become pregnant with a history of gestational diabetes.(2) Authorization of Appropriations.— There is authorized to be appropriated to carry out this subsection $5,000,000 for each of fiscal years 2027 through 2031.(c) Demonstration grants To lower the rate of gestational diabetes.—(1) In General.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall award grants, on a competitive basis, to eligible entities for demonstration projects that implement evidence-based interventions to reduce the incidence of gestational diabetes, the recurrence of gestational diabetes in subsequent pregnancies, and the development of type 2 diabetes in individuals who can become pregnant with a history of gestational diabetes.(2) Priority.— In making grants under this subsection, the Secretary shall give priority to projects focusing on—(A) helping individuals who can become pregnant who have 1 or more risk factors for developing gestational diabetes;(B) working with individuals who can become pregnant with a history of gestational diabetes during a previous pregnancy;(C) providing postpartum care for individuals who can become pregnant with gestational diabetes;(D) tracking cases where individuals who can become pregnant with a history of gestational diabetes developed type 2 diabetes;(E) educating mothers with a history of gestational diabetes about the increased risk of their child developing diabetes;(F) working to prevent gestational diabetes and prevent or delay the development of type 2 diabetes in individuals who can become pregnant with a history of gestational diabetes; and(G) achieving outcomes designed to assess the efficacy and cost-effectiveness of interventions that can inform decisions on long-term sustainability, including third-party reimbursement.(3) Application.— An eligible entity desiring to receive a grant under this subsection shall submit to the Secretary—(A) an application at such time, in such manner, and containing such information as the Secretary may require; and(B) a plan to—(i) lower the rate of gestational diabetes during pregnancy; or(ii) develop methods of tracking individuals who can become pregnant with a history of gestational diabetes and develop effective interventions to lower the incidence of the recurrence of gestational diabetes in subsequent pregnancies and the development of type 2 diabetes.(4) Uses of Funds.— An eligible entity receiving a grant under this subsection shall use the grant funds to carry out demonstration projects described in paragraph (1), including—(A) expanding community-based health promotion education, activities, and incentives focused on the prevention of gestational diabetes and development of type 2 diabetes in individuals who can become pregnant with a history of gestational diabetes;(B) aiding State- and Tribal-based diabetes prevention and control programs to collect, analyze, disseminate, and report surveillance data on individuals who can become pregnant with, and at risk for, gestational diabetes, the recurrence of gestational diabetes in subsequent pr

    The bill says: Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by adding after section 317H (42 U.S.C. 247b–9) the following:

    Bill text · Current law (42 U.S.C. 243)

  517. 42 U.S.C. 237a(b)(6)changedby H.R. 9877 Sec. 5215(1)

    The bill says: in paragraph (6), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 237a)

  518. 42 U.S.C. 237a(b)(7)changedby H.R. 9877 Sec. 5215(2)

    The bill says: in paragraph (7), by striking the period at the end and inserting a semicolon; and

    Bill text · Current law (42 U.S.C. 237a)

  519. 42 U.S.C. 237a(b)added (8)by H.R. 9877 Sec. 5215(3)

    (8) not later than 1 year after the date of enactment of this paragraph, develop and implement a 4-year culturally and linguistically appropriate multimedia consumer education campaign that is designed to promote understanding and acceptance of evidence-based maternity practices and models of care for optimal maternity outcomes among individuals of childbearing ages and families of such individuals and that—(A) highlights the importance of protecting, promoting, and supporting the innate capacities of childbearing individuals and their newborns for childbirth, breastfeeding, and attachment;(B) promotes understanding of the importance of using obstetric interventions when medically necessary and when supported by strong, high-quality evidence;(C) highlights the widespread overuse of maternity practices that have been shown to have benefit when used appropriately in situations of medical necessity, but which can expose pregnant individuals, infants, or both to risk of harm if used routinely and indiscriminately;(D) emphasizes the noninvasive maternity practices that have proven correlation or may be associated with improvement in outcomes with no detrimental side effects, and are significantly underused in the United States, including smoking cessation programs in pregnancy, group model prenatal care, continuous labor support, nonsupine positions for birth, and external version to turn breech babies at term;(E) educates consumers about—(i) the qualifications of licensed providers of maternity care, including obstetrician-gynecologists, family physicians, certified nurse-midwives, certified midwives, and certified professional midwives; and(ii) the best evidence about the safety, satisfaction, outcomes, and costs of such providers;(F) informs consumers about the best available research comparing birth center births, planned home births, and hospital births, including information about each setting’s safety, satisfaction, outcomes, and costs;(G) fosters participation in high-quality, evidence-based childbirth education that promotes a healthy and safe approach to pregnancy, childbirth, and early parenting; is taught by certified educators, peer counselors, and health professionals; and promotes informed decision making by childbearing individuals;(H) informs consumers about—(i) the effects of systemic, institutional, and interpersonal racism on the health, well-being, and outcomes of birthing people;(ii) the importance of respectful, culturally and linguistically appropriate, and culturally congruent care; and(iii) the value of community-based and community-led maternal care and support; and(I) is pilot tested for consumer comprehension, cultural sensitivity, and acceptance of the messages across geographically, racially, ethnically, and linguistically diverse populations;

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 237a)

  520. 42 U.S.C. 202added 229Aby H.R. 9877 Sec. 5301(a)

    229A. Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes.—(a) In general.— The Secretary, acting through the Deputy Assistant Secretary for Women’s Health under section 229 and in collaboration with the Federal officials specified in subsection (b), shall establish the Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes (referred to in this section as the "ICCPOM").(b) Other agencies.— The officials specified in this subsection are the Secretary of Labor, the Secretary of Defense, the Secretary of Veterans Affairs, the Surgeon General, the Director of the Centers for Disease Control and Prevention, the Administrator of the Health Resources and Services Administration, the Administrator of the Centers for Medicare & Medicaid Services, the Director of the Indian Health Service, the Assistant Secretary for Mental Health and Substance Use, the Director of the National Institute of Child Health and Human Development, the Director of the Agency for Healthcare Research and Quality, the Assistant Secretary for Children and Families, the Deputy Assistant Secretary for Minority Health, the Director of the Office of Personnel Management, and such other Federal officials as the Secretary of Health and Human Services determines to be appropriate.(c) Chair.— The Deputy Assistant Secretary for Women’s Health shall serve as the chair of the ICCPOM.(d) Duties.— The ICCPOM shall guide policy and program development across the Federal Government with respect to promotion of optimal maternity care. Nothing in this section shall be construed as transferring regulatory or program authority from an agency to the ICCPOM.(e) Consultations.— The ICCPOM shall actively seek the input of, and shall consult with, all appropriate and interested stakeholders, including State health departments, public health research and interest groups, foundations, childbearing individuals and their advocates, and maternity care professional associations and organizations, reflecting racially, ethnically, demographically, and geographically diverse communities.(f) Annual report.—(1) In general.— The Secretary, on behalf of the ICCPOM, shall annually submit to Congress a report that summarizes—(A) all programs and policies of Federal agencies (including the Medicare program under title XVIII of the Social Security Act and the Medicaid program under title XIX of such Act) designed to promote optimal maternity care, focusing particularly on programs and policies that support the adoption of evidence-based maternity care, as defined by timely, scientifically sound systematic reviews;(B) all programs and policies of Federal agencies (including the Medicare program under title XVIII of the Social Security Act and the Medicaid program under title XIX of such Act) designed to address the problems of maternal mortality and morbidity, infant mortality, prematurity, and low birth weight, including such programs and policies designed to address racial and ethnic inequities with respect to each of such problems;(C) the extent of progress in reducing maternal mortality and infant mortality, low birth weight, and prematurity at State and national levels; and(D) such other information regarding optimal maternity care (such as quality and performance measures) as the Secretary determines to be appropriate.(2) Reducing inequities with respect to indigenous status.— The information specified in paragraph (1)(C) shall be included in each such report in a manner that disaggregates such information by race, ethnicity, and indigenous status in order to determine the extent of progress in reducing racial and ethnic inequities and inequities related to indigenous status.(3) Certain information.— Each report under paragraph (1) shall include information (disaggregated by race, ethnicity, and indigenous status, as applicable) on the following rates, trends, and costs by State:(A) The rate and trend of primary cesarean deliveries and repeat cesarean deliveries.(B) The rate and trend of vaginal births after cesarean.(C) The rate and trend of vaginal breech births.(D) The rate and trend of induction of labor.(E) The rate and trend of freestanding birth center births.(F) The rate and trend of planned and unplanned home birth.(G) The rate and trends of attended births by different types of maternity care providers, including by an obstetrician-gynecologist, family practice physician, obstetrician-gynecologist, physician assistant, certified nurse-midwife, certified midwife, and certified professional midwife.(H) The rate and trend of severe maternal morbidity.(I) The rates and trends of prenatal and postpartum anxiety and depression.(J) The rate and trend of preterm birth.(K) The rate and trend of low birth weight.(L) The cost of maternity care disaggregated by place of birth and provider of care, including—(i) uncomplicated vaginal birth;(ii) complicated vaginal birth;(iii) uncomplicated cesarean birth; and(iv) complicated cesarean birth.(g) Authorization of appropriations.— There is authorized to be appropriated, in addition to amounts authorized to be appropriated under section 229(e), to carry out this section $1,000,000 for each of the fiscal years 2027 through 2031.

    The bill says: Part A of title II of the Public Health Service Act (42 U.S.C. 202 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 202)

  521. 42 U.S.C. 237a(b)added (9)by H.R. 9877 Sec. 5301(b)

    (9) establish the Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes in accordance with section 229A; and

    The bill says: Section 229(b) of the Public Health Service Act (42 U.S.C. 237a(b)) (as amended by section 5215) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 237a)

  522. 42 U.S.C. 237a(d)changedby H.R. 9877 Sec. 5301(b)

    The bill says: Section 229(d) of such Act (42 U.S.C. 237a(d)) is amended by inserting "(other than under subsection (b)(9))" after "under this section".

    Bill text · Current law (42 U.S.C. 237a)

  523. 42 U.S.C. 1315a(b)(2)(B)added (xxix)by H.R. 9877 Sec. 5303(1)

    (xxix) Promoting evidence-based models of care that have been associated with reductions in pregnancy-related and infant health inequities, including incorporating the use of and payment for doulas, particularly community-based doulas, and promoting support for people during pregnancy and for the one-year period after the last day of such person’s pregnancy, through evidence-based models of antepartum, birth, postpartum care, and two-generation birthing person and newborn care models, and supporting the risk-appropriate use of out-of-hospital birth models, including births at home and in freestanding birth centers. Such models shall be selected and evaluated based on their impact on quality, equity, and developmental outcomes, notwithstanding any other provision of this section.

    The bill says: in subparagraph (B), by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1315a)

  524. 42 U.S.C. 1315a(b)(2)(C)added (ix)by H.R. 9877 Sec. 5303(2)

    (ix) Whether the model includes a regular process for ensuring the provision of culturally and linguistically appropriate services.(x) Whether health care services and supportive services included in the model are tailored to community health and health-related social needs and provided by community-based and community-led providers.(xi) Whether the model is designed to mitigate harmful effects of discrimination on the basis of race, sex, disability, ethnicity, language, and age.

    The bill says: in subparagraph (C), by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1315a)

  525. 42 U.S.C. 1315a(b)(2)added (D)by H.R. 9877 Sec. 5303(3)

    (D) Mandatory health equity models to be tested.— The Secretary shall select— Such models shall be selected and evaluated based on their impact on quality, equity, and developmental outcomes, notwithstanding any other provision of this section.(i) Medicaid payment models for culturally and linguistically appropriate antepartum, labor and delivery, and postpartum doula services, including community-based doula services, that are—(I) structured to provide payment to doulas as individuals, health care entity staff, or members of a doula group or collective, or through a third-party administrator;(II) designed to reduce racial and intersecting health inequities;(III) designed to provide doulas providing support with an equitable and sustainable reimbursement rate;(IV) designed to reduce barriers to workforce entry for culturally and linguistically competent and racially congruent doulas to provide services to Medicaid enrollees; and(V) designed with input from community-based doulas, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries;(ii) a Medicaid episode-based payment model for pregnancy-related services, including health care services and supportive services to address health-related social needs, during the prenatal, intrapartum, and postpartum periods, to improve health outcomes and reduce racial health inequities, and to be designed with input from maternity care providers, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries;(iii) a Medicaid alternative payment model for a pregnancy-related health home service to improve health outcomes during and for one year after pregnancy and during the newborn period, and to reduce racial health inequities, designed with input from maternity care providers, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries;(iv) a Medicaid perinatal health worker service delivery model for culturally and linguistically appropriate and respectful health care and supportive services that are tailored to community health and health-related social needs, designed to improve health outcomes and mitigate harmful effects of racism and other forms of discrimination, and provided by community-based and community-led providers; and(v) one or more models exclusively focused on early intervention and prevention for children enrolled in a State plan (or waiver of such plan) under title XIX or a State child health plan under title XXI using evidence-based interventions including parenting support programs, home-visiting services, and dyadic therapy treatment for children and adolescents at risk.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1315a)

  526. 42 U.S.C. 238added 249by H.R. 9877 Sec. 5403

    249 Duties of pharmacies to ensure provision of FDA-approved contraception.—(a) In general.— Subject to subsection (c), a pharmacy that receives Food and Drug Administration-approved drugs or devices in interstate commerce shall maintain compliance with each of the following:(1) If a customer requests a contraceptive or a medication related to a contraceptive, including emergency contraception, that is in stock, the pharmacy shall ensure that the requested contraceptive or medication is provided to the customer without delay.(2) If a customer requests a contraceptive or a medication related to a contraceptive that is not in stock and the pharmacy in the normal course of business stocks contraception, the pharmacy shall immediately inform the customer that the requested contraceptive or medication is not in stock and without delay offer the customer the following options:(A) If the customer prefers to obtain the requested contraceptive or medication through a referral or transfer, the pharmacy shall—(i) locate a pharmacy of the customer’s choice or the closest pharmacy confirmed to have the requested contraceptive or medication in stock; and(ii) refer the customer or transfer the prescription to that pharmacy.(B) If the customer prefers for the pharmacy to order the requested contraceptive or medication, the pharmacy shall obtain the contraceptive or medication under the pharmacy’s standard procedure for expedited ordering of medication and notify the customer when the contraceptive or medication arrives.(3) The pharmacy shall ensure that—(A) the pharmacy does not operate an environment in which customers are intimidated, threatened, or harassed in the delivery of services relating to a request for contraception or a medication related to a contraceptive;(B) the pharmacy’s employees do not interfere with or obstruct the delivery of services relating to a request for contraception or a medication related to a contraceptive;(C) the pharmacy’s employees do not intentionally misrepresent or deceive customers about the availability of a contraceptive or a medication related to a contraceptive, or the mechanism of action of such contraceptive or medication;(D) the pharmacy’s employees do not breach medical confidentiality with respect to a request for a contraceptive or a medication related to a contraceptive or threaten to breach such confidentiality; or(E) the pharmacy’s employees do not refuse to return a valid, lawful prescription for a contraceptive or a medication related to a contraceptive upon customer request.(b) Contraceptives not ordinarily stocked.— Nothing in subsection (a)(2) shall be construed to require any pharmacy to comply with such subsection if the pharmacy does not ordinarily stock contraceptives or medications related to contraceptives, as the case may be, in the normal course of business.(c) Refusals pursuant to standard pharmacy practice.— This section does not prohibit a pharmacy from refusing to provide a contraceptive or a medication related to a contraceptive to a customer in accordance with any of the following:(1) If it is unlawful to dispense the requested contraceptive or medication to the customer without a valid, lawful prescription and no such prescription is presented.(2) If the customer is unable to pay for the requested contraceptive or medication.(3) If the employee of the pharmacy refuses to provide the requested contraceptive or medication on the basis of a professional clinical judgment.(d) Relation to other law.—(1) Rule of construction.— Nothing in this section shall be construed to invalidate or limit rights, remedies, procedures, or legal standards under title VII of the Civil Rights Act of 1964.(2) Certain claims.— The Religious Freedom Restoration Act of 1993 shall not provide a basis for a claim concerning, or a defense to a claim under, this section, or provide a basis for challenging the application or enforcement of this section.(e) Preemption.— This section does not preempt any provision of State law or affect any professional obligation made applicable by a State board or other entity responsible for licensing or discipline of pharmacies or pharmacists, to the extent that such State law or professional obligation provides protections for customers that are greater than the protections provided by this section.(f) Enforcement.—(1) Civil penalty.— A pharmacy that violates a requirement of subsection (a) is liable to the United States for a civil penalty in an amount not exceeding $1,000 per day of violation, not to exceed $100,000 for all violations adjudicated in a single proceeding.(2) Private cause of action.— Any person aggrieved as a result of a violation of a requirement of subsection (a) may, in any court of competent jurisdiction, commence a civil action against the pharmacy involved to obtain appropriate relief, including actual and punitive damages, injunctive relief, and a reasonable attorney’s fee and costs.(3) Limitations.— A civil action under paragraph (1) or (2) may not be commenced against a pharmacy after the expiration of the 5-year period beginning on the date on which the pharmacy allegedly engaged in the violation involved.(g) Definitions.— In this section:(1) Contraception.— The term contraception or contraceptive means any drug or device approved by the Food and Drug Administration to prevent pregnancy.(2) Employee.— The term employee means a person hired, by contract or any other form of an agreement, by a pharmacy.(3) Medication related to a contraceptive.— The term medication related to a contraceptive means any drug or device approved by the Food and Drug Administration that a medical professional determines necessary to use before or in conjunction with use of a contraceptive.(4) Pharmacy.— The term pharmacy means an entity that—(A) is authorized by a State to engage in the business of selling prescription drugs at retail; and(B) employs one or more employees.(5) Product.— The ter

    The bill says: Part B of title II of the Public Health Service Act (42 U.S.C. 238 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 238)

  527. 42 U.S.C. 300eechangedby H.R. 9877 Sec. 5404(j)

    The bill says: Section 2500 of the Public Health Service Act (42 U.S.C. 300ee) is amended by striking subsections (b) through (d) and inserting the following:

    Bill text · Current law (42 U.S.C. 300ee)

  528. 20 U.S.C. 7906removedby H.R. 9877 Sec. 5404(j)

    The bill says: by striking paragraphs (3), (5), and (6);

    Bill text · Current law (20 U.S.C. 7906)

  529. 20 U.S.C. 7906renumberedby H.R. 9877 Sec. 5404(j)

    The bill says: by redesignating paragraph (4) as paragraph (3);

    Bill text · Current law (20 U.S.C. 7906)

  530. 20 U.S.C. 7906(3)changedby H.R. 9877 Sec. 5404(j)

    The bill says: in paragraph (3), as redesignated by paragraph (2), by inserting "or" after the semicolon; and

    Bill text · Current law (20 U.S.C. 7906)

  531. 20 U.S.C. 7906renumberedby H.R. 9877 Sec. 5404(j)

    The bill says: by redesignating paragraph (7) as paragraph (4).

    Bill text · Current law (20 U.S.C. 7906)

  532. 42 U.S.C. 710repealedby H.R. 9877 Sec. 5404(k)

    The bill says: Section 510 of the Social Security Act (42 U.S.C. 710 et seq.) is repealed.

    Bill text · Current law (42 U.S.C. 710)

  533. 42 U.S.C. 1395cc(a)(1)(Y)(ii)(V)changedby H.R. 9877 Sec. 5405(a)

    The bill says: in subparagraph (Y)(ii)(V), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395cc)

  534. 42 U.S.C. 1395cc(a)(1)(Z)(iii)changedby H.R. 9877 Sec. 5405(a)

    The bill says: in subparagraph (Z)(iii), by striking the period and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1395cc)

  535. 42 U.S.C. 1395cc(a)(1)added (AA)by H.R. 9877 Sec. 5405(a)

    (AA) in the case of a hospital, critical access hospital, or rural emergency hospital, to adopt and enforce a policy to ensure compliance with the requirements of subsection (l) and to meet the requirements of such subsection.

    The bill says: by inserting after subparagraph (Z) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395cc)

  536. 42 U.S.C. 1395ccadded (l)by H.R. 9877 Sec. 5405(a)

    (l) Compassionate assistance for rape emergencies.—(1) In general.— For purposes of subsection (a)(1)(AA), a hospital meets the requirements of this subsection if the hospital provides each of the services described in paragraph (2) to each individual, whether or not eligible for benefits under this title or under any other form of health insurance, who comes to the hospital on or after January 1, 2027, and—(A) who states to hospital personnel that they are victims of sexual assault;(B) who is accompanied by an individual who states to hospital personnel that the individual is a victim of sexual assault; or(C) whom hospital personnel, during the course of treatment and care for the individual, have reason to believe is a victim of sexual assault.(2) Required services described.— For purposes of paragraph (1), the services described in this subparagraph are the following:(A) Provision of medically and factually accurate and unbiased written and oral information about emergency contraception that—(i) is written in clear and concise language;(ii) is readily comprehensible;(iii) includes an explanation that emergency contraceptives—(I) have been approved by the Food and Drug Administration for individuals and are a safe and effective way to prevent pregnancy after unprotected intercourse or contraceptive failure if taken in a timely manner;(II) are more effective the sooner it is taken; and(III) do not cause an abortion and cannot interrupt an established pregnancy;(iv) meet such conditions regarding the provision of such information in languages other than English as the Secretary may establish; and(v) are provided without regard to the ability of the individual or their family to pay costs associated with the provision of such information to the individual.(B) Immediate offer to provide emergency contraception to the individual at the hospital and, in the case that such individual accepts such offer, immediate provision to such individual of such contraception on the same day it is requested without regard to the inability of the individual or their family to pay costs associated with the offer and provision of such contraception.(C) Development and implementation of a written policy to ensure that an individual is present at the hospital, or on-call, who—(i) has authority to dispense or prescribe emergency contraception, independently, or under a protocol prepared by a physician for the administration of emergency contraception at the hospital to a victim of sexual assault; and(ii) is trained to comply with the requirements of this section.(D) Provision of medically and factually accurate and unbiased written and oral information and counseling about post-exposure prophylaxis (referred to in this paragraph as "PEP") protocol for the prevention of HIV.(E) Immediate offer to begin PEP to the individual at the hospital except in cases where the medical professional’s best judgement is that further evaluation is required or that such a regimen will be substantially detrimental to the health of such individual. Such provision shall be offered regardless of the individual’s ability to pay. Hospitals shall be responsible for ensuring adequate supply of PEP medications to provide to patients.(3) Hospital defined.— In this subsection, the term hospital has the meaning given such term in section 1861(e), except that for purposes of this subsection, such term shall include a critical access hospital (as defined in section 1861(mm)(1)) and a rural emergency hospital (as defined in section 1861(kkk)).

    The bill says: Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395cc)

  537. 20 U.S.C. 7118(5)(C)(vi)changedby H.R. 9877 Sec. 5406(b)

    The bill says: in clause (vi), by striking "or" after the semicolon;

    Bill text · Current law (20 U.S.C. 7118)

  538. 20 U.S.C. 7118(5)(C)(vii)changedby H.R. 9877 Sec. 5406(b)

    The bill says: in clause (vii), by inserting "or" after the semicolon; and

    Bill text · Current law (20 U.S.C. 7118)

  539. 20 U.S.C. 7118(5)(C)added (viii)by H.R. 9877 Sec. 5406(b)

    (viii) provide free menstrual products to students who use menstrual products;

    The bill says: by adding at the end the following:

    Bill text · Current law (20 U.S.C. 7118)

  540. 20 U.S.C. 7112renumberedby H.R. 9877 Sec. 5406(b)

    The bill says: by redesignating paragraphs (6) through (8) as paragraphs (7) through (9), respectively; and

    Bill text · Current law (20 U.S.C. 7112)

  541. 20 U.S.C. 7112added (6)by H.R. 9877 Sec. 5406(b)

    (6) Menstrual products.— The term menstrual products means sanitary napkins and tampons that conform to applicable industry standards.

    The bill says: by inserting after paragraph (5) the following:

    Bill text · Current law (20 U.S.C. 7112)

  542. 42 U.S.C. 11346(a)(5)changedby H.R. 9877 Sec. 5406(e)

    The bill says: in paragraph (5), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 11346)

  543. 42 U.S.C. 11346(a)(6)changedby H.R. 9877 Sec. 5406(e)

    The bill says: in paragraph (6), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 11346)

  544. 42 U.S.C. 11346(a)added (7)by H.R. 9877 Sec. 5406(e)

    (7) guidelines that ensure that amounts provided under the program to private nonprofit organizations and local governments may be used to provide sanitary napkins and tampons that conform to applicable industry standards.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 11346)

  545. 29 U.S.C. 655added (h)by H.R. 9877 Sec. 5406(g)

    (h) The Secretary shall by rule promulgate a requirement that each employer with not less than 100 employees provide menstrual products free of charge for employees of the employer. For purposes of the preceding sentence, "menstrual products" means sanitary napkins and tampons that conform to applicable industry standards.

    The bill says: Section 6 of the Occupational Safety and Health Act of 1970 (29 U.S.C. 655) is amended by adding at the end the following:

    Bill text · Current law (29 U.S.C. 655)

  546. 42 U.S.C. 603(a)added (6)by H.R. 9877 Sec. 5406(k)

    (6) Grants for menstrual products.—(A) In general.— The Secretary may make grants, on a competitive basis, for each fiscal year to eligible applicants for the grants, in such amounts as the Secretary deems appropriate to enable the eligible applicants to provide, to covered families that include an individual who is capable of menstruating, such benefits as are needed to ensure that the individual can purchase menstrual products for personal use.(B) Definitions.— In subparagraph (A):(i) Covered families.— The term covered families means families eligible for assistance under a State program funded under this part.(ii) Eligible applicant.— The term eligible applicant means—(I) a State to which a grant is made under paragraph (1) for a fiscal year; and(II) a political subdivision of a State that administers the State program funded under this part in the political subdivision.(iii) Menstrual products.— The term menstrual products means menstrual cups, menstrual discs, menstrual underwear, and sanitary napkins and tampons, that conform to applicable industry standards.(C) Consideration of applications.— The Secretary shall award grants under this paragraph on the basis of how effectively the programs proposed by the eligible applicants will help low-income individuals suffering from material deprivation meet their need for menstrual products.(D) Administration.— A State or political subdivision to which a grant is made under this paragraph may use the grant to provide benefits under this paragraph in such form and in such manner as the State or political subdivision deems appropriate.(E) Treatment of assistance.— Benefits provided using funds made available under this paragraph shall not be considered assistance under any State program funded under this part.(F) Appropriation.— Out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated for fiscal year 2027 and each succeeding fiscal year $10,000,000 for grants under this paragraph.

    The bill says: Section 403(a) of the Social Security Act (42 U.S.C. 603(a)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 603)

  547. 42 U.S.C. 613renumberedby H.R. 9877 Sec. 5406(k)

    (h) Evaluations of grants for menstrual products.—(1) In general.— The Secretary shall submit to the Congress reports, in writing, that evaluate the effectiveness of the benefit program provided for in section 403(a)(6). Each such report shall, for the period covered by the report—(A) describe—(i) the extent of material deprivation in the population, including lacking sufficient funds to regularly purchase necessities such as menstrual products; and(ii) the extent to which the program alleviated such material deprivation;(B) specify the number and identity of the entities to which a grant has been made under such section, and the amount of the grant made to each such entity;(C) describe how the grantees used the grants to provide benefits under the program;(D) specify the number of individuals who received the benefits;(E) describe how efficacious the program has been in helping low-income individuals meet their need for menstrual products;(F) describe the extent to which the program has improved the economic security of the benefit recipients; and(G) include such other relevant information as the Secretary deems appropriate.(2) Timing.— The Secretary shall submit a report that meets the requirements of paragraph (1) within 2 years after the date of the enactment of this paragraph and every 2 years thereafter.

    The bill says: Section 413 of such Act (42 U.S.C. 613) is amended by redesignating subsection (h) as subsection (i) and inserting after subsection (g) the following:

    Bill text · Current law (42 U.S.C. 613)

  548. 42 U.S.C. 1395x(b)(6)changedby H.R. 9877 Sec. 5408(a)

    The bill says: in paragraph (6), by striking "; or" at the end and inserting ", or in the case of services in a hospital or osteopathic hospital by a student midwife or an intern or resident-in-training under a teaching program previously described in this paragraph who is in the field of obstetrics and gynecology, if such student midwife, intern, or resident-in-training is supervised by a certified nurse-midwife or certified midwife to the extent permitted under applicable State law and as may be authorized by the hospital;";

    Bill text · Current law (42 U.S.C. 1395x)

  549. 42 U.S.C. 1395x(b)(7)changedby H.R. 9877 Sec. 5408(a)

    The bill says: in paragraph (7), by striking the period at the end and inserting "; or"; and

    Bill text · Current law (42 U.S.C. 1395x)

  550. 42 U.S.C. 1395x(b)added (8)by H.R. 9877 Sec. 5408(a)

    (8) a certified nurse-midwife or certified midwife where the hospital has a teaching program approved as specified in paragraph (6), if—(A) the hospital elects to receive any payment due under this title for reasonable costs of such services; and(B) all certified nurse-midwives or certified midwives in such hospital agree not to bill charges for professional services rendered in such hospital to individuals covered under the insurance program established by this title.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395x)

  551. 42 U.S.C. 1397dd(a)(28)rewrittenby H.R. 9877 Sec. 5501(a)

    The bill says: Section 2104(a)(28) of the Social Security Act (42 U.S.C. 1397dd(a)(28)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1397dd)

  552. 42 U.S.C. 1397dd(m)(2)(B)changedby H.R. 9877 Sec. 5501(a)

    The bill says: in the matter preceding clause (i), by striking "through (27)" and inserting "through (28)"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  553. 42 U.S.C. 1397dd(m)(2)(B)(i)changedby H.R. 9877 Sec. 5501(a)

    The bill says: in clause (i), by striking "2023, and 2029" and inserting "and 2023";

    Bill text · Current law (42 U.S.C. 1397dd)

  554. 42 U.S.C. 1397dd(m)(7)(A)changedby H.R. 9877 Sec. 5501(a)

    The bill says: in subparagraph (A), by striking "and ending with fiscal year 2029,"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  555. 42 U.S.C. 1397dd(m)(7)changedby H.R. 9877 Sec. 5501(a)

    The bill says: in the flush left matter at the end, by striking "fiscal year 2026, or fiscal year 2028" and inserting "fiscal year 2026, or a subsequent even-numbered fiscal year";

    Bill text · Current law (42 U.S.C. 1397dd)

  556. 42 U.S.C. 1397dd(m)(9)changedby H.R. 9877 Sec. 5501(a)

    The bill says: by striking "(10), or (11)" and inserting "or (10)"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  557. 42 U.S.C. 1397dd(m)(9)changedby H.R. 9877 Sec. 5501(a)

    The bill says: by striking "2023, or 2029," and inserting "or 2023"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  558. 42 U.S.C. 1397dd(m)removedby H.R. 9877 Sec. 5501(a)

    The bill says: by striking paragraph (11).

    Bill text · Current law (42 U.S.C. 1397dd)

  559. Public Law 115-123(b)(2)repealedby H.R. 9877 Sec. 5501(a)

    The bill says: Section 50101(b)(2) of the Bipartisan Budget Act of 2018 (Public Law 115–123) is repealed.

    Bill text

  560. 42 U.S.C. 1396a(e)(13)removedby H.R. 9877 Sec. 5501(b)

    The bill says: Section 1902(e)(13) of the Social Security Act (42 U.S.C. 1396a(e)(13)) is amended by striking subparagraph (I).

    Bill text · Current law (42 U.S.C. 1396a)

  561. 42 U.S.C. 1397ee(d)(3)changedby H.R. 9877 Sec. 5501(b)

    The bill says: in the paragraph heading, by striking "through September 30, 2029"; and

    Bill text · Current law (42 U.S.C. 1397ee)

  562. 42 U.S.C. 1397ee(d)(3)(A)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "During the period that begins on the date of enactment of the Patient Protection and Affordable Care Act and ends on September 30, 2029" and inserting "Beginning on the date of the enactment of the Patient Protection and Affordable Care Act";

    Bill text · Current law (42 U.S.C. 1397ee)

  563. 42 U.S.C. 1397ee(d)(3)(A)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "During the period that begins on October 1, 2019, and ends on September 30, 2029" and inserting "Beginning on October 1, 2019"; and

    Bill text · Current law (42 U.S.C. 1397ee)

  564. 42 U.S.C. 1397ee(d)(3)(A)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "The preceding sentences shall not be construed as preventing a State during any such periods from" and inserting "The preceding sentences shall not be construed as preventing a State from".

    Bill text · Current law (42 U.S.C. 1397ee)

  565. 42 U.S.C. 1396a(gg)(2)changedby H.R. 9877 Sec. 5501(b)

    The bill says: in the paragraph heading, by striking "through September 30, 2029"; and

    Bill text · Current law (42 U.S.C. 1396a)

  566. 42 U.S.C. 1396a(gg)(2)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "through September 30" and all that follows through "ends on September 30, 2029" and inserting "(but beginning on October 1, 2019".

    Bill text · Current law (42 U.S.C. 1396a)

  567. 42 U.S.C. 1397ee(g)(4)changedby H.R. 9877 Sec. 5501(b)

    The bill says: in the paragraph heading, by striking "for fiscal years 2009 through 2029" and inserting "after fiscal year 2008"; and

    Bill text · Current law (42 U.S.C. 1397ee)

  568. 42 U.S.C. 1397ee(g)(4)(A)changedby H.R. 9877 Sec. 5501(b)

    The bill says: in subparagraph (A), by striking "for any of fiscal years 2009 through 2029" and inserting "for any fiscal year after fiscal year 2008".

    Bill text · Current law (42 U.S.C. 1397ee)

  569. 42 U.S.C. 1397mm(a)(1)changedby H.R. 9877 Sec. 5501(b)

    The bill says: in paragraph (1), by striking "during the period of fiscal years 2009 through 2029" and inserting ", beginning with fiscal year 2009,";

    Bill text · Current law (42 U.S.C. 1397mm)

  570. 42 U.S.C. 1397mm(a)(2)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "10 percent of such amounts" and inserting "10 percent of such amounts for the period or the fiscal year for which such amounts are appropriated"; and

    Bill text · Current law (42 U.S.C. 1397mm)

  571. 42 U.S.C. 1397mm(a)(2)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "during such period" and inserting ", during such period or such fiscal year,"; and

    Bill text · Current law (42 U.S.C. 1397mm)

  572. 42 U.S.C. 1397mm(a)(3)changedby H.R. 9877 Sec. 5501(b)

    The bill says: in paragraph (3), by striking "For the period of fiscal years 2024 through 2029, an amount equal to 10 percent of such amounts" and inserting "Beginning with fiscal year 2024, an amount equal to 10 percent of such amounts for the period or the fiscal year for which such amounts are appropriated"; and

    Bill text · Current law (42 U.S.C. 1397mm)

  573. 42 U.S.C. 1397mm(g)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "and $40,000,000" and inserting "$40,000,000"; and

    Bill text · Current law (42 U.S.C. 1397mm)

  574. 42 U.S.C. 1397mm(g)addedby H.R. 9877 Sec. 5501(b)

    The bill says: by inserting after "fiscal years 2028 and 2029," the following: "$12,000,000 for fiscal year 2030, and, for each fiscal year after fiscal year 2030, the amount appropriated under this subsection for the previous fiscal year, increased by the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over such previous fiscal year,".

    Bill text · Current law (42 U.S.C. 1397mm)

  575. 42 U.S.C. 1397dd(n)(2)(A)(ii)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "and 2024 through 2028" and inserting "and for each fiscal year after fiscal year 2023"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  576. 42 U.S.C. 1397dd(n)(2)(A)(ii)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "2023, and 2029" and inserting "and 2023"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  577. 42 U.S.C. 1397dd(n)(2)(B)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "2024 through 2028" and inserting "and for each fiscal year after fiscal year 2023"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  578. 42 U.S.C. 1397dd(n)(2)(B)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "2023, and 2029" and inserting "and 2023"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  579. 42 U.S.C. 1397dd(n)(3)(A)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "fiscal years 2024 through 2028" and inserting "a fiscal year after fiscal year 2023"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  580. 42 U.S.C. 1397dd(n)(3)(A)changedby H.R. 9877 Sec. 5501(b)

    The bill says: by striking "2023, or 2027" and inserting "or 2023".

    Bill text · Current law (42 U.S.C. 1397dd)

  581. 2 U.S.C. 905(h)addedby H.R. 9877 Sec. 5502(a)

    Targeted funding for States for diaper assistance (including diapering supplies and adult incontinence materials and supplies) through the Social Services Block Grant Program.

    The bill says: Section 255(h) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 905(h)) is amended by inserting after "Supplemental Security Income Program (28–0406–0–1–609)." the following:

    Bill text · Current law (2 U.S.C. 905)

  582. 42 U.S.C. 1396n(c)added (12)by H.R. 9877 Sec. 5502(b)

    (12)(A) In the case of any waiver under this subsection that provides medical assistance to a medically complex child who has been diagnosed with bowel or bladder incontinence, a bowel or bladder condition that causes excess urine or stool (such as short gut syndrome or diabetes insipidus), or a severe skin condition that causes skin erosions (such as epidermolysis bullosa), such medical assistance shall include, for the duration of the waiver, the provision of 200 medically necessary diapers per month and diapering supplies. Such medical assistance may include the provision of medically necessary diapers in amounts greater than 200 if a licensed health care provider (such as a physician, nurse practitioner, or physician assistant) specifies that such greater amounts are necessary for such medically complex child.(B) For purposes of this paragraph:(i) The term medically complex child means an individual who has attained age 3 and for whom a licensed health care provider has provided a diagnosis of 1 or more significant chronic conditions.(ii) The term medically necessary diaper means an absorbent garment that is—(I) washable or disposable;(II) worn by a medically complex child who has been diagnosed with a condition described in subparagraph (A) and needs such garment to correct or ameliorate such condition; and(III) if disposable—(aa) does not use any latex or common allergens; and(bb) meets or exceeds the quality standards for diapers commercially available through retail sale in the following categories:(AA) Absorbency (with acceptable rates for first and second wetting).(BB) Waterproof outer cover.(CC) Flexible leg openings.(DD) Refastening closures.(iii) The term diapering supplies means items, including diaper wipes and diaper creams, necessary to ensure that a medically complex child who has been diagnosed with a condition described in subparagraph (A) and uses a medically necessary diaper is properly cleaned and protected from diaper rash.

    The bill says: Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396n)

  583. 26 U.S.C. 223(d)(2)changedby H.R. 9877 Sec. 5502(c)

    The bill says: by inserting ", medically necessary diapers, and diapering supplies" after "menstrual care products" in the last sentence of subparagraph (A); and

    Bill text · Current law (26 U.S.C. 223)

  584. 26 U.S.C. 223(d)(2)added (E)by H.R. 9877 Sec. 5502(c)

    (E) Medically necessary diapers and diapering supplies.— For purposes of this paragraph—(i) Medically necessary diapers.— The term medically necessary diaper means an absorbent garment which is washable or disposable and which is worn by an individual who has attained 3 years of age because of medical necessity, such as someone who has been diagnosed with bowel or bladder incontinence, a bowel or bladder condition that causes excess urine or stool (such as short gut syndrome or diabetes insipidus), or a severe skin condition that causes skin erosions (such as epidermolysis bullosa) and needs such garment to correct or ameliorate such condition, to serve a preventative medical purpose, or to correct or ameliorate defects or physical or mental illnesses or conditions diagnosed by a licensed health care provider, and, if disposable—(I) does not use any latex or common allergens; and(II) meets or exceeds the quality standards for diapers commercially available through retail sale in the following categories:(aa) Absorbency (with acceptable rates for first and second wetting).(bb) Waterproof outer cover.(cc) Flexible leg openings.(dd) Refastening closures.(ii) Diapering supplies.— The term diapering supplies means items, including diaper wipes and diaper creams, necessary to ensure that an individual wearing medically necessary diapers is properly cleaned and protected from diaper rash.

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (26 U.S.C. 223)

  585. 42 U.S.C. 701(a)(1)(B)changedby H.R. 9877 Sec. 5701(1)

    The bill says: in paragraph (1)(B), by inserting "to reduce the incidence of stillbirth," after "among children,"; and

    Bill text · Current law (42 U.S.C. 701)

  586. 42 U.S.C. 701(a)(2)addedby H.R. 9877 Sec. 5701(2)

    The bill says: in paragraph (2), by inserting after "follow-up services" the following: ", and for evidence-based programs and activities and outcome research to reduce the incidence of stillbirth (including tracking and awareness of fetal movements, improvement of birth timing for pregnancies with risk factors, initiatives that encourage safe sleeping positions during pregnancy, screening and surveillance for fetal growth restriction, efforts to achieve smoking cessation during pregnancy, community-based programs that provide home visits or other types of support, and any other research or evidence-based programming to prevent stillbirths)".

    Bill text · Current law (42 U.S.C. 701)

  587. 42 U.S.C. 1395x(s)(2)(KK)changedby H.R. 9877 Sec. 6101(a)

    The bill says: in subparagraph (KK), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395x)

  588. 42 U.S.C. 1395x(s)(2)changedby H.R. 9877 Sec. 6101(a)

    The bill says: by inserting "and" at the end of subparagraph (LL); and

    Bill text · Current law (42 U.S.C. 1395x)

  589. 42 U.S.C. 1395x(s)(2)added (MM)by H.R. 9877 Sec. 6101(a)

    (MM) substance use disorder counselor services (as defined in subsection (rrr)(1)), and peer support specialist services (as defined in subsection (rrr)(3));

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  590. 42 U.S.C. 1395xadded (rrr)by H.R. 9877 Sec. 6101(a)

    (rrr) Substance use disorder counselor services; substance use disorder counselor; peer support specialist services; peer support specialist.—(1) The term substance use disorder counselor services means services performed by a substance use disorder counselor (as defined in paragraph (2)) for the diagnosis and treatment of substance use disorder and addiction that the substance use disorder counselor is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician’s professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.(2) The term substance use disorder counselor means an individual who—(A) has performed at least 2 years of supervised substance use disorder counselor practice;(B) in the case of an individual performing services in a State that provides for licensure or certification of substance use disorder counselors or professional counselors, is licensed or certified as a substance use disorder counselor or professional counselor in such State; or(C) is a drug and alcohol counselor as described in section 40.281(a)(6) of title 49, Code of Federal Regulations.(3) The term peer support specialist services means services performed by a peer support specialist (as defined in paragraph (4)) for the well-being of individuals needing mental health support that the peer support specialist is legally authorized to perform under State law (or the State regulatory mechanism provided by the State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician’s professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.(4) The term peer support specialist means an individual who—(A) is an individual living in recovery with mental illness, addiction, or justice system involvement;(B) has skills learned in formal training;(C) uses assets-based framing in speaking about mental health, recovery, and well-being; and(D) delivers services in behavioral health settings to promote mind-body recovery and resiliency.

    The bill says: Section 1861 of the Social Security Act (42 U.S.C. 1395x), as amended by sections 2007(b), 4221(a), and 4251(c)(2), is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  591. 42 U.S.C. 1395k(a)(2)(B)added (v)by H.R. 9877 Sec. 6101(a)

    (v) substance use disorder counselor services and peer support specialist services;

    The bill says: Section 1832(a)(2)(B) of the Social Security Act (42 U.S.C. 1395k(a)(2)(B)) is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1395k)

  592. 42 U.S.C. 1395l(a)(1)changedby H.R. 9877 Sec. 6101(a)

    The bill says: by striking "and" before "(II)"; and

    Bill text · Current law (42 U.S.C. 1395l)

  593. 42 U.S.C. 1395l(a)(1)addedby H.R. 9877 Sec. 6101(a)

    The bill says: by inserting before the semicolon at the end the following: ", and (JJ) with respect to substance use disorder counselor services and peer support specialist services under section 1861(s)(2)(MM), the amounts paid shall be 80 percent of the lesser of the actual charge for the services or 75 percent of the amount determined for payment of a psychologist under subparagraph (L)".

    Bill text · Current law (42 U.S.C. 1395l)

  594. 42 U.S.C. 1395yy(e)(2)(A)(ii)changedby H.R. 9877 Sec. 6101(a)

    The bill says: Section 1888(e)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting "peer support specialist services (as defined in section 1861(rrr)(3))," after "mental health counselor services (as defined in section 1861(lll)(3))".

    Bill text · Current law (42 U.S.C. 1395yy)

  595. 42 U.S.C. 1395u(b)(18)(C)added (ix)by H.R. 9877 Sec. 6101(a)

    (ix) A substance use disorder counselor (as defined in section 1861(rrr)(2)).(x) A peer support specialist (as defined in section 1861(rrr)(4)).

    The bill says: Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clauses:

    Bill text · Current law (42 U.S.C. 1395u)

  596. 42 U.S.C. 1395x(aa)(1)(B)changedby H.R. 9877 Sec. 6101(b)

    The bill says: Section 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(1)(B)) is amended by striking "or by a mental health counselor (as defined in subsection (lll)(4))" and inserting "by a mental health counselor (as defined in subsection (lll)(4)), by a substance use disorder counselor (as defined in subsection (rrr)(2)), or by a peer support specialist (as defined in subsection (rrr)(4))".

    Bill text · Current law (42 U.S.C. 1395x)

  597. 42 U.S.C. 290ll(c)changedby H.R. 9877 Sec. 6102

    The bill says: Section 597(c) of the Public Health Service Act (42 U.S.C. 290ll(c)) is amended by striking "$25,000,000 for each of fiscal years 2023 through 2027" and inserting "$36,700,000 for each of fiscal years 2027 through 2031".

    Bill text · Current law (42 U.S.C. 290ll)

  598. 42 U.S.C. 290ddadded 554by H.R. 9877 Sec. 6202

    554 Interprofessional health care teams for provision of behavioral health care in primary care settings.—(a) Grants.— The Secretary, acting through the Assistant Secretary, shall award grants to eligible entities for the purpose of establishing interprofessional health care teams that provide behavioral health care.(b) Eligible entities.— To be eligible to receive a grant under this section, an entity shall be a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act), rural health clinic, women’s health clinic, or behavioral health program (including any such program operated by a community-based organization) serving a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)).(c) Loan forgiveness.— To encourage qualified and diverse allied health professionals to enter the mental health field, an eligible entity receiving a grant under this section shall agree to use not less than $10,000 of the grant funds on a loan forgiveness program for practitioners who commit to working in the mental health field for a period of 2 years.(d) Scientifically and culturally based.— Integrated health care funded through this section shall be scientifically and culturally based, taking into consideration the results of the most recent peer-reviewed research available, including information on language accessibility, cultural humility, diversity of practitioners, and consideration of social determinants of health.(e) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $20,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 290dd)

  599. 42 U.S.C. 290ddadded 555by H.R. 9877 Sec. 6203

    555 Interprofessional health care teams for provision of behavioral health care in primary care settings.—(a) Grants.— The Secretary shall award grants to eligible entities for the purpose of establishing interprofessional health care teams that provide behavioral health care.(b) Eligible entities.— To be eligible to receive a grant under this section, an entity shall be a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act), rural health clinic, or behavioral health program, serving a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)).(c) Scientifically based.— Integrated health care funded through this section shall be scientifically based, taking into consideration the results of the most recent peer-reviewed research available.(d) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated $20,000,000 for each of the first 5 fiscal years following the date of enactment of the Health Equity and Accountability Act 2026.

    The bill says: Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.), as amended by section 6202, is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 290dd)

  600. 42 U.S.C. 254badded VIby H.R. 9877 Sec. 6401

    VI Pediatric behavioral health programs.—340A–1. Program to improve access to community-based pediatric behavioral health care.—(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants, contracts, or cooperative agreements to eligible entities for the purpose of supporting pediatric behavioral health care integration and coordination within communities to meet local community needs.(b) Eligible entities.— Entities eligible for grants under subsection (a) include—(1) health care providers, including family physicians, pediatric medical sub-specialists, and surgical specialists;(2) children’s hospitals;(3) facilities that are eligible to receive funds under section 340E or 340H;(4) nonprofit medical facilities that predominantly treat individuals under the age of 21;(5) rural health clinics and Federally qualified health centers (as such terms are defined in section 1861(aa) of the Social Security Act);(6) pediatric mental health and substance use disorder providers, such as child and adolescent psychiatrists, psychologists, developmental and behavioral pediatricians, general pediatricians, advanced practice nurses, social workers, licensed professional counselors, and other licensed professionals that provide mental health and substance use disorder services to patients under 21 years of age;(7) children's advocacy centers described in section 214(c)(2)(B) of the Victims of Child Abuse Act of 1990;(8) school-based health centers; and(9) other entities as determined appropriate by the Secretary.(c) Prioritization.— In making awards under subsection (a), the Secretary shall prioritize—(1) applicants that provide children and adolescents from high-need, rural, or under-resourced communities with services across the continuum of children's mental health and substance use disorder care; and(2) applicants that predominantly provide care to children and adolescents that demonstrate plans to utilize funds to expand provision of care to children, adolescents, and youth under age 21.(d) Use of funds.— Activities that may be funded through an award under subsection (a) include—(1) increasing the capacity of pediatric practices, family medicine practices, and school-based health centers to integrate pediatric mental, emotional, and behavioral health services into their practices including through co-location of mental, emotional, and behavioral health providers;(2) training for non-clinical pediatric health care workers, including care coordinators and navigators, on child and adolescent mental health and substance use disorder, trauma-informed care, and local resources to support children and caregivers;(3) expanding evidence-based, integrated models of care for pediatric mental health and substance use disorder services;(4) pediatric practice integration for the provision of pediatric mental health and substance use disorder services;(5) addressing surge capacity for pediatric mental health and substance use disorder needs;(6) providing pediatric mental, emotional, and behavioral health services to children as delivered by mental health and substance use disorder professionals utilizing telehealth services;(7) establishing or maintaining initiatives to allow more children to access care outside of emergency departments, including partial hospitalization, step down residency programs, and intensive outpatient programs;(8) supporting, enhancing, or expanding pediatric mental health and substance use disorder preventive and crisis intervention services;(9) establishing or maintaining pediatric mental health and substance use disorder urgent care or walk-in clinics;(10) establishing or maintaining community-based pediatric mental health and substance use disorder initiatives, such as partnerships with schools and early childhood education programs;(11) addressing other access and coordination gaps to pediatric mental health and substance use disorder services in the community for children; and(12) supporting the collection of data on children and adolescents’ mental health needs, service utilization and availability, and demographic data, to capture community needs and identify gaps and barriers in children's access to care, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws.(e) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2027 through 2031.340A–2. Pediatric behavioral health workforce training program.—(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants, contracts, or cooperative agreements to eligible entities for the purpose of supporting evidence-based pediatric mental health and substance use disorder workforce training.(b) Eligible entities.— Entities eligible for grants under subsection (a) include—(1) children’s hospitals;(2) facilities that are eligible to receive funds under section 340E or 340H;(3) nonprofit medical facilities that predominantly treat individuals under the age of 21;(4) rural health clinics and Federally qualified health centers (as such terms are defined in section 1861(aa) of the Social Security Act);(5) entities that employ mental health and substance use disorder professionals, such as child and adolescent psychiatrists, psychologists, developmental and behavioral pediatricians, general pediatricians, advanced practice nurses, social workers, licensed professional counselors, or other licensed professionals that provide mental health or substance use disorder services to patients under 21 years of age; and(6) other pediatric health care providers as determined appropriate by the Secretary.(c) Use of funds.— Activities that may be supported through an award under subsection (a) include the following:(1) Training

    The bill says: Part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended by inserting after subpart V the following new subpart:

    Bill text · Current law (42 U.S.C. 254b)

  601. 42 U.S.C. 201added XXXVby H.R. 9877 Sec. 6402

    XXXV Assistance for construction and modernization of children’s mental health and substance use disorder infrastructure.—3501 Increasing Federal investment in pediatric behavioral health services.—(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants, contracts, or cooperative agreements to eligible entities for the purpose of improving their ability to provide pediatric behavioral health services, including by—(1) constructing or modernizing sites of care for pediatric behavioral health services;(2) expanding capacity to provide pediatric behavioral health services, including enhancements to digital infrastructure, telehealth capabilities, or other improvements to patient care infrastructure;(3) supporting the reallocation of existing resources to accommodate pediatric behavioral health patients, including by converting or adding a sufficient number of beds to establish or increase the hospital’s inventory of licensed and operational, short-term psychiatric and substance use inpatient beds; and(4) addressing gaps in the continuum of care for children, by expanding capacity to provide intermediate levels of care, such as intensive outpatient services, partial hospitalization programs, and day programs that can prevent hospitalizations and support children as they transition back to their homes and communities.(b) Eligibility.— To be eligible to seek an award under this section, an entity shall be a hospital or rural health clinic that predominantly treats individuals under the age of 21, including any hospital that receives funds under section 340E.(c) Authorization of appropriations.— To carry out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2027 through 2031.(d) Supplement, not supplant.— Funds provided under this section shall be used to supplement, not supplant Federal and non-Federal funds available for carrying out the activities described in this section.(e) Reporting.—(1) Reports from award recipients.— Not later than 180 days after the completion of activities funded by an award under this section, the entity that received such award shall submit a report to the Secretary on the activities conducted using funds from such award, and other information as the Secretary may require.(2) Reports to Congress.— Not later than one year after the completion of activities funded by an award under this section, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on the projects and activities conducted with funds awarded under this section, and the outcome of such projects and activities. Such report shall include—(A) the number of projects supported by awards made under this section;(B) an overview of the impact, if any, of such projects on pediatric health care infrastructure, including any impact on access to pediatric mental health and substance use disorder services;(C) recommendations for improving the investment program under this section; and(D) any other considerations as the Secretary determines appropriate.

    The bill says: The Public Health Service Act (42 U.S.C. 201 et seq.) (as amended by section 2004) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 201)

  602. 42 U.S.C. 290hhrewrittenby H.R. 9877 Sec. 6403(a)

    581 School-based mental health; children and adolescents.—(a) In general.— The Secretary, in consultation with the Secretary of Education, shall, through grants, contracts, or cooperative agreements awarded to eligible entities described in subsection (c), provide comprehensive school-based mental health services and supports to assist children in local communities and schools (including schools funded by the Bureau of Indian Education) dealing with traumatic experiences, grief, bereavement, risk of suicide, and violence. Such services and supports shall—(1) be developmentally, linguistically, and culturally appropriate;(2) be trauma-informed; and(3) incorporate positive behavioral interventions and supports.(b) Activities.— Grants, contracts, or cooperative agreements awarded under subsection (a), shall, as appropriate, be used for—(1) implementation of school- and community-based mental health programs that—(A) build awareness of individual trauma and the intergenerational, continuum of impacts of trauma on populations;(B) train appropriate staff to identify, and screen for, signs of trauma exposure, mental health disorders, or risk of suicide; and(C) incorporate positive behavioral interventions, family engagement, student treatment, and multigenerational supports to foster the health and development of children, prevent mental health disorders, and ameliorate the impact of trauma;(2) technical assistance to local communities with respect to the development of programs described in paragraph (1);(3) facilitating community partnerships among families, students, law enforcement agencies, education agencies, mental health and substance use disorder service systems, family-based mental health service systems, child welfare agencies, health care providers (including primary care physicians, mental health professionals, and other professionals who specialize in children’s mental health such as child and adolescent psychiatrists), institutions of higher education, faith-based programs, trauma networks, and other community-based systems to address child and adolescent trauma, mental health issues, and violence; and(4) establishing mechanisms for children and adolescents to report incidents of violence or plans by other children, adolescents, or adults to commit violence.(c) Requirements.—(1) In general.— To be eligible for a grant, contract, or cooperative agreement under subsection (a), an entity shall be a partnership that includes—(A) a State educational agency, as defined in section 8101 of the Elementary and Secondary Education Act of 1965, in coordination with one or more local educational agencies, as defined in section 8101 of the Elementary and Secondary Education Act of 1965, or a consortium of any entities described in subparagraph (B), (C), (D), or (E) of section 8101(30) of such Act; and(B) at least 1 community-based mental health provider, including a public or private mental health entity, health care entity, family-based mental health entity, trauma network, or other community-based entity, as determined by the Secretary (and which may include additional entities such as a human services agency, law enforcement or juvenile justice entity, child welfare agency, an institution of higher education, or another entity, as determined by the Secretary).(2) Compliance with HIPAA.— Any patient records developed by covered entities through activities under the grant shall meet the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996.(3) Compliance with FERPA.— Section 444 of the General Education Provisions Act (commonly known as the "Family Educational Rights and Privacy Act of 1974") shall apply to any entity that is a member of the partnership in the same manner that such section applies to an educational agency or institution (as that term is defined in such section).(d) Geographical distribution.— The Secretary shall ensure that grants, contracts, or cooperative agreements under subsection (a) will be distributed equitably among the regions of the country and among urban and rural areas.(e) Duration of awards.— With respect to a grant, contract, or cooperative agreement under subsection (a), the period during which payments under such an award will be made to the recipient shall be 5 years, with options for renewal.(f) Evaluation and measures of outcomes.—(1) Development of process.— The Assistant Secretary shall develop a fiscally appropriate process for evaluating activities carried out under this section. Such process shall include—(A) the development of guidelines for the submission of program data by grant, contract, or cooperative agreement recipients;(B) the development of measures of outcomes (in accordance with paragraph (2)) to be applied by such recipients in evaluating programs carried out under this section; and(C) the submission of annual reports by such recipients concerning the effectiveness of programs carried out under this section.(2) Measures of outcomes.— The Assistant Secretary shall develop measures of outcomes to be applied by recipients of assistance under this section to evaluate the effectiveness of programs carried out under this section, including outcomes related to the student, family, and local educational systems supported by this Act.(3) Submission of annual data.— An eligible entity described in subsection (c) that receives a grant, contract, or cooperative agreement under this section shall annually submit to the Assistant Secretary a report that includes data to evaluate the success of the program carried out by the entity based on whether such program is achieving the purposes of the program. Such reports shall utilize the measures of outcomes under paragraph (2) in a reasonable manner to demonstrate the progress of the program in achieving such purposes.(4) Evaluation by assistant secretary.— Based on the data submitted under paragraph (3), the Assistant Sec

    The bill says: Section 581 of the Public Health Service Act (42 U.S.C. 290hh) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 290hh)

  603. 42 U.S.C. 290hhchangedby H.R. 9877 Sec. 6403(b)

    The bill says: Part G of title V of the Public Health Service Act (42 U.S.C. 290hh et seq.), as amended by subsection (a), is amended by striking the part designation and heading and inserting the following:

    Bill text · Current law (42 U.S.C. 290hh)

  604. 42 U.S.C. 1396badded (cc)by H.R. 9877 Sec. 6404

    (cc) Youth and young adult intervention services.—(1) In general.— Notwithstanding section 1902(a)(1) (relating to Statewideness), section 1902(a)(10)(B) (relating to comparability), section 1902(a)(23)(A) (relating to freedom of choice of providers), or section 1902(a)(27) (relating to provider agreements), a State may, during the 5-year period beginning on the first day of the fiscal year quarter that begins on or after January 1, 2027, provide medical assistance for qualifying youth and young adult mental health and substance use intervention services (as defined in paragraph (2)(C)) under a State plan amendment or waiver approved under section 1115 or 1915(c).(2) Definitions.— For the purposes of this subsection:(A) Priority service.— The term priority service means any of the following, if voluntarily received and provided in a manner that maintains the privacy and confidentiality of patient information consistent with Federal and State requirements:(i) Qualifying community-based mobile crisis intervention services, as defined in section 1947.(ii) Telehealth.(iii) Youth peer support.(iv) Screening for adverse childhood experiences.(v) Trauma responsive care.(vi) Other priority services for youth, as defined by the Secretary.(B) Qualified mental health provider.— The term qualified mental health provider means a behavioral health care professional who is capable of conducting an assessment of an individual described in subparagraph (C)(i), in accordance with the professional’s permitted scope of practice under State law, and any other professional or paraprofessional with appropriate expertise in youth and young adult behavioral health or mental health, including a social worker, peer support specialist, recovery coach, community health worker, mental health clinician, and any other provider designated by the State and approved by the Secretary.(C) Qualifying youth and young adult mental health and substance use intervention services defined.— The term qualifying youth and young adult mental health and substance use intervention services means, with respect to a State, items and services for which medical assistance is available under the State plan under this title or a waiver of such plan, that are—(i) furnished to an individual 16 to 25 years of age who is—(I) experiencing a mental health or substance use disorder crisis;(II) an offender, as defined in section 3 of the Workforce Innovation and Opportunity Act;(III)(aa) experiencing homelessness (as defined in section 41403(6) of the Violence Against Women Act of 1994);(bb) a homeless child or youth (as defined in section 725(2) of the McKinney-Vento Homeless Assistance Act);(cc) a runaway, is in foster care, or has aged out of the foster care system;(dd) a child eligible for assistance under section 477; or(ee) in an out-of-home placement;(IV) an individual who is pregnant or parenting, including—(aa) a custodial or non-custodial mother or father; or(bb) an expectant mother;(V) a youth who is an individual with a disability (as defined in section 3 of the Americans with Disabilities Act of 1990);(VI) a low-income youth requiring additional assistance to enter or complete an educational program or to secure or hold employment; or(VII) living in a community that has faced acute or long-term exposure to substantial discrimination, historical oppression, intergenerational poverty, civil unrest, or a high rate of violence or drug overdose deaths, as determined by the Secretary;(ii) furnished by a qualified mental health provider; and(iii) a priority service.(D) Telehealth.— The term telehealth means use of electronic information and telecommunications technologies, including voice only audio, text, remote patient monitoring, and mHealth through applications, to support clinical mental health care, patient and professional health-related education, public health, and health administration.(3) Payments.— Notwithstanding section 1905(b), beginning January 1, 2027, during each of the first 20 fiscal quarters that a State meets the requirements described in paragraph (4), the Federal medical assistance percentage applicable to amounts expended by the State for medical assistance for qualifying youth and young adult mental health and substance use intervention services furnished during such quarter shall be equal to 100 percent.(4) Requirements.— The requirements described in this paragraph are the following:(A) The State demonstrates, to the satisfaction of the Secretary, that the State will be able to support—(i) the provision of qualifying youth and young adult mental health and substance use intervention services in accordance with paragraph (1); and(ii) coordination between qualified mental health providers and substance use teams and community partners, including health care providers, to enable the provision of services, needed referrals, and other activities identified by the Secretary.(B) The State provides assurances satisfactory to the Secretary that—(i) any additional Federal funds received by the State for qualifying youth and young adult mental health and substance use intervention services provided under this subsection that are attributable to the increased Federal medical assistance percentage under paragraph (3) will be used to supplement, and not supplant, the level of State funds expended for such services for fiscal year 2027;(ii) if the State made qualifying youth and young adult mental health and substance use intervention services available in a region of the State in fiscal year 2026 the State will continue to make such services available in such region under this subsection at the same level that the State made such services available in such fiscal year; and(iii) the State will conduct the evaluation and assessment, and submit the report, required under paragraph (5).(5) State evaluation and report.—(A) State evaluation.— Not later than 4 fiscal quarters after a State begins

    The bill says: Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1396b)

  605. 42 U.S.C. 300x-1(b)(1)renumberedby H.R. 9877 Sec. 6405(a)

    The bill says: by redesignating subparagraph (E) as subparagraph (F); and

    Bill text · Current law (42 U.S.C. 300x-1)

  606. 42 U.S.C. 300x-1(b)(1)added (E)by H.R. 9877 Sec. 6405(a)

    (E) Early intervention and prevention programs for transition-age youth.— The plan shall describe the State’s plans to carry out demonstration grants or contracts for early intervention and prevention programs for transition-age youth of 16 to 25 years of age who meet one or more of the criteria specified in section 129(a)(1)(B) of the Workforce Innovation and Opportunity Act to be considered out-of-school youth.

    The bill says: by inserting after subparagraph (D) the following:

    Bill text · Current law (42 U.S.C. 300x-1)

  607. 42 U.S.C. 300x-9added (e)by H.R. 9877 Sec. 6405(b)

    (e) Early intervention and prevention programs for transition-Age youth.—(1) In general.— Except as provided in paragraph (2), a State shall expend at least 15 percent of the amount of the allotment of the State pursuant to a funding agreement under section 1911 for each fiscal year to support programs described in section 1912(b)(1)(E).(2) State flexibility.— In lieu of expending 15 percent of the amount of the allotment for a fiscal year as required by paragraph (1), a State may elect to expend not less than 30 percent of such amount to support such programs by the end of two consecutive fiscal years.

    The bill says: Section 1920 of the Public Health Service Act (42 U.S.C. 300x–9) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300x-9)

  608. 42 U.S.C. 290ddadded 556by H.R. 9877 Sec. 6501

    556 Behavioral outreach and education strategy.—(a) In general.— The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall, in coordination with advocacy and behavioral organizations serving populations of Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, Middle Eastern and North African (in this section referred to as "MENA"), and Hispanic and Latino/a/x individuals or communities, develop and implement an outreach and education strategy to promote behavioral health, emphasize that behavioral health conditions are treatable and that reasonable accommodations under section 504 of the Rehabilitation Act of 1973 and titles II and III of the Americans with Disabilities Act of 1990 are necessary and may help, as well as reduce stigma associated with mental health conditions and substance use disorder among the Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, MENA, and Hispanic and Latino/a/x populations. Such strategy shall—(1) be designed to—(A) meet the diverse cultural and language needs of the various Asian American, African American, Indigenous, MENA, Native Hawaiian, Pacific Islander, and Hispanic and Latino/a/x populations; and(B) ensure that approaches recommended in the strategy are developmentally (with respect to the beneficiary’s relative age and experience) and age appropriate, as well as cognitively accessible to persons with cognitive disabilities;(2) increase awareness of symptoms of mental illnesses common among such populations, taking into account differences within subgroups (such as gender, gender identity, age, sexual orientation, disability, and ethnicity) of such populations;(3) provide information on evidence-based, culturally and linguistically appropriate and adapted interventions and treatments;(4) ensure full participation of, and engage, both consumers and community members representing the communities of focus in the development and implementation of materials; and(5) seek to broaden the perspective among both individuals in such communities and stakeholders serving such communities to use a comprehensive public health approach to promoting behavioral health that addresses a holistic view of health by focusing on the intersection between behavioral and physical health.(b) Reports.— Beginning not later than 1 year after the date of the enactment of this section and annually thereafter, the Secretary, acting through the Assistant Secretary, shall submit to the Congress, and make publicly available, a report on the extent to which the strategy developed and implemented under subsection (a) increased behavioral health outcomes associated with mental health conditions and substance use disorder among Asian American, African American, Native Hawaiian, Pacific Islander, Indigenous, MENA, and Hispanic and Latino/a/x populations.(c) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2027 through 2032.

    The bill says: Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.), as amended by section 6203, is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 290dd)

  609. 42 U.S.C. 300x-52(a)renumberedby H.R. 9877 Sec. 6701(a)

    The bill says: by redesignating paragraphs (2) and (3) as paragraphs (5) and (6), respectively; and

    Bill text · Current law (42 U.S.C. 300x-52)

  610. 42 U.S.C. 300x-52(a)added (2)by H.R. 9877 Sec. 6701(a)

    (2) services provided by the State to adults with a serious mental illness and children with a serious emotional disturbance who are members of racial and ethnic minority groups, including—(A) the extent to which such services are provided to such adults and children; and(B) the outcomes experienced by such adults and children as a result of the provision of such services, including with respect to—(i) diversions from hospitalization and criminal justice system involvement;(ii) treatment for first episode psychosis or undefined psychosis;(iii) reductions in suicide and increased utilization of appropriate treatments and interventions for suicidal ideation;(iv) response through crisis services, including mobile crisis services;(v) treatment of individuals who are experiencing homelessness or housing insecurity and individuals residing in rural communities; and(vi) increased patient family and caregiver engagement and education on serious mental illness to reduce social stigma and promote healthy social support for patients;(3) any outreach by the State to, and the hiring of, providers of mental health services from multiple disciplines (such as a psychologist, psychiatrist, peer support provider, or social worker) who are members of racial and ethnic minority groups;(4) any outreach by the State to providers from multiple disciplines of mental health services—(A) to provide training on culturally effective, culturally affirming, and linguistically competent services; and(B) to increase awareness of community-defined practices by practitioners of racial and ethnic minority groups;

    The bill says: by inserting after paragraph (1) the following:

    Bill text · Current law (42 U.S.C. 300x-52)

  611. 42 U.S.C. 300kkadded 3102by H.R. 9877 Sec. 6702(a)

    3102 Data analysis and strategy implementation to prevent and mitigate childhood trauma.—(a) In general.— The Secretary shall establish a program—(1) to support the development and implementation of programs that use data analysis methods to identify and facilitate strategies for early intervention and prevention, in order to prevent and mitigate childhood trauma and support communities and families, including—(A) improving connections through care coordination;(B) aligning community initiatives in targeted areas of need; and(C) expanding community capacity through cross-sector collaboration; and(2) to evaluate the effectiveness of these programs in improving outcomes for children.(b) Grants.— The Secretary shall award grants to up to 5 eligible entities to carry out the activities described in subsection (a).(c) Use of funds.— A grant for activities under this section shall be used to support the development and implementation of programs that use data analysis methods to identify and facilitate strategies for early intervention and prevention, in order to prevent and mitigate childhood trauma and support communities and families, including as follows:(1) Utilize data analysis methods to—(A) identify specific geographic areas, such as census tracts, with a high prevalence of adverse childhood experiences and significant risk factors for poor outcomes for children (such as increased risk of experiencing adverse childhood experiences), including areas with high rates of—(i) poor public health outcomes including illness, disease, suicide, and mortality;(ii) exclusionary discipline practices, including suspensions, expulsions, and referrals to law enforcement, as well as low graduation rates;(iii) substance use disorders;(iv) poverty;(v) foster system involvement or referrals;(vi) housing instability and homelessness;(vii) food insecurity;(viii) inequity, including disparities in income, wealth, employment, educational attainment, health care access, and public health outcomes, along lines of race, sex, sexuality and gender identity, ethnicity, or nationality;(ix) incarceration rates; or(x) other indicators of adversity as defined by the Secretary; and(B) identify strategies to improve outcomes for children aged 0 through 17 that build on strengths in communities that could be further supported, including—(i) existing support networks for families; and(ii) enhanced connections to community-based organizations.(2) Implement strategies identified pursuant to paragraph (1)(B) to facilitate outreach and involvement of children and their caregivers in Federal, State, or local programs that provide reparative, gender-responsive, culturally specific, and trauma-informed prevention services, and for which children and their caregivers are eligible, including—(A) home visiting programs;(B) training and education on parenting skills;(C) substance use disorder prevention and treatment that is voluntary and noncoercive;(D) mental health supports and care that is voluntary and noncoercive;(E) family and intimate partner violence prevention services;(F) child advocacy center programming;(G) economic and nutrition support services;(H) housing support services, including emergency and temporary shelter for those experiencing homelessness and housing insecurity, as well as stable, long-term housing;(I) voluntary, noncoercive, gender-responsive, and culturally specific mental health supports in school and early childhood education center-based settings;(J) wraparound programs for transitioning youth and youth currently in the foster system;(K) programming to support the health and well-being of lesbian, gay, bisexual, transgender, and intersex children and their families; and(L) family resource center services.(d) Special rules.—(1) Primary payer restriction.— The Secretary may not award a grant under this section to an eligible entity for a service if the service to be provided is available pursuant to the State plan approved under title XIX of the Social Security Act for the State in which the program funded by the grant is being conducted unless the State and all eligible subdivisions involved—(A) will enter into agreements with public or nonprofit private entities under which the entities will provide the service; and(B) demonstrate that the State and all eligible subdivisions will ensure that the entities providing the service—(i) will seek payment for each such service rendered in accordance with the usual payment schedule under the State plan; and(ii) the entities have entered into a participation agreement and are qualified to receive payments under such plan.(2) Implementation.— An eligible entity that receives a grant under this section may use—(A) not more than 25 percent of the amounts made available through the grant for the first 24 months of the grant period to utilize data analysis methods to—(i) identify specific geographic areas where care coordination, prevention and early intervention, and facilitation services will be provided; and(ii) identify support and intervention services to improve outcomes for children located in a geographic area identified under subsection (c)(1)(A); and(B) not more than 10 percent of the grant in each subsequent year to continue data analysis activities.(3) Administration.— An eligible entity that receives a grant under this section may not use more than 5 percent of amounts received through the grant for administration, reporting, and program oversight functions, including the development of systems to improve data collection and data sharing for the purposes of improving services and the provision of care.(4) Priority.—(A) In general.— In awarding grants under this section, the Secretary shall give priority, to the extent practical, to eligible entities that use community-based system dynamic modeling as the primary data analysis method.(B) System dynamic modeling defined.— The term system dynamic modeling m

    The bill says: Title XXXI of the Public Health Service Act (42 U.S.C. 300kk) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300kk)

  612. 42 U.S.C. 300d-51added 1255by H.R. 9877 Sec. 6702(b)

    1255 Care coordination grants.—(a) In general.— The Secretary shall award grants to eligible entities to establish or expand trauma-informed care coordination services to support—(1) children aged 0 through 5 at risk of adverse childhood experiences; and(2) their caregivers, including prenatal people of any age.(b) Number of grants.— Subject to the availability of appropriations, the Secretary shall award not fewer than 9 and not more than 40 grants under this section.(c) Amount of grants.— Subject to the availability of appropriations, the amount of a grant under this section for a fiscal year shall be—(1) not less than $250,000; and(2) not more than $1,000,000.(d) Eligible entities.— To be eligible to receive a grant under this section, an entity shall be a local government or Indian Tribe, acting through the public health department thereof if such government or Tribe has a public health department.(e) Priority.—(1) In general.— In awarding grants under this section, the Secretary shall give priority to eligible entities proposing to serve communities with a high need for trauma-informed care coordination services, as demonstrated by indicators such as—(A) pregnant people who face barriers to prenatal care;(B) mortality or morbidity of people giving birth or infants;(C) caretakers and parents who are living with a mental health condition or substance use disorder;(D) a high prevalence of community violence, including domestic violence, as demonstrated by instances of homicide and public health statistics, including treatment of injury or trauma;(E) high proportions of low-income children;(F) a high prevalence of child fatalities or near fatalities related to child abuse and neglect;(G) significant disparities in health outcomes for people giving birth and infants;(H) a high rate of exclusionary discipline and referrals to law enforcement; and(I) a high rate of homelessness and housing instability.(2) Data from Tribal areas.— The Secretary, acting through the Director of the Indian Health Service, shall consult with Indian Tribes to establish criteria to measure indicators of need, for purposes of paragraph (1), with respect to Tribal areas.(f) Use of funds.—(1) Required uses.—(A) In general.— A grant received under this section shall be used to establish or expand gender-responsive, culturally specific, trauma-informed care coordination services, including by instituting and conducting risk and needs assessments including—(i) using strengths-based approaches focused on protective factors for children and their caregivers, including prenatal people of any age; and(ii) inputting screening results into a centralized intake system to promote a single point of access system across providers and services.(B) Training.— A grant received under this section shall be used to ensure that individuals employed through the grant funds, in whole or in part, have received sufficient and up-to-date training on trauma-informed care and strategies that are reparative, culturally sensitive, gender responsive, and healing centered.(2) Permissible uses.— A grant received under this section may be used for any of the following:(A) Employing care coordinators, case managers, community health workers, certified infant mental health specialists, and outreach and engagement specialists to work with children and their caregivers, including prenatal individuals, to prevent and respond to adverse childhood experiences by connecting clients with culturally specific, trauma-informed care treatment services, including economic, social, food, and housing supports.(B) Providing training described in paragraph (1)(B) to community health providers and community partners.(C) Expanding, enhancing, modifying, and connecting the existing network of community programs and services to achieve a more comprehensive and coordinated system of care approach, including—(i) developing local infrastructure to bolster and shape community support systems and map and build access to services in a coordinated and comprehensive way; and(ii) creating infrastructure to conduct outreach to children and families, including those experiencing homelessness and housing instability, so they acquire access to the services and supports they need and the benefits to which they are entitled.(D) Compiling information on resources (including any referral services) available through community-based organizations and local, State, and Federal agencies, such as—(i) programs addressing social determinants of health, including—(I) emergency, temporary, and long-term housing;(II) programs that offer free or affordable and nutritious food;(III) vocational and workforce development; and(IV) transportation supports;(ii) home visiting programs for new parents and their infants;(iii) workforce development programs to support caregivers in skill building;(iv) trauma-responsive, parenting skills-building programs;(v) the continuum of substance use prevention, intervention, and treatment programs and mental health support programs, including programs with trauma-informed, gender-responsive, and culturally specific counseling; and(vi) childcare support and early childhood education, including Head Start and Early Head Start programs.(E) Subject to subsection (g)(1), establishing or updating a database that compiles data used to track the effectiveness of the care coordination services funded through the grant.(F) Developing and implementing referral partnership agreements with community-based organizations, parent organizations, substance use disorder treatment providers and facilities, housing and shelter providers, health care providers, mental health care providers, and Federal and State offices and programs that implement practices to support children ages 0 through 5 who are at risk of adverse childhood experiences and their caregivers, including prenatal people. Such practices shall include—(i) a bilateral "warm hand

    The bill says: Part E of title XII of the Public Health Service Act (42 U.S.C. 300d–51 et seq.) is amended by adding at the end the following new section:

    Bill text · Current law (42 U.S.C. 300d-51)

  613. 42 U.S.C. 1395l(a)(1)(D)(ii)changedby H.R. 9877 Sec. 6703(a)

    The bill says: in subparagraph (D)(ii), by striking "such negotiated rate,," and inserting "such negotiated rate,"; and

    Bill text · Current law (42 U.S.C. 1395l)

  614. 42 U.S.C. 1395l(a)(1)(F)(ii)changedby H.R. 9877 Sec. 6703(a)

    The bill says: in subparagraph (F)(ii) by striking "75 percent of the amount determined for payment of a psychologist under clause (L)" and inserting "85 percent of the fee schedule amount provided under section 1848".

    Bill text · Current law (42 U.S.C. 1395l)

  615. 42 U.S.C. 1395yy(e)(2)(A)(ii)changedby H.R. 9877 Sec. 6703(b)

    The bill says: Section 1888(e)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)), as amended by section 6101(a)(5), is amended by inserting "clinical social worker services," after "peer support specialist services (as defined in section 1861(rrr)(3)),".

    Bill text · Current law (42 U.S.C. 1395yy)

  616. 42 U.S.C. 1395x(hh)(2)changedby H.R. 9877 Sec. 6703(b)

    The bill says: Section 1861(hh)(2) of the Social Security Act (42 U.S.C. 1395x(hh)(2)) is amended by striking "and other than services furnished to an inpatient of a skilled nursing facility which the facility is required to provide as a requirement for participation".

    Bill text · Current law (42 U.S.C. 1395x)

  617. 42 U.S.C. 1395x(hh)(2)changedby H.R. 9877 Sec. 6703(c)

    The bill says: Section 1861(hh)(2) of the Social Security Act (42 U.S.C. 1395x(hh)(2)) is amended by striking "for the diagnosis and treatment of mental illnesses (other than services" and inserting "(including services for the diagnosis and treatment of mental illnesses or services for health and behavior assessment and intervention (identified as of January 1, 2022, by HCPCS codes 96150 through 96161 (and any succeeding codes)), but not including services".

    Bill text · Current law (42 U.S.C. 1395x)

  618. 20 U.S.C. 7291added 4645by H.R. 9877 Sec. 6705(a)

    4645 Grants for school social workers.—(a) Grants authorized.—(1) In general.— From the amounts appropriated under subsection (h), the Secretary shall award grants to high-need local educational agencies to enable such agencies to retain school social workers employed by such agencies or to hire additional school social workers.(2) Duration.— A grant awarded under this section shall be awarded for a period not to exceed 4 years.(3) Supplement, not supplant.— Funds made available under this section shall be used to supplement, and not to supplant, other Federal, State, or local funds used for hiring and retaining school social workers.(b) Application.—(1) In general.— To be eligible to receive a grant under this section, a high-need local educational agency shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.(2) Contents.— An application submitted under paragraph (1) shall include an assurance that each school social worker who receives assistance under the grant will provide the services described in subsection (d), and a description of the specific services to be provided by such social worker.(c) Use of funds.— A high-need local educational agency receiving a grant under this section—(1) shall use the grant—(A) to achieve a ratio of not less than 1 school social worker for every 250 students served by the agency, by—(i) retaining school social workers employed by such agency; or(ii)(I) employing additional school social workers; or(II) hiring contractors to serve as school social workers only in a case in which—(aa) the local educational agency demonstrates to the Secretary that the agency—(AA) has not been able to employ a sufficient number of school social workers under subclause (I) to achieve such ratio despite strong and continuing efforts to recruit and employ school social workers; and(BB) hiring contractors is the only viable option to ensure students have adequate access to school social work services; and(bb) each such contractor meets the requirements of subparagraphs (A) and (B) of subsection (g)(2); and(B) to ensure that each school social worker who receives assistance under such grant provides the services described in subsection (d); and(2) may use the grant to reimburse school social workers who receive assistance under such grant for—(A) in the case of a school served by the agency in which the majority of students are higher risk students, to hire or retain additional school social workers in accordance with clauses (i) and (ii) of paragraph (1)(A) to achieve a ratio of not less than 1 school social worker for every 50 students;(B) travel expenses incurred during home visits and other school-related trips;(C) any additional expenses incurred by such social workers in rendering any service described in subsection (d); and(D) the cost of clinical social work supervision for such social workers.(d) Responsibilities of a school social worker.— A school social worker who receives assistance under a grant under this section shall provide the following services:(1) Identifying high-need students in each school that the social worker serves, and targeting services provided at the school to such students.(2) Providing students, in each school that the school social worker serves, social work services to promote school engagement and improve academic outcomes, including—(A) counseling and crisis intervention;(B) trauma-informed services;(C) evidence-based educational, behavioral, and mental health services (such as implementing multi-tiered programs and practices, monitoring progress, and evaluating service effectiveness);(D) addressing the social and emotional learning needs of students;(E) promoting a school climate and culture conducive to student learning and teaching excellence (such as promoting effective school policies and administrative procedures, enhancing the professional capacity of school personnel, and facilitating engagement between student, family, school, and community);(F) providing access to school-based and community-based resources (such as promoting a continuum of services, mobilizing resources and promoting assets, and providing leadership, interdisciplinary collaboration, systems coordination, professional consultation, and connecting students and families to resource systems);(G) working with students, families, schools, and communities to address barriers to educational attainment (such as homelessness and housing insecurity, lack of transportation, food insecurity, equity, social justice issues, access to quality education, and school, family, and community risk factors);(H) providing assistance to schools and teachers to design social-emotional, educational, behavioral, and mental health interventions;(I) case management activities to coordinate the delivery of and access to the appropriate social work services to the highest-need students;(J) home visits to meet the family of students in need of social work services in the home environment;(K) supervising or coordinating school social work services at the local educational agency level; and(L) other services the Secretary determines, in partnership with students, educators, and community member voices, are necessary to be carried out by such a social worker.(e) Grant renewal.—(1) In general.— A grant awarded under this section may be renewed for additional periods with the same duration as the original grant period.(2) Continuing eligibility application.— To be eligible for a renewal under this section, a high-need local educational agency shall submit to the Secretary, for each renewal, a report on the progress of such agency in retaining and hiring school social workers to achieve the ratio of not less than 1 school social worker for every 250 students served by the agency, and shall include—(A) a description of the staffing expansion of school social workers funded thro

    The bill says: Subpart 4 of part F of title IV of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7291 et seq.) is amended by adding at the end the following:

    Bill text · Current law (20 U.S.C. 7291)

  619. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(a)

    The bill says: in section 464H(c) (42 U.S.C. 285n(c)), section 464R(c) (42 U.S.C. 285p(c)), and subsections (b) and (c)(1) of section 2303 (42 U.S.C. 300cc–2), by striking "Administrator of the Substance Abuse and Mental Health Services Administration" each place it appears and inserting "Assistant Secretary for Mental Health and Substance Use";

    Bill text · Current law (42 U.S.C. 201)

  620. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(a)

    The bill says: in the title heading, by striking "Abuse" and inserting "Use"; and

    Bill text · Current law (42 U.S.C. 201)

  621. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(a)

    The bill says: in the section heading, by striking "Abuse" and inserting "Use"; and

    Bill text · Current law (42 U.S.C. 201)

  622. 42 U.S.C. 201(f)(4)changedby H.R. 9877 Sec. 6707(a)

    The bill says: in subsection (f)(4), by striking "Substance Abuse and Mental Health Administration" and inserting "Substance Use and Mental Health Services Administration"; and

    Bill text · Current law (42 U.S.C. 201)

  623. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(a)

    The bill says: by striking "Substance Abuse and Mental Health Services Administration" each place it appears and inserting "Substance Use and Mental Health Services Administration".

    Bill text · Current law (42 U.S.C. 201)

  624. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: in subpart 1, in the subpart heading, by striking "Abuse Treatment" and inserting "Use Services";

    Bill text · Current law (42 U.S.C. 201)

  625. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: in subpart 2, in the subpart heading, by striking "Abuse Prevention" and inserting "Use Prevention Services";

    Bill text · Current law (42 U.S.C. 201)

  626. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: in section 507 (42 U.S.C. 290bb), in the section heading, by striking "Abuse Treatment" and inserting "Use Services";

    Bill text · Current law (42 U.S.C. 201)

  627. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: in section 513(a) (42 U.S.C. 290bb–6(a)), in the subsection heading, by striking "Abuse Treatment" and inserting "Use Services"; and

    Bill text · Current law (42 U.S.C. 201)

  628. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: in section 515 (42 U.S.C. 290bb–21), in the section heading, by striking "Abuse Prevention" and inserting "Use Prevention Services";

    Bill text · Current law (42 U.S.C. 201)

  629. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: in section 1932(b)(3) (42 U.S.C. 300x–32(b)(3)), in the paragraph heading, by striking "abuse prevention" and inserting "use prevention services";

    Bill text · Current law (42 U.S.C. 201)

  630. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: in section 1935(b)(2) of the Public Health Service Act (42 U.S.C. 300x–35(b)(2)), in the paragraph heading, by striking "abuse prevention" and inserting "use prevention services";

    Bill text · Current law (42 U.S.C. 201)

  631. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: by striking "Center for Substance Abuse Treatment" each place it appears and inserting "Center for Substance Use Services"; and

    Bill text · Current law (42 U.S.C. 201)

  632. 42 U.S.C. 201changedby H.R. 9877 Sec. 6707(b)

    The bill says: by striking "Center for Substance Abuse Prevention" each place it appears and inserting "Center for Substance Use Prevention Services".

    Bill text · Current law (42 U.S.C. 201)

  633. 42 U.S.C. 290ddadded 557by H.R. 9877 Sec. 6708

    557 Behavioral and mental health outreach and education strategy.—(a) In general.— The Secretary, acting through the Assistant Secretary, shall, in coordination with advocacy and behavioral and mental health organizations serving populations of Hispanic and Latino individuals or communities, develop and implement an outreach and education strategy to promote behavioral and mental health and reduce stigma associated with mental health conditions and substance abuse among the Hispanic and Latino populations. Such strategy shall—(1) be designed to—(A) meet the diverse cultural and language needs of the various Hispanic and Latino populations; and(B) be developmentally and age appropriate;(2) increase awareness of symptoms of mental illnesses common among such populations, taking into account differences within subgroups, such as gender, gender identity, age, sexual orientation, or ethnicity, of such populations;(3) provide information on evidence-based, culturally and linguistically appropriate and adapted interventions and treatments;(4) ensure full participation of, and engage, both consumers and community members in the development and implementation of materials; and(5) seek to broaden the perspective among both individuals in these communities and stakeholders serving these communities to use a comprehensive public health approach to promoting behavioral health that addresses a holistic view of health by focusing on the intersection between behavioral and physical health.(b) Reports.— Beginning not later than 1 year after the date of the enactment of this section and annually thereafter, the Secretary, acting through the Assistant Secretary, shall submit to Congress, and make publicly available, a report on the extent to which the strategy developed and implemented under subsection (a) improved behavioral and mental health outcomes associated with mental health conditions and substance abuse among Hispanic and Latino populations.(c) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $1,000,000 for fiscal year 2027.

    The bill says: Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.), as amended by section 6501, is amended by adding at the end the following new section:

    Bill text · Current law (42 U.S.C. 290dd)

  634. 7 U.S.C. 5936changedby H.R. 9877 Sec. 6709(b)

    The bill says: by inserting "farm work," after "ranching," each place it appears;

    Bill text · Current law (7 U.S.C. 5936)

  635. 7 U.S.C. 5936(b)(1)(D)changedby H.R. 9877 Sec. 6709(b)

    The bill says: in paragraph (1)(D), by striking "or" at the end;

    Bill text · Current law (7 U.S.C. 5936)

  636. 7 U.S.C. 5936(b)renumberedby H.R. 9877 Sec. 6709(b)

    The bill says: by redesignating paragraph (2) as paragraph (3);

    Bill text · Current law (7 U.S.C. 5936)

  637. 7 U.S.C. 5936(b)added (2)by H.R. 9877 Sec. 6709(b)

    (2) to initiate, expand, or sustain programs that deliver peer-to-peer mental health support to individuals who are engaged in farming, ranching, farm work, and other occupations relating to agriculture; or

    The bill says: by inserting after paragraph (1) the following:

    Bill text · Current law (7 U.S.C. 5936)

  638. 7 U.S.C. 5936(b)(3)changedby H.R. 9877 Sec. 6709(b)

    The bill says: in paragraph (3) (as so redesignated), by striking "paragraph (1) and subsection (a)" and inserting "paragraphs (1) and (2) and subsection (a)"; and

    Bill text · Current law (7 U.S.C. 5936)

  639. 7 U.S.C. 5936(d)changedby H.R. 9877 Sec. 6709(b)

    The bill says: in subsection (d), by striking "2023" and inserting "2031".

    Bill text · Current law (7 U.S.C. 5936)

  640. 42 U.S.C. 290ddadded 558by H.R. 9877 Sec. 6711

    558 Training community mental wellness workers.—(a) In general.— The Secretary, acting through the Assistant Secretary, may award grants to eligible entities to implement community mental wellness worker training programs.(b) Use of funds.— An eligible entity that receives a grant under this section shall use the funds received through such grant to carry out a community mental wellness worker training program, which may include—(1) supporting training, certification, and supervision during and after training of community mental wellness workers and community mental wellness supervisors—(A) to screen for common mental health and substance use conditions; and(B) to deliver evidence-informed, culturally and linguistically competent counseling and interviewing interventions addressing basic psychosocial or psychotherapeutic treatment needs of persons with or at risk for mental and substance use disorders, including safety planning and interventions to reduce suicide risk; and(2) covering costs associated with—(A) the acquisition and use of digital platforms to provide the screening, training, supervision, and ongoing quality assurance monitoring, outcomes evaluation, and delivery of evidence-based treatments;(B) the delivery of counseling and interviewing interventions described in paragraph (1)(B); and(C) the clinical supervision (during and after training) of community mental wellness workers and the certification of such workers upon the completion of required training.(c) Community mental wellness technical assistance.—(1) In general.— The Secretary may provide appropriate training and technical assistance to eligible entities receiving a grant under this section in meeting the requirements of this section, including by—(A) consulting with such recipients on evidence-based employment practices for community mental wellness workers, including assistance with integrating community wellness workers into the workflows of such recipients and other eligible entities;(B) identifying a diverse array of candidates for community mental wellness worker training; and(C) identifying behavioral health providers who may benefit from and employ community mental wellness workers.(2) Additional dissemination of technical assistance.— The information and resources provided by the Secretary under paragraph (1) shall be made available to States, political subdivisions of States, Indian Tribes and Tribal organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act), outpatient and inpatient substance use treatment providers, other community-based behavioral health organizations, and other entities as the Secretary determines appropriate.(d) Priority.— In awarding grants under this section, the Secretary shall give priority to eligible entities that are located—(1) in an area with rates of poverty and unemployment that exceed the average in the United States, as determined by the survey conducted by the Secretary of Commerce commonly referred to as the ‘American Community Survey’ (or any successor survey);(2) in a medically underserved community;(3) in an area with rates of substance use that exceed the average in the United States, as determined by the National Institute on Drug Abuse; or(4) serving communities with rates of individuals who are dually eligible for both the Medicare program under title XVIII of the Social Security Act and the Medicaid program under title XIX of such Act that exceed the average in the United States.(e) Malpractice and negligence suits against community behavioral health clinic and community mental health centers.—(1) In general.— Except as inconsistent with this subsection, the provisions of section 224, including subsections (g), (h), (i), (j), (k), and (l) of such section, shall apply with respect to acts and omissions of a covered entity that occur during the period of the grant under this section, to the same extent and in the same manner as such provisions apply with respect to an entity described in subsection (g)(4) of such section 224, and any officer, governing board member, employee, or contractor of such an entity.(2) List required.— Each covered entity described in paragraph (3)(A) shall submit to the Secretary, and update as necessary, a list of each officer, governing board member, employee, or contractor participating in the entity’s program funded through a grant under this section.(3) Covered entity defined.— In this subsection, the term "covered entity" means an entity that—(A) is an eligible entity (as defined in subsection (g)(3)) in receipt of a grant under this section; and(B)(i) is an officer, governing board member, or employee of such an entity or a contractor of such an entity who is a physician or other licensed or certified health care practitioner; and(ii) is participating in the entity’s program funded through a grant under this section, as indicated in a list submitted pursuant to paragraph (2).(4) Delayed applicability.— This subsection applies beginning with respect to the first full fiscal year that begins after the date of the enactment of this section.(f) Report.—(1) Submission.— The Secretary shall submit to Congress—(A) not later than one year after the date of enactment of this section, an interim report on the results of the grant program under this section; and(B) not later than the end of fiscal year 2031, a final report of such results.(2) Contents.— The reports required by paragraph (1) shall each include—(A) the total number of community mental wellness workers participating in the grant program under this section; and(B) the total number of community mental wellness workers who obtained certification through such participation.(g) Definitions.— In this section:(1) The term community mental wellness worker means an individual trained and certified by an eligible entity to assist with providing basic screening and evidence-based treatments to individuals wi

    The bill says: Part D of title V of the Public Health Service Act (42 U.S.C. 290dd), as amended by section 6708, is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 290dd)

  641. 42 U.S.C. 285added 417Hby H.R. 9877 Sec. 7001(b)

    417H. Lung cancer mortality reduction program.—(a) In general.— Not later than 6 months after the date of the enactment of the Health Equity and Accountability Act of 2026, the Secretary, in consultation with the Secretary of Defense, the Secretary of Veterans Affairs, the Director of the National Institutes of Health, the Director of the Centers for Disease Control and Prevention, the Commissioner of Food and Drugs, the Administrator of the Centers for Medicare & Medicaid Services, the Director of the National Institute on Minority Health and Health Disparities, the Administrator of the Environmental Protection Agency, and other members of the Lung Cancer Advisory Board established under section 7001(d) of the Health Equity and Accountability Act of 2026, shall implement a comprehensive program, to be known as the Lung Cancer Mortality Reduction Program, to achieve a reduction of at least 25 percent in the mortality rate of lung cancer by 2028.(b) Requirements.— The Program shall include at least the following:(1) With respect to the National Institutes of Health—(A) a strategic review and prioritization by the National Cancer Institute of research grants to achieve the goal specified in subsection (a);(B) the provision of funds to enable the Airway Biology and Disease Branch of the National Heart, Lung, and Blood Institute to expand its research programs to include predispositions to lung cancer, the interrelationship between lung cancer and other pulmonary and cardiac disease, the diagnosis and treatment of such diseases, and the investigation of rising rates of lung cancer in populations that have never smoked, such as among Asian American, Native Hawaiian, and Pacific Islander women;(C) the provision of funds to enable the National Institute of Biomedical Imaging and Bioengineering to expedite the development of computer-assisted diagnostic, surgical, treatment, and drug-testing innovations to reduce lung cancer mortality, such as through expansion of the Institute’s Quantum Grant Program and Image-Guided Interventions program; and(D) the provision of funds to enable the National Institute of Environmental Health Sciences to implement research programs relative to the lung cancer incidence.(2) With respect to the Food and Drug Administration—(A) activities under section 529B of the Federal Food, Drug, and Cosmetic Act; and(B) activities under section 561 of the Federal Food, Drug, and Cosmetic Act to expand access to investigational drugs and devices for the diagnosis, monitoring, or treatment of lung cancer.(3) With respect to the Centers for Disease Control and Prevention, the establishment of an early disease research and management program under section 1511.(4) With respect to the Agency for Healthcare Research and Quality, the conduct of a biannual review of lung cancer screening, diagnostic, and treatment protocols, and the issuance of updated guidelines.(5) The promotion (including education) of lung cancer screening within minority and rural populations and the study of the effectiveness of efforts to increase such screening.(6) The cooperation and coordination of all minority and health disparity programs within the Department of Health and Human Services to ensure that all aspects of the Lung Cancer Mortality Reduction Program under this section adequately address the burden of lung cancer on minority and rural populations including among populations who have never smoked, such as Asian American, Native Hawaiian, and Pacific Islander women.(7) The cooperation and coordination of all tobacco control and cessation programs within agencies of the Department of Health and Human Services to achieve the goals of the Lung Cancer Mortality Reduction Program under this section with particular emphasis on the coordination of drug and other cessation treatments with early detection protocols.

    The bill says: Subpart 1 of part C of title IV of the Public Health Service Act (42 U.S.C. 285 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285)

  642. 21 U.S.C. 360aaaadded 529Bby H.R. 9877 Sec. 7001(b)

    529B. Drugs relating to lung cancer.—(a) In general.— The provisions of this subchapter shall apply to a drug described in subsection (b) to the same extent and in the same manner as such provisions apply to a drug for a rare disease or condition (as defined in section 526).(b) Qualified drugs.— A drug described in this subsection is—(1) a chemoprevention drug for precancerous conditions of the lung;(2) a drug for targeted therapeutic treatments, including any vaccine, for lung cancer; or(3) a drug to curtail or prevent nicotine addiction.(c) Board.— The Board established under section 7001(d) of the Health Equity and Accountability Act of 2026 shall monitor the program implemented under this section.

    The bill says: Subchapter B of chapter V of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360aaa et seq.) is amended by adding at the end the following:

    Bill text · Current law (21 U.S.C. 360aaa)

  643. 21 U.S.C. 360bbb(e)addedby H.R. 9877 Sec. 7001(b)

    The bill says: Section 561(e) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb(e)) is amended by inserting before the period the following: "and shall include expanding access to drugs under section 529B, with substantial consideration being given to whether the totality of information available to the Secretary regarding the safety and effectiveness of an investigational drug, as compared to the risk of morbidity and death from the disease, indicates that a patient may obtain more benefit than risk if treated with the drug".

    Bill text · Current law (21 U.S.C. 360bbb)

  644. 42 U.S.C. 300kadded 1511by H.R. 9877 Sec. 7001(b)

    1511 Early disease research and management program.— The Secretary shall establish and implement an early disease research and management program targeted at the high incidence and mortality rates of lung cancer among minority and low-income populations.

    The bill says: Title XV of the Public Health Service Act (42 U.S.C. 300k et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300k)

  645. 42 U.S.C. 1308(g)(4)changedby H.R. 9877 Sec. 7006(a)

    The bill says: by striking "paragraphs (1), (2), (3), and (4) of"; and

    Bill text · Current law (42 U.S.C. 1308)

  646. 42 U.S.C. 1308(g)(4)addedby H.R. 9877 Sec. 7006(a)

    The bill says: by adding at the end the following: "With respect to fiscal years beginning with fiscal year 2027, payment for medical assistance for individuals who are eligible for such assistance only on the basis of section 1902(a)(10)(A)(ii)(XVIII) shall not be taken into account in applying subsection (f) (as increased in accordance with this subsection) to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa for such fiscal year.".

    Bill text · Current law (42 U.S.C. 1308)

  647. 42 U.S.C. 1396d(b)addedby H.R. 9877 Sec. 7006(b)

    The bill says: Section 1905(b) of such Act (42 U.S.C. 1396d(b)) is amended by adding at the end the following: "Notwithstanding the first sentence of this subsection, with respect to medical assistance described in clause (4) of such sentence that is furnished in Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa in a fiscal year, the Federal medical assistance percentage is equal to the highest such percentage applied under such clause for such fiscal year for any of the 50 States or the District of Columbia that provides such medical assistance for any portion of such fiscal year.".

    Bill text · Current law (42 U.S.C. 1396d)

  648. 42 U.S.C. 241changedby H.R. 9877 Sec. 7101(1)

    The bill says: by striking section 317N (42 U.S.C. 247b–15); and

    Bill text · Current law (42 U.S.C. 241)

  649. 42 U.S.C. 241added Xby H.R. 9877 Sec. 7101(2)

    X Biennial assessment of HHS Hepatitis B and Hepatitis C prevention, education, research, and medical management plan.—399PP. Biennial update of the plan.—(a) In general.— The Secretary shall conduct a biennial assessment of the Secretary’s plan for the prevention, control, and medical management of, and education and research relating to, hepatitis B and hepatitis C, for the purposes of—(1) incorporating into such plan new knowledge or observations relating to hepatitis B and hepatitis C (such as knowledge and observations that may be derived from clinical, laboratory, and epidemiological research and disease detection, prevention, and surveillance outcomes);(2) addressing gaps in the coverage or effectiveness of the plan; and(3) evaluating and, if appropriate, updating recommendations, guidelines, or educational materials of the Centers for Disease Control and Prevention or the National Institutes of Health for health care providers or the public on viral hepatitis in order to be consistent with the plan.(b) Publication of notice of assessments.— Not later than October 1 of the first even-numbered year beginning after the date of the enactment of this part, and October 1 of each even-numbered year thereafter, the Secretary shall publish in the Federal Register a notice of the results of the assessments conducted under subsection (a). Such notice shall include—(1) a description of any revisions to the plan referred to in subsection (a) as a result of the assessment;(2) an explanation of the basis for any such revisions, including the ways in which such revisions can reasonably be expected to further promote the original goals and objectives of the plan; and(3) in the case of a determination by the Secretary that the plan does not need revision, an explanation of the basis for such determination.399PP–1. Elements of program.—(a) Education and awareness programs.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, the Administrator of the Health Resources and Services Administration, and the Assistant Secretary for Mental Health and Substance Use, and in accordance with the plan referred to in section 399PP(a), shall implement programs to increase awareness and enhance knowledge and understanding of hepatitis B and hepatitis C. Such programs shall include—(1) the conduct of culturally and linguistically appropriate health education in primary and secondary schools, college campuses, public awareness campaigns, and community outreach activities (especially to the ethnic communities with high rates of chronic hepatitis B and chronic hepatitis C and other high-risk groups) to promote public awareness and knowledge about—(A) the value of hepatitis A and hepatitis B immunization, including the importance of universal birth dose hepatitis B vaccination and universal childhood and adult hepatitis B vaccination;(B) risk factors, transmission, and prevention of hepatitis B and hepatitis C;(C) the value of screening for the early detection of hepatitis B and hepatitis C; and(D) options available for the treatment of chronic hepatitis B and chronic hepatitis C;(2) the promotion of immunization programs that increase awareness and access to hepatitis A and hepatitis B vaccines for susceptible adults and children;(3) the training of health care professionals regarding the importance of vaccinating individuals regarding the importance of hepatitis B screening in individuals infected with hepatitis C and the importance of vaccinating individuals who are at risk for hepatitis C infection against hepatitis A and hepatitis B;(4) the training of health care professionals regarding the importance of vaccinating individuals chronically infected with hepatitis B and individuals who are at risk for chronic hepatitis B infection against the hepatitis A virus;(5) the training of health care professionals and health educators to make them aware of the high rates of chronic hepatitis B and chronic hepatitis C in certain adult ethnic populations, and the importance of prevention, detection, and medical management of hepatitis B and hepatitis C and of liver cancer screening;(6) the development and distribution of health education curricula (including information relating to the special needs of individuals infected with or at risk of hepatitis B and hepatitis C, such as the importance of prevention and early intervention, regular monitoring, the recognition of psychosocial needs, appropriate treatment, and liver cancer screening) for individuals providing hepatitis B and hepatitis C counseling; and(7) support for the implementation of the curricula described in paragraph (6) by State and local public health agencies.(b) Immunization, prevention, and control programs.—(1) In general.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall support the integration of activities described in paragraph (3) into existing clinical and public health programs at State, local, territorial, and Tribal levels (including community health clinics, programs for the prevention and treatment of HIV/AIDS, sexually transmitted infections, and substance use disorder, and programs for individuals in correctional settings).(2) Coordination of development of federal screening guidelines.—(A) References.— For purposes of this subsection, the term CDC Director means the Director of the Centers for Disease Control and Prevention, and the term AHRQ Director means the Director of the Agency for Healthcare Research and Quality.(B) Agency for healthcare research and quality.— Due to the rapidly evolving standard of care associated with diagnosing and treating viral hepatitis infection, the AHRQ Director shall convene the Preventive Services Task Force under section 915(a) to review its recommendation for screening for HBV and HCV infection every 3 years.(3) Activities.—(A) Voluntary testing programs.—(i) In general.— The Secretary

    The bill says: by adding after part W the following:

    Bill text · Current law (42 U.S.C. 241)

  650. 42 U.S.C. 254badded 330Qby H.R. 9877 Sec. 7102

    330Q. Liver cancer and disease prevention, awareness, and patient tracking grants.—(a) Prevention initiative grant program.—(1) In general.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants and enter into cooperative agreements with entities for the purpose of expanding and supporting—(A) prevention activities (including providing screenings, vaccinations, or other preventative interventions) for conditions known to increase an individual’s risk of developing a major liver disease, such as liver cancer, hepatitis B, hepatitis C, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and cirrhosis of the liver;(B) activities relating to detection and provision of guidance for individuals at high risk for contracting liver cancer and other liver diseases; and(C) viral hepatitis surveillance to provide for timely and accurate information regarding progress to eliminate viral hepatitis.(2) Report.— An entity that receives a grant or cooperative agreement under paragraph (1) shall submit to the Secretary, at a time specified by the Secretary, a report describing each activity carried out pursuant to such paragraph and evaluating the effectiveness of such activity in promoting prevention and treatment of liver cancer and other liver diseases.(3) Authorization of appropriations.— For purposes of carrying out this subsection, there is authorized to be appropriated $90,000,000 for each of fiscal years 2027 through 2031.(b) Awareness initiative grant program.—(1) In general.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants to eligible entities for the purpose of raising awareness for liver cancer and other liver diseases, which may include the production, dissemination, and distribution of informational materials targeted towards communities and populations with a higher risk for developing liver cancer and other liver diseases.(2) Eligible entities.— To be eligible to receive a grant under paragraph (1), an entity shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require, including a description of how the entity, in disseminating information on liver cancer and other liver diseases pursuant to paragraph (1), will—(A) with respect to any community or population, consult with members of such community or population and provide such information in a manner that is culturally and linguistically appropriate for such community or population;(B) highlight the range of preventative measures and treatments available for liver cancer and other liver diseases;(C) integrate information on available hepatitis B and hepatitis C testing programs into any liver cancer presentations carried out by the entity; and(D) address communities and populations with a higher risk for contracting liver cancer and other liver diseases.(3) Preference.— In awarding grants under paragraph (1), the Secretary shall give preference to entities that—(A) work with a Federally qualified health center;(B) are community-based organizations; or(C) serve communities and populations with a higher risk for contracting liver cancer and other liver diseases.(4) Report.— An entity that receives a grant under paragraph (1) shall submit to the Secretary, at a time specified by the Secretary, a report describing each activity carried out pursuant to such paragraph and evaluating the effectiveness of such activity in raising awareness for liver cancer and other liver diseases.(5) Authorization of appropriations.— For purposes of carrying out this subsection, there is authorized to be appropriated $10,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Subpart I of part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 254b)

  651. 42 U.S.C. 241added 317Xby H.R. 9877 Sec. 7201(a)

    317X. National Acquired Bone Marrow Failure Disease Registry.—(a) Establishment of registry.—(1) In general.— Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall—(A) develop a system to collect data on acquired bone marrow failure diseases; and(B) establish and maintain a national and publicly available registry, to be known as the National Acquired Bone Marrow Failure Disease Registry, in accordance with paragraph (3).(2) Recommendations of advisory committee.— In carrying out this subsection, the Secretary shall take into consideration the recommendations of the Advisory Committee on Acquired Bone Marrow Failure Diseases established under subsection (b).(3) Purposes of registry.— The National Acquired Bone Marrow Failure Disease Registry shall—(A) identify the incidence and prevalence of acquired bone marrow failure diseases in the United States;(B) be used to collect and store data on acquired bone marrow failure diseases, including data concerning—(i) the age, race or ethnicity, general geographic location, sex, and family history of individuals who are diagnosed with acquired bone marrow failure diseases, and any other characteristics of such individuals determined appropriate by the Secretary;(ii) the genetic and environmental factors that may be associated with developing acquired bone marrow failure diseases;(iii) treatment approaches for dealing with acquired bone marrow failure diseases;(iv) outcomes for individuals treated for acquired bone marrow failure diseases, including outcomes for recipients of stem cell therapeutic products as contained in the database established pursuant to section 379A; and(v) any other factors pertaining to acquired bone marrow failure diseases determined appropriate by the Secretary; and(C) be made available—(i) to the general public; and(ii) to researchers to facilitate further research into the causes of, and treatments for, acquired bone marrow failure diseases in accordance with standard practices of the Centers for Disease Control and Prevention.(b) Advisory committee.—(1) Establishment.— Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish an advisory committee, to be known as the Advisory Committee on Acquired Bone Marrow Failure Diseases.(2) Members.— The members of the Advisory Committee on Acquired Bone Marrow Failure Diseases shall be appointed by the Secretary, acting through the Director of the Centers for Disease Control and Prevention, and shall include at least one representative from each of the following:(A) A national patient advocacy organization with experience advocating on behalf of patients suffering from acquired bone marrow failure diseases.(B) The National Institutes of Health, including at least one representative from each of—(i) the National Cancer Institute;(ii) the National Heart, Lung, and Blood Institute; and(iii) the Office of Rare Diseases.(C) The Centers for Disease Control and Prevention.(D) Clinicians with experience in—(i) diagnosing or treating acquired bone marrow failure diseases; or(ii) medical data registries.(E) Epidemiologists who have experience with data registries.(F) Publicly or privately funded researchers who have experience researching acquired bone marrow failure diseases.(G) The entity operating the C.W. Bill Young Cell Transplantation Program established pursuant to section 379 and the entity operating the C.W. Bill Young Cell Transplantation Program Outcomes Database.(3) Responsibilities.— The Advisory Committee on Acquired Bone Marrow Failure Diseases shall provide recommendations to the Secretary on the establishment and maintenance of the National Acquired Bone Marrow Failure Disease Registry, including recommendations on the collection, maintenance, and dissemination of data.(4) Public availability.— The Secretary shall make the recommendations of the Advisory Committee on Acquired Bone Marrow Failure Disease publicly available.(c) Grants.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants to, and enter into contracts and cooperative agreements with, public or private nonprofit entities for the management of, as well as the collection, analysis, and reporting of data to be included in, the National Acquired Bone Marrow Failure Disease Registry.(d) Definition.— In this section, the term acquired bone marrow failure disease means—(1) myelodysplastic syndromes;(2) aplastic anemia;(3) paroxysmal nocturnal hemoglobinuria;(4) pure red cell aplasia;(5) acute myeloid leukemia that has progressed from myelodysplastic syndromes; or(6) large granular lymphocytic leukemia.(e) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $3,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by inserting after section 317W, as added by section 1009, the following:

    Bill text · Current law (42 U.S.C. 241)

  652. 42 U.S.C. 300uadded 1707Bby H.R. 9877 Sec. 7201(c)

    1707B. Minority-focused programs on acquired bone marrow failure disease.—(a) Information and referral services.—(1) In general.— Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall establish and coordinate outreach and informational programs targeted to minority populations affected by acquired bone marrow failure diseases.(2) Program requirements.— Minority-focused outreach and informational programs authorized by this section at the National Minority Health Resource Center supported under section 1707(b)(8) (including by means of the Center’s website, through appropriate locations such as the Center’s knowledge center, and through appropriate programs such as the Center’s resource persons network) and through minority health consultants located at each Department of Health and Human Services regional office—(A) shall make information about treatment options and clinical trials for acquired bone marrow failure diseases publicly available; and(B) shall provide referral services for treatment options and clinical trials.(b) Hispanic and asian-American and pacific islander outreach.—(1) In general.— The Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall undertake a coordinated outreach effort to connect Hispanic, Asian-American, and Pacific Islander communities with comprehensive services focused on treatment of, and information about, acquired bone marrow failure diseases.(2) Collaboration.— In carrying out this subsection, the Secretary may collaborate with public health agencies, nonprofit organizations, community groups, and online entities to disseminate information about treatment options and clinical trials for acquired bone marrow failure diseases.(c) Grants and cooperative agreements.—(1) In general.— Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall award grants to, or enter into cooperative agreements with, entities to perform research on acquired bone marrow failure diseases.(2) Requirement.— Grants and cooperative agreements authorized by this subsection shall be awarded or entered into on a competitive, peer-reviewed basis.(3) Scope of research.— Research funded under this subsection shall examine factors affecting the incidence of acquired bone marrow failure diseases in minority populations.(d) Definition.— In this section, the term acquired bone marrow failure disease has the meaning given to such term in section 317X(d).(e) Authorization of appropriations.— There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Title XVII of the Public Health Service Act (42 U.S.C. 300u et seq.) is amended by inserting after section 1707A the following:

    Bill text · Current law (42 U.S.C. 300u)

  653. 42 U.S.C. 300n-4a(a)changedby H.R. 9877 Sec. 7302(1)

    The bill says: by striking the heading and inserting "In general"; and

    Bill text · Current law (42 U.S.C. 300n-4a)

  654. 42 U.S.C. 300n-4a(a)changedby H.R. 9877 Sec. 7302(1)

    The bill says: in the matter preceding paragraph (1), by striking "may make grants" and all that follows through "purpose" and inserting the following: "may make grants to such States for the purpose"; and

    Bill text · Current law (42 U.S.C. 300n-4a)

  655. 42 U.S.C. 300n-4a(d)(1)changedby H.R. 9877 Sec. 7302(2)

    The bill says: in subsection (d)(1), by striking "there are authorized" and all that follows through the period and inserting "there are authorized to be appropriated $23,000,000 for fiscal year 2027, $25,300,000 for fiscal year 2028, $27,800,000 for fiscal year 2029, $30,800,000 for fiscal year 2030, and $34,000,000 for fiscal year 2031.".

    Bill text · Current law (42 U.S.C. 300n-4a)

  656. 42 U.S.C. 280gadded 399V–10by H.R. 9877 Sec. 7303

    399V–10. Report on cardiovascular care for women and minorities.— Not later than September 30, 2027, and annually thereafter, the Secretary shall prepare and submit to Congress a report on the quality of and access to care for women and minorities with heart disease, stroke, and other cardiovascular diseases. The report shall contain recommendations for eliminating disparities in, and improving the treatment of, heart disease, stroke, and other cardiovascular diseases in women, racial and ethnic minorities, those for whom English is not their primary language, and individuals with disabilities.

    The bill says: Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 5201(c)(3), is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280g)

  657. 42 U.S.C. 1396d(a)(4)changedby H.R. 9877 Sec. 7305(a)

    The bill says: in subsection (a)(4), by striking "(D)" and all that follows through "subsection (bb))" and inserting the following: "(D) counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the State plan (as defined in subsection (bb))";

    Bill text · Current law (42 U.S.C. 1396d)

  658. 42 U.S.C. 1396d(b)changedby H.R. 9877 Sec. 7305(a)

    The bill says: in subsection (b), by inserting "(bb)(2)," after "(aa),"; and

    Bill text · Current law (42 U.S.C. 1396d)

  659. 42 U.S.C. 1396dchangedby H.R. 9877 Sec. 7305(a)

    (bb) Counseling and pharmacotherapy for cessation of tobacco use.—(1) In general.— For purposes of this title, the term counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the State plan means diagnostic, therapy, and counseling services and pharmacotherapy (including the coverage of prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration) for the cessation of tobacco use by individuals who use tobacco products or who are being treated for tobacco use that is furnished—(A) by or under the supervision of a physician; or(B) by any other health care professional who—(i) is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished; and(ii) is authorized to receive payment for other services under this title or is designated by the Secretary for this purpose, which is recommended in the guideline entitled, "Treating Tobacco Use and Dependence: 2008 Update: A Clinical Practice Guideline" published by the Public Health Service in May 2008 (or any subsequent modification of such guideline) or is recommended for the cessation of tobacco use by the United States Preventive Services Task Force or any additional intervention approved by the Food and Drug Administration as safe and effective in helping smokers quit.(2) Temporary enhanced fmap for coverage of tobacco cessation services.— Notwithstanding subsection (b), for calendar quarters occurring during the period beginning on the date of the enactment of this paragraph and ending 5 years after the date of enactment of this paragraph, the Federal medical assistance percentage with respect to amounts expended by a State for medical assistance for counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the State plan (as defined in paragraph (1)) shall be equal to 90 percent.

    The bill says: by striking subsection (bb) and inserting the following:

    Bill text · Current law (42 U.S.C. 1396d)

  660. 42 U.S.C. 1396o-1(b)(3)(B)(iii)changedby H.R. 9877 Sec. 7305(b)

    The bill says: in clause (iii), by striking ", and counseling and pharmacotherapy for cessation of tobacco use by pregnant women (as defined in section 1905(bb))"; and

    Bill text · Current law (42 U.S.C. 1396o-1)

  661. 42 U.S.C. 1396o-1(b)(3)(B)added (xv)by H.R. 9877 Sec. 7305(b)

    (xv) Counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the State plan (as defined in section 1905(bb)) and covered outpatient drugs (as defined in subsection (k)(2) of section 1927 and including nonprescription drugs described in subsection (d)(2) of such section) that are prescribed for purposes of promoting tobacco cessation in accordance with the guideline specified in section 1905(bb).

    The bill says: by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1396o-1)

  662. 42 U.S.C. 1396r-8(d)(2)(F)rewrittenby H.R. 9877 Sec. 7305(c)

    The bill says: Section 1927(d)(2)(F) of the Social Security Act (42 U.S.C. 1396r–8(d)(2)(F)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1396r-8)

  663. 42 U.S.C. 1396a(a)(90)(C)changedby H.R. 9877 Sec. 7305(d)

    The bill says: in paragraph (90)(C), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1396a)

  664. 42 U.S.C. 1396a(a)(91)changedby H.R. 9877 Sec. 7305(d)

    The bill says: in paragraph (91), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1396a)

  665. 42 U.S.C. 1396a(a)added (92)by H.R. 9877 Sec. 7305(d)

    (92) provide that the State will monitor and promote the use of comprehensive tobacco cessation services under the State plan (including conducting an outreach campaign to increase awareness of the benefits of using such services) among—(A) individuals entitled to medical assistance under the State plan who use tobacco products; and(B) clinicians and others who provide services to individuals entitled to medical assistance under the State plan.

    The bill says: by inserting after paragraph (91) the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396a)

  666. 42 U.S.C. 1396b(a)(6)(B)changedby H.R. 9877 Sec. 7305(e)

    The bill says: in paragraph (6)(B), by striking "plus" at the end;

    Bill text · Current law (42 U.S.C. 1396b)

  667. 42 U.S.C. 1396b(a)(7)changedby H.R. 9877 Sec. 7305(e)

    (7) subject to section 1396r(g)(3)(B) of this title, an amount equal to 50 per centum of the remainder of the amounts expended during such quarter as found necessary by the Secretary for the proper and efficient administration of the State plan.; plus

    The bill says: in paragraph (7), by striking the period at the end and inserting "; plus"; and

    Bill text · Current law (42 U.S.C. 1396b)

  668. 42 U.S.C. 1396b(a)added (8)by H.R. 9877 Sec. 7305(e)

    (8) with respect to the development, implementation, and evaluation of an outreach campaign to—(A) increase awareness of comprehensive tobacco cessation services covered in the State plan among—(i) individuals who are likely to be eligible for medical assistance under the State plan; and(ii) clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the State plan; and(B) increase awareness of the benefits of using comprehensive tobacco cessation services covered in the State plan among—(i) individuals who are likely to be eligible for medical assistance under the State plan; and(ii) clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the State plan about the benefits of using comprehensive tobacco cessation services, for calendar quarters occurring during the period beginning on the date of the enactment of this paragraph and ending on the date that is 5 years after the date of enactment of this paragraph, an amount equal to 90 percent of the sums expended during each quarter which are attributable to such development, implementation, and evaluation, and for calendar quarters succeeding such period, an amount equal to Federal medical assistance percentage determined under section 1905(b) of the sums expended during each quarter which are so attributable.

    The bill says: by inserting after paragraph (7) the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396b)

  669. 42 U.S.C. 1396r-8(d)(1)(A)changedby H.R. 9877 Sec. 7305(f)

    The bill says: in paragraph (1)(A), by striking "A State" and inserting "Subject to paragraph (8), a State"; and

    Bill text · Current law (42 U.S.C. 1396r-8)

  670. 42 U.S.C. 1396r-8(d)added (8)by H.R. 9877 Sec. 7305(f)

    (8) No prior authorization programs for tobacco cessation drugs.— A State plan may not require, as a condition of coverage or payment for a covered outpatient drug, the approval of an agent to promote smoking cessation (including agents approved by the Food and Drug Administration) or tobacco cessation.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396r-8)

  671. 42 U.S.C. 1397cc(c)(2)added (D)by H.R. 9877 Sec. 7305(h)

    (D) Counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the State child health plan.

    The bill says: Section 2103(c)(2) of the Social Security Act (42 U.S.C. 1397cc(c)(2)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1397cc)

  672. 42 U.S.C. 1397jj(c)added (10)by H.R. 9877 Sec. 7305(h)

    (10) Counseling and pharmacotherapy for cessation of tobacco use.— The term counseling and pharmacotherapy for cessation of tobacco use means diagnostic, therapy, and counseling services and pharmacotherapy (including the coverage of prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration) for the cessation of tobacco use by individuals who use tobacco products or who are being treated for tobacco use that are furnished—(A) by or under the supervision of a physician; or(B) by any other health care professional who—(i) is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished; and(ii) is authorized to receive payment for other services under this title or is designated by the Secretary for this purpose, which is recommended in the guideline entitled, "Treating Tobacco Use and Dependence: 2008 Update: A Clinical Practice Guideline" published by the Public Health Service in May 2008 (or any subsequent modification of such guideline) or is recommended for the cessation of tobacco use by the United States Preventive Services Task Force or any additional intervention approved by the Food and Drug Administration as safe and effective in helping smokers quit.

    The bill says: Section 2110(c) of the Social Security Act (42 U.S.C. 1397jj(c)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397jj)

  673. 42 U.S.C. 1397cc(e)added (5)by H.R. 9877 Sec. 7305(i)

    (5) No cost sharing on benefits for counseling and pharmacotherapy for cessation of tobacco use.— The State child health plan may not impose deductibles, coinsurance, or other cost sharing with respect to benefits for counseling and pharmacotherapy for cessation of tobacco use (as defined in section 2110(c)(10)) and prescription drugs that are covered under a State child health plan that are prescribed for purposes of promoting tobacco cessation in accordance with the guideline specified in section 2110(c)(10)(B).

    The bill says: Section 2103(e) of the Social Security Act (42 U.S.C. 1397cc(e)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397cc)

  674. 42 U.S.C. 1397ccadded (g)by H.R. 9877 Sec. 7305(j)

    (g) Exception from optional restriction under CHIP prescription drug coverage.— The State child health plan may exclude or otherwise restrict nonprescription drugs, except, in the case of—(1) pregnant women when recommended in accordance with the guideline specified in section 2110(c)(10)(B), agents approved by the Food and Drug Administration under the over-the-counter monograph process for purposes of promoting tobacco cessation; and(2) individuals who are eligible under the State child health plan when recommended in accordance with the Guideline referred to in section 2110(c)(10)(B), agents approved by the Food and Drug Administration under the over-the-counter monograph process for purposes of promoting tobacco cessation.

    The bill says: Section 2103 of the Social Security Act (42 U.S.C. 1397cc) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1397cc)

  675. 42 U.S.C. 1397bbadded (e)by H.R. 9877 Sec. 7305(k)

    (e) State monitoring and promoting of comprehensive tobacco cessation services under CHIP.— A State child health plan shall include a description of the procedures to be used by the State to monitor and promote the use of comprehensive tobacco cessation services under the State plan (including conducting an outreach campaign to increase awareness of the benefits of using such services) among—(1) individuals entitled to medical assistance under the State child health plan who use tobacco products; and(2) clinicians and others who provide services to individuals entitled to medical assistance under the State child health plan.

    The bill says: Section 2102 of the Social Security Act (42 U.S.C. 1397bb) is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1397bb)

  676. 42 U.S.C. 1397ee(a)added (5)by H.R. 9877 Sec. 7305(l)

    (5) Federal reimbursement for CHIP coverage of comprehensive tobacco cessation services and outreach campaign.— In addition to the payments made under paragraph (1) for calendar quarters occurring during the period beginning on the date of the enactment of this paragraph and ending 5 years after such date, the Secretary shall pay—(A) an amount equal to 90 percent of the sums expended during each quarter which are attributable to the cost of furnishing counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the State child health plan (net of any payments made to the State under paragraph (1) with respect to such counseling and pharmacotherapy); plus(B) an amount equal to 90 percent of the sums expended during each quarter which are attributable to the development, implementation, and evaluation of an outreach campaign to—(i) increase awareness of comprehensive tobacco cessation services covered in the State child health plan among—(I) individuals who are likely to be eligible for medical assistance under the State child health plan; and(II) clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the State child health plan; and(ii) increase awareness of the benefits of using comprehensive tobacco cessation services covered in the State child health plan among—(I) individuals who are likely to be eligible for medical assistance under the State child health plan; and(II) clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the State child health plan about the benefits of using comprehensive tobacco cessation services.

    The bill says: Section 2105(a) of the Social Security Act (42 U.S.C. 1397ee(a)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397ee)

  677. 42 U.S.C. 1397dd(m)(2)(B)changedby H.R. 9877 Sec. 7305(l)

    The bill says: in paragraph (2)(B), by striking "and (12)" and inserting "(12), and (13)"; and

    Bill text · Current law (42 U.S.C. 1397dd)

  678. 42 U.S.C. 1397dd(m)added (13)by H.R. 9877 Sec. 7305(l)

    (13) Adjusting allotments to account for federal payments for chip coverage of comprehensive tobacco cessation services and outreach campaign.— If a State (including the District of Columbia and each commonwealth and territory) receives a payment for a fiscal year under section 2105(a)(5), the allotment determined for the State for such fiscal year shall be increased by the amount of such payment.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397dd)

  679. 42 U.S.C. 300gg-13added (d)by H.R. 9877 Sec. 7305(n)

    (d) No prior authorization.— A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not impose any prior authorization requirement for tobacco cessation counseling and pharmacotherapy that has in effect a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force.

    The bill says: Section 2713 of the Public Health Service Act (42 U.S.C. 300gg–13) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300gg-13)

  680. 42 U.S.C. 300ff-31badded (c)by H.R. 9877 Sec. 7402

    (c) Additional funding for AIDS drug assistance program treatments.— In addition to amounts otherwise authorized to be appropriated for carrying out this subpart, there are authorized to be appropriated such sums as may be necessary to carry out sections 2612(b)(3)(B) and 2616 for each of fiscal years 2027 through 2030.

    The bill says: Section 2623 of the Public Health Service Act (42 U.S.C. 300ff–31b) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300ff-31b)

  681. 42 U.S.C. 1396a(e)added (17)by H.R. 9877 Sec. 7416(a)

    (17) Enrollment of ex-offenders.—(A) Automatic enrollment or reinstatement.—(i) In general.— The State plan shall provide for the automatic enrollment or reinstatement of enrollment of an eligible individual—(I) if such individual is scheduled to be released from a public institution due to the completion of sentence, not less than 30 days prior to the scheduled date of the release; and(II) if such individual is to be released from a public institution on parole or on probation, as soon as possible after the date on which the determination to release such individual was made, and before the date such individual is released.(ii) Exception.— If a State makes a determination that an individual is not eligible to be enrolled under the State plan—(I) on or before the date by which the individual would be enrolled under clause (i), such clause shall not apply to such individual; or(II) after such date, the State may terminate the enrollment of such individual.(B) Relationship of enrollment to payment for services.—(i) In general.— Subject to subparagraph (A)(ii), an eligible individual who is enrolled, or whose enrollment is reinstated, under subparagraph (A) shall be eligible for all services for which medical assistance is provided under the State plan after the date that the eligible individual is released from the public institution.(ii) Relationship to payment prohibition for inmates.— No provision of this paragraph may be construed to permit payment for care or services for which payment is excluded under subparagraph (A) following the last numbered paragraph of section 1905(a).(C) Treatment of continuous eligibility.—(i) Suspension for inmates.— Any period of continuous eligibility under this title shall be suspended on the date an individual enrolled under this title becomes an inmate of a public institution (except as a patient of a medical institution).(ii) Determination of remaining period.— Notwithstanding any changes to State law related to continuous eligibility during the time that an individual is an inmate of a public institution (except as a patient of a medical institution), subject to clause (iii), with respect to an eligible individual who was subject to a suspension under clause (i), on the date that such individual is released from a public institution the suspension of continuous eligibility under such clause shall be lifted for a period that is equal to the time remaining in the period of continuous eligibility for such individual on the date that such period was suspended under such clause.(iii) Exception.— If a State makes a determination that an individual is not eligible to be enrolled under the State plan—(I) on or before the date that the suspension of continuous eligibility is lifted under clause (ii), such clause shall not apply to such individual; or(II) after such date, the State may terminate the enrollment of such individual.(D) Automatic enrollment or reinstatement of enrollment defined.— For purposes of this paragraph, the term automatic enrollment or reinstatement of enrollment means that the State determines eligibility for medical assistance under the State plan without a program application from, or on behalf of, the eligible individual, but an individual can only be automatically enrolled in the State Medicaid plan if the individual affirmatively consents to being enrolled through affirmation in writing, by telephone, orally, through electronic signature, or through any other means specified by the Secretary.(E) Eligible individual defined.— For purposes of this paragraph, the term eligible individual means an individual who is an inmate of a public institution (except as a patient in a medical institution)—(i) who was enrolled under the State plan for medical assistance immediately before becoming an inmate of such an institution; or(ii) who is diagnosed with human immunodeficiency virus.

    The bill says: Section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1396a)

  682. 18 U.S.C. 4014(a)changedby H.R. 9877 Sec. 7417(f)

    The bill says: by striking "for a period of 6 months or more";

    Bill text · Current law (18 U.S.C. 4014)

  683. 18 U.S.C. 4014(a)changedby H.R. 9877 Sec. 7417(f)

    The bill says: by striking ", as appropriate,"; and

    Bill text · Current law (18 U.S.C. 4014)

  684. 18 U.S.C. 4014(a)changedby H.R. 9877 Sec. 7417(f)

    The bill says: by striking "if such individual is determined to be at risk for infection with such virus in accordance with the guidelines issued by the Bureau of Prisons relating to infectious disease management." and inserting "unless the individual declines. The Attorney General shall also cause such individual to be so tested before release from that incarceration unless the individual declines.".

    Bill text · Current law (18 U.S.C. 4014)

  685. 18 U.S.C. 4014(d)changedby H.R. 9877 Sec. 7417(f)

    The bill says: Section 4014(d) of title 18, United States Code, is amended by inserting "or under section 7417 of the Health Equity and Accountability Act of 2026" after "under this section".

    Bill text · Current law (18 U.S.C. 4014)

  686. 18 U.S.C. 4014(e)addedby H.R. 9877 Sec. 7417(f)

    The bill says: Section 4014(e) of title 18, United States Code, is amended by adding at the end the following: "Such rules shall also provide that the initial test under this section be performed as part of the routine health screening conducted at intake.".

    Bill text · Current law (18 U.S.C. 4014)

  687. 42 U.S.C. 202added 241Aby H.R. 9877 Sec.

    241A. Transfer of funds for implementation of National HIV/AIDS Strategy.—(a) Transfer authorization.— Of the discretionary appropriations made available to the Department of Health and Human Services for any fiscal year for programs and activities that, as determined by the Secretary, pertain to HIV, the Secretary may transfer up to 1 percent of such appropriations to the Office of the Assistant Secretary for Health for implementation of the Ending the HIV Epidemic: A Plan for America.(b) Congressional notification.— Not less than 30 days before making any transfer under this section, the Secretary shall give notice of the transfer to the Congress.(c) Definitions.— In this section, the term Ending the HIV Epidemic: A Plan for America means the initiative of the Department of Health and Human Services that seeks to reduce the number of new HIV infections in the United States by 75 percent by 2027, and then by at least 90 percent by 2032, for an estimated 250,000 total HIV infections averted.

    The bill says: Title II of the Public Health Service Act (42 U.S.C. 202 et seq.) is amended by inserting after section 241 (42 U.S.C. 238j) the following:

    Bill text · Current law (42 U.S.C. 202)

  688. 42 U.S.C. 300gg-13(a)rewrittenby H.R. 9877 Sec. 7419(a)

    (a) Coverage of preventive health services.—(1) In general.— A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum, provide coverage for and shall not impose any cost sharing requirements for—(A) evidence-based items or services that have in effect a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force;(B) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved;(C) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration;(D) with respect to women, such additional preventive care and screenings not described in subparagraph (A) as provided for in comprehensive guidelines supported by the Health Resources and Services Administration for purposes of this subparagraph;(E) any prescription drug approved by the Food and Drug Administration for the prevention of HIV (other than a drug subject to preauthorization requirements consistent with section 2729A), administrative fees for such drugs, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow-up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation; and

    The bill says: Section 2713(a) of the Public Health Service Act (42 U.S.C. 300gg–13(a)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 300gg-13)

  689. 42 U.S.C. 300gg-111added 2799A–12by H.R. 9877 Sec. 7419(a)

    2799A–12. Prohibition on preauthorization requirements with respect to certain services.— A group health plan or a health insurance issuer offering group or individual health insurance coverage shall not impose any preauthorization requirements with respect to coverage of the services described in section 2713(a)(1)(E), except that a plan or issuer may impose preauthorization requirements with respect to coverage of a particular drug approved under section 505(c) of the Federal Food, Drug, and Cosmetic Act or section 351(a) of this Act if such plan or issuer provides coverage without any preauthorization requirements for a drug that is therapeutically equivalent.

    The bill says: Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–111 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300gg-111)

  690. 29 U.S.C. 1185added 727by H.R. 9877 Sec. 7419(a)

    727 Prohibition on preauthorization requirements with respect to certain services.— A group health plan or a health insurance issuer offering group health insurance coverage shall not impose any preauthorization requirements with respect to coverage of the services described in section 2713(a)(1)(E), except that a plan or issuer may impose preauthorization requirements with respect to coverage of a particular drug approved under section 505(c) of the Federal Food, Drug, and Cosmetic Act or section 351(a) of this Act if such plan or issuer provides coverage without any preauthorization requirements for a drug that is therapeutically equivalent.

    The bill says: Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following:

    Bill text · Current law (29 U.S.C. 1185)

  691. 5 U.S.C. 8904added (c)by H.R. 9877 Sec. 7419(a)

    (c) Any health benefits plan offered under this chapter shall include benefits for, and may not impose any cost sharing requirements for, any prescription drug approved by the Food and Drug Administration for the prevention of HIV, administrative fees for such drugs, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow-up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation.

    The bill says: Section 8904 of title 5, United States Code, is amended by adding at the end the following:

    Bill text · Current law (5 U.S.C. 8904)

  692. 42 U.S.C. 1396d(a)(4)changedby H.R. 9877 Sec. 7419(a)

    The bill says: by striking "; and (G)" and inserting "; (G)"; and

    Bill text · Current law (42 U.S.C. 1396d)

  693. 42 U.S.C. 1396d(a)(4)changedby H.R. 9877 Sec. 7419(a)

    The bill says: by striking the semicolon at the end and inserting "; and (H) HIV prevention services;"; and

    Bill text · Current law (42 U.S.C. 1396d)

  694. 42 U.S.C. 1396dadded (rr)by H.R. 9877 Sec. 7419(a)

    (rr) HIV prevention services.— For purposes of subsection (a)(4)(H), the term HIV prevention services means prescription drugs for the prevention of HIV acquisition, administrative fees for such drugs, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow-up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1396d)

  695. 42 U.S.C. 1396changedby H.R. 9877 Sec. 7419(a)

    The bill says: in section 1916, by inserting "HIV prevention services described in section 1905(a)(4)(H)," after "section 1905(a)(4)(C)," each place it appears; and

    Bill text · Current law (42 U.S.C. 1396)

  696. 42 U.S.C. 1396added (xvi)by H.R. 9877 Sec. 7419(a)

    (xvi) HIV prevention services described in section 1905(a)(4)(H).

    The bill says: in section 1916A(b)(3)(B), as amended by section 7305, by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1396)

  697. 42 U.S.C. 1396u-7(b)(7)changedby H.R. 9877 Sec. 7419(a)

    The bill says: in the paragraph header, by inserting "and HIV prevention services" after "supplies"; and

    Bill text · Current law (42 U.S.C. 1396u-7)

  698. 42 U.S.C. 1396u-7(b)(7)changedby H.R. 9877 Sec. 7419(a)

    The bill says: by striking "includes for any individual described in section 1905(a)(4)(C), medical assistance for family planning services and supplies in accordance with such section" and inserting "includes medical assistance for HIV prevention services described in section 1905(a)(4)(H), and includes, for any individual described in section 1905(a)(4)(C), medical assistance for family planning services and supplies in accordance with such section".

    Bill text · Current law (42 U.S.C. 1396u-7)

  699. 42 U.S.C. 1397cc(a)changedby H.R. 9877 Sec. 7419(a)

    The bill says: in subsection (a), by striking "through (13)" and inserting "through (14)"; and

    Bill text · Current law (42 U.S.C. 1397cc)

  700. 42 U.S.C. 1397cc(c)added (14)by H.R. 9877 Sec. 7419(a)

    (14) HIV prevention services.— Regardless of the type of coverage elected by a State under subsection (a), the child health assistance provided for a targeted low-income child, and, in the case of a State that elects to provide pregnancy-related assistance pursuant to section 2112, the pregnancy-related assistance provided for a targeted low-income pregnant woman (as such terms are defined for purposes of such section), shall include coverage of HIV prevention services (as defined in section 1905(rr)).

    The bill says: in subsection (c), by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1397cc)

  701. 42 U.S.C. 1397cc(e)(2)changedby H.R. 9877 Sec. 7419(a)

    The bill says: Section 2103(e)(2) of the Social Security Act (42 U.S.C. 1397cc(e)(2)) is amended by inserting "HIV prevention services described in subsection (c)(14)," before "or for pregnancy-related assistance".

    Bill text · Current law (42 U.S.C. 1397cc)

  702. 42 U.S.C. 1395x(s)(2)changedby H.R. 9877 Sec. 7419(a)

    The bill says: by striking "and" at the end of subparagraph (LL);

    Bill text · Current law (42 U.S.C. 1395x)

  703. 42 U.S.C. 1395x(s)(2)changedby H.R. 9877 Sec. 7419(a)

    The bill says: by inserting "and" at the end of subparagraph (MM); and

    Bill text · Current law (42 U.S.C. 1395x)

  704. 42 U.S.C. 1395x(s)(2)added (NN)by H.R. 9877 Sec. 7419(a)

    (NN) HIV prevention services (as defined in subsection (sss));

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  705. 42 U.S.C. 1395xadded (sss)by H.R. 9877 Sec. 7419(a)

    (sss) HIV prevention services.— The term HIV prevention services means—(1) drugs or biologicals approved by the Food and Drug Administration for the prevention of HIV;(2) administrative fees for such drugs;(3) laboratory and other diagnostic procedures associated with the use of such drugs; and(4) clinical follow-up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation.

    The bill says: Section 1861 of the Social Security Act (42 U.S.C. 1395x), as amended by sections 2007(b), 4221(a), 4251(c)(2), and 6101(a)(2), is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  706. 42 U.S.C. 1395l(a)(1)changedby H.R. 9877 Sec. 7419(a)

    The bill says: by striking "and" before "(JJ)"; and

    Bill text · Current law (42 U.S.C. 1395l)

  707. 42 U.S.C. 1395l(a)(1)addedby H.R. 9877 Sec. 7419(a)

    The bill says: by inserting before the semicolon at the end the following: "and (KK) with respect to HIV prevention services (as defined in section 1861(sss)), the amount paid shall be 100 percent of (i) except as provided in clause (ii), the lesser of the actual charge for the service or the amount determined under the fee schedule that applies to such services under this part, and (ii) in the case of such services that are covered OPD services (as defined in subsection (t)(1)(B)), the amount determined under subsection (t)".

    Bill text · Current law (42 U.S.C. 1395l)

  708. 42 U.S.C. 1395l(b)(12)changedby H.R. 9877 Sec. 7419(a)

    The bill says: in paragraph (12), by striking "section 1861(s)(10)(A),, and" and inserting "section 1861(s)(10)(A),";

    Bill text · Current law (42 U.S.C. 1395l)

  709. 42 U.S.C. 1395l(b)(13)changedby H.R. 9877 Sec. 7419(a)

    The bill says: in paragraph (13), by striking "section 1861(n).." and inserting "section 1861(n), and (14) such deductible shall not apply with respect to HIV prevention services (as defined in section 1861(sss).".

    Bill text · Current law (42 U.S.C. 1395l)

  710. 42 U.S.C. 1395w-102(b)(1)(A)changedby H.R. 9877 Sec. 7419(a)

    The bill says: in paragraph (1)(A), in the matter preceding clause (i), by striking "(8) and (9)" and inserting "(8), (9), and (10)";

    Bill text · Current law (42 U.S.C. 1395w-102)

  711. 42 U.S.C. 1395w-102(b)(2)(A)changedby H.R. 9877 Sec. 7419(a)

    The bill says: in paragraph (2)(A), in subparagraph (A), in the matter preceding clause (i), by striking "(8) and (9)" and inserting "(8), (9), and (10)"; and

    Bill text · Current law (42 U.S.C. 1395w-102)

  712. 42 U.S.C. 1395w-102(b)added (10)by H.R. 9877 Sec. 7419(a)

    (10) Elimination of cost-sharing for drugs for the prevention of HIV.— For plan years beginning on or after January 1, 2027, with respect to a covered part D drug that is for the prevention of HIV—(A) the deductible under paragraph (1) shall not apply; and(B) there shall be no coinsurance or other cost-sharing under this part with respect to such drug.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395w-102)

  713. 42 U.S.C. 1395w-102(c)added (7)by H.R. 9877 Sec. 7419(a)

    (7) Treatment of cost-sharing for drugs for the prevention of hiv.— The coverage is in accordance with subsection (b)(10).

    The bill says: in subsection (c), by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395w-102)

  714. 42 U.S.C. 1395w-114(a)(1)(D)changedby H.R. 9877 Sec. 7419(a)

    The bill says: Section 1860D–14(a)(1)(D) of the Social Security Act (42 U.S.C. 1395w–114(a)(1)(D)) is amended in each of clauses (ii) and (iii), by striking "paragraph (6)" and inserting "paragraph (6) and section 1860D–2(b)(10)".

    Bill text · Current law (42 U.S.C. 1395w-114)

  715. 38 U.S.C. 1722A(a)added (5)by H.R. 9877 Sec. 7419(a)

    (5) Paragraph (1) does not apply to a medication for the prevention of HIV.

    The bill says: Section 1722A(a) of title 38, United States Code, is amended by adding at the end the following new paragraph:

    Bill text · Current law (38 U.S.C. 1722A)

  716. 10 U.S.C. 1079cadded 1079dby H.R. 9877 Sec. 7419(a)

    1079d. Coverage of HIV prevention treatment.—(a) In general.— The Secretary of Defense shall ensure coverage under the TRICARE program of HIV prevention treatment described in subsection (b) for any beneficiary under section 1074(a) of this title.(b) HIV prevention treatment described.— HIV prevention treatment described in this subsection includes any prescription drug approved by the Food and Drug Administration for the prevention of HIV, administrative fees for such drugs, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow-up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation.(c) No cost-Sharing.— Notwithstanding section 1075, 1075a, or 1074g(a)(6) of this title or any other provision of law, there is no cost-sharing requirement for HIV prevention treatment covered under this section.

    The bill says: Chapter 55 of title 10, United States Code, is amended by inserting after section 1079c the following new section:

    Bill text · Current law (10 U.S.C. 1079c)

  717. 25 U.S.C. 1621vadded 224by H.R. 9877 Sec. 7419(a)

    224 Testing, monitoring, and prescription drugs for the prevention of HIV.—(a) In general.— The Secretary, acting through the Service, Indian tribes, and tribal organizations, shall provide, without limitation, funding for any prescription drug approved by the Food and Drug Administration for the prevention of human immunodeficiency virus (commonly known as "HIV"), administrative fees for that drug, laboratory and other diagnostic procedures associated with the use of that drug, and clinical follow-up and monitoring, including any related services recommended in current Public Health Service clinical practice guidelines.(b) Authorization of appropriations.— There are authorized to be appropriated such sums as are necessary to carry out this section.

    The bill says: Title II of the Indian Health Care Improvement Act is amended by inserting after section 223 (25 U.S.C. 1621v) the following:

    Bill text · Current law (25 U.S.C. 1621v)

  718. 42 U.S.C. 280gadded 399V–11by H.R. 9877 Sec. 7419(d)

    399V–11. Pre-exposure prophylaxis and post-exposure prophylaxis funding.—(a) In general.— Not later than 1 year after the date of enactment of this section, the Secretary shall establish a program that awards grants to States, territories, Indian Tribes, and directly eligible entities for the establishment and support of pre-exposure prophylaxis (referred to in this section as "PrEP") and post-exposure prophylaxis (referred to in this section as "PEP") HIV programs.(b) Applications.— To be eligible to receive a grant under subsection (a), a State, territory, Indian Tribe, or directly eligible entity shall—(1) submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan describing how any funds awarded will be used to increase access to PrEP for uninsured and underinsured individuals and reduce disparities in access to PrEP and PEP for uninsured and underinsured individuals and reduce disparities in access to PrEP and PEP; and(2) appoint a PrEP and PEP grant administrator to manage the program.(c) Directly eligible entity.— For purposes of this section, the term directly eligible entity—(1) means a Federally qualified health center or other nonprofit entity engaged in providing PrEP and PEP information and services; and(2) may include—(A) a Federally qualified health center (as defined in section 1861(aa)(4) of the Social Security Act);(B) a family planning grantee (other than States) funded under section 1001;(C) a rural health clinic (as defined in section 1861(aa)(2) of the Social Security Act);(D) a health facility operated by or pursuant to a contract with the Indian Health Service;(E) a community-based organization, clinic, hospital, or other health facility that provides services to individuals at risk for or living with HIV; and(F) a nonprofit private entity providing comprehensive primary care to populations at risk of HIV, including faith-based and community-based organizations.(d) Awards.— In determining whether to award a grant, and the grant amount for each grant awarded, the Secretary shall consider the grant application and the need for PrEP and PEP services in the area, the number of uninsured and underinsured individuals in the area, and how the State, territory, or Indian Tribe coordinates PrEP and PEP activities with the directly funded entity, if the State, territory, or Indian Tribe applies for the funds.(e) Use of funds.—(1) In general.— Any State, territory, Indian Tribe, or directly eligible entity that is awarded funds under subsection (a) shall use such funds for eligible PrEP and PEP expenses.(2) Eligible prep expenses.— The Secretary shall publish a list of expenses that qualify as eligible PrEP and PEP expenses for purposes of this section, which shall include—(A) any prescription drug approved by the Food and Drug Administration for the prevention of HIV, administrative fees for such drugs, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow-up and monitoring, including any related services recommended in current United States Public Health Service clinical practice guidelines, without limitation;(B) outreach and public education activities directed toward populations overrepresented in the domestic HIV epidemic that increase awareness about the existence of PrEP and PEP, provide education about access to and health care coverage of PrEP and PEP, PrEP and PEP adherence programs, and counter stigma associated with the use of PrEP and PEP; and(C) outreach activities directed toward physicians and other providers that provide education about PrEP and PEP.(f) Report to congress.— The Secretary shall, in each of the first 5 years beginning one year after the date of the enactment of this section, submit to Congress, and make public on the internet website of the Department of Health and Human Services, a report on the impact of any grants provided to States, territories, and Indian Tribes and directly eligible entities for the establishment and support of pre-exposure prophylaxis programs under this section.(g) Authorization of appropriations.— To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2027 through 2032.

    The bill says: Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 7303, is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280g)

  719. 42 U.S.C. 285cadded 434Bby H.R. 9877 Sec. 7501

    434B. Diabetes in minority populations.—(a) In general.— The Director of NIH shall expand, intensify, and support ongoing research and other activities with respect to prediabetes and diabetes, particularly type 2, in minority populations.(b) Research.—(1) Description.— Research under subsection (a) shall include investigation into—(A) the causes of diabetes, including socioeconomic, geographic, clinical, environmental, genetic, and other factors that may contribute to increased rates of diabetes in minority populations; and(B) the causes of increased incidence of diabetes complications in minority populations, and possible interventions to decrease such incidence.(2) Inclusion of minority participants.— In conducting and supporting research described in subsection (a), the Director of NIH shall seek to include minority participants as study subjects in clinical trials.(c) Report; comprehensive plan.—(1) In general.— The Diabetes Mellitus Interagency Coordinating Committee shall—(A) prepare and submit to Congress, not later than 6 months after the date of enactment of this section, a report on Federal research and public health activities with respect to prediabetes and diabetes in minority populations; and(B) develop and submit to Congress, not later than 1 year after the date of enactment of this section, an effective and comprehensive Federal plan (including all appropriate Federal health programs) to address prediabetes and diabetes in minority populations.(2) Contents.— The report under paragraph (1)(A) shall at minimum address each of the following:(A) Research on diabetes and prediabetes in minority populations, including such research on—(i) genetic, behavioral, socioeconomic, and environmental factors;(ii) prevention of diabetes within these populations and which of the populations have individuals at increased risk of developing diabetes;(iii) prevention of complications among individuals in these populations who have already developed diabetes; and(iv) barriers to health care access and diabetes treatment within populations at increased risk of developing diabetes.(B) Surveillance and data collection on diabetes and prediabetes in minority populations, including with respect to—(i) efforts to better determine the prevalence of diabetes among Asian-American, Native Hawaiian, and Pacific Islander subgroups; and(ii) efforts to coordinate data collection on the American Indian population.(C) Community-based interventions to address diabetes and prediabetes targeting minority populations, including—(i) the evidence base for such interventions;(ii) the cultural appropriateness of such interventions; and(iii) efforts to educate the public on the causes and consequences of diabetes.(D) Education and training programs for health professionals (including community health workers) on the prevention and management of diabetes and its related complications that is supported by the Health Resources and Services Administration, including such programs supported by—(i) the National Health Service Corps; or(ii) the community health centers program under section 330.(d) Education.— The Director of NIH shall—(1) through the National Institute on Minority Health and Health Disparities and the National Diabetes Education Program—(A) make grants to programs funded under section 464z–4 for the purpose of establishing a medical education program for health care professionals to be more involved in weight counseling, obesity research, nutrition, and shared decision making; and(B) provide for the participation of minority health professionals in diabetes-focused research programs; and(2) make grants to programs that establish a professional pipeline that will increase the participation of minority individuals in diabetes-focused health fields by expanding Minority Access to Research Careers program internships and mentoring opportunities for the purposes of recruitment.(e) Definitions.— For purposes of this section:(1) Diabetes mellitus interagency coordinating committee.— The "Diabetes Mellitus Interagency Coordinating Committee" means the Diabetes Mellitus Interagency Coordinating Committee established under section 429.(2) Minority population.— The term minority population means a racial and ethnic minority group, as defined in section 1707.

    The bill says: Subpart 3 of part C of title IV of the Public Health Service Act (42 U.S.C. 285c et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285c)

  720. 42 U.S.C. 243added 317Yby H.R. 9877 Sec. 7502

    317Y. Diabetes in minority populations.—(a) Research and other activities.—(1) In general.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall conduct and support research and public health activities with respect to diabetes in minority populations.(2) Certain activities.— Activities under paragraph (1) regarding diabetes in minority populations shall include the following:(A) Further enhancing the National Health and Nutrition Examination Survey by oversampling Asian Americans, Native Hawaiians, and Pacific Islanders in appropriate geographic areas to better determine the prevalence of diabetes in such populations as well as to improve the data collection of diabetes penetration disaggregated into major ethnic groups within such populations. The Secretary shall ensure that any such oversampling does not reduce the oversampling of other minority populations including African-American and Latino populations.(B) Through the Division of Diabetes Translation—(i) providing for prevention research to better understand how to influence health care systems changes to improve quality of care being delivered to such populations;(ii) carrying out model demonstration projects to design, implement, and evaluate effective diabetes prevention and control interventions for minority populations, including culturally appropriate community-based interventions;(iii) developing and implementing a strategic plan to reduce diabetes in minority populations through applied research to reduce disparities and culturally and linguistically appropriate community-based interventions;(iv) supporting, through the national diabetes prevention program under section 399V–3, diabetes prevention program sites in underserved regions highly impacted by diabetes; and(v) implementing, through the national diabetes prevention program under section 399V–3, a demonstration program developing new metrics measuring health outcomes related to diabetes that can be stratified by specific minority populations.(b) Education.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall direct the Division of Diabetes Translation to conduct and support both programs to educate the public on diabetes in minority populations and programs to educate minority populations about the causes and effects of diabetes.(c) Diabetes; health promotion, prevention initiatives, and access.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention and the National Diabetes Education Program, shall conduct and support programs to educate specific minority populations through culturally appropriate and linguistically appropriate information campaigns and initiatives about prevention of, and managing, diabetes.(d) Definition.— For purposes of this section, the term minority population means a racial and ethnic minority group, as defined in section 1707.

    The bill says: Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.), as amended by section 7201, is amended by inserting after section 317X the following:

    Bill text · Current law (42 U.S.C. 243)

  721. 42 U.S.C. 280gadded 399V–12by H.R. 9877 Sec. 7503

    399V–12. Programs to educate health providers on the causes and effects of diabetes in minority populations.—(a) In general.— The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall conduct and support programs described in subsection (b) to educate health professionals on the causes and effects of diabetes in minority populations.(b) Programs.— Programs described in this subsection, with respect to education on diabetes in minority populations, shall include the following:(1) Giving priority, under the primary care training and enhancement program under section 747—(A) to awarding grants to focus on or address diabetes; and(B) to adding minority populations to the list of vulnerable populations that should be served by such grants.(2) Providing additional funds for the Health Careers Opportunity Program and the Centers of Excellence to partner with the Office of Minority Health under section 1707 and the National Institutes of Health to strengthen programs for career opportunities focused on diabetes treatment and care within underserved regions highly impacted by diabetes.(3) Developing a diabetes focus within, and providing additional funds for, the National Health Service Corps scholarship program—(A) to place individuals in areas that are disproportionately affected by diabetes and to provide diabetes treatment and care in such areas; and(B) to provide such individuals continuing medical education specific to diabetes care.

    The bill says: Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 7419(d), is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280g)

  722. 42 U.S.C. 280gadded 399V–13by H.R. 9877 Sec. 7504

    399V–13. Research, education, and other activities regarding diabetes in American Indian populations.— In addition to activities under sections 317X, 399V–12, and 434B, the Secretary, acting through the Indian Health Service and in collaboration with other appropriate Federal agencies, shall—(1) conduct and support research and other activities with respect to diabetes; and(2) coordinate the collection of data on clinically and culturally appropriate diabetes treatment, care, prevention, and services by health care professionals to the American Indian population.

    The bill says: Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 7503, is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280g)

  723. 42 U.S.C. 247b-10rewrittenby H.R. 9877 Sec. 7601

    317I. Asthma-related activities of the Centers for Disease Control and Prevention.—(a) Program for providing information and education to the public.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall collaborate with State and local health departments to conduct activities, including the provision of information and education to the public, regarding asthma including—(1) deterring the harmful consequences of uncontrolled asthma; and(2) disseminating health education and information regarding prevention of asthma episodes and strategies for managing asthma.(b) Development of state asthma plans.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall collaborate with State and local health departments to develop State plans incorporating public health responses to reduce the burden of asthma, particularly regarding disproportionately affected populations.(c) Compilation of data.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall, in cooperation with State and local public health officials—(1) conduct asthma surveillance activities to collect data on the prevalence and severity of asthma, the effectiveness of public health asthma interventions, and the quality of asthma management, including—(A) collection of data among people with asthma to monitor the impact on health and quality of life;(B) surveillance of health care facilities; and(C) collection of data not containing individually identifiable information from electronic health records or other electronic communications;(2) compile and annually publish data regarding the prevalence and incidence of childhood asthma, the child mortality rate, and the number of hospital admissions and emergency department visits by children associated with asthma nationally and in each State and at the county level by age, sex, race, and ethnicity, as well as lifetime and current prevalence; and(3) compile and annually publish data regarding the prevalence and incidence of adult asthma, the adult mortality rate, and the number of hospital admissions and emergency department visits by adults associated with asthma nationally and in each State and at the county level by age, sex, race, ethnicity, industry, and occupation, as well as lifetime and current prevalence.(d) Coordination of data collection.— The Director of the Centers for Disease Control and Prevention, in conjunction with State and local health departments, shall coordinate data collection activities under paragraphs (2) and (3) of subsection (c) so as to maximize comparability of results.(e) Collaboration.—(1) In general.— The Centers for Disease Control and Prevention may collaborate with national, State, and local nonprofit organizations to provide information and education about asthma, and to strengthen such collaborations when possible.(2) Specific activities.— The Director of the Centers for Disease Control and Prevention, acting through the Division of Population Health of the Centers, may expand activities relating to asthma with non-Federal partners, especially State-level entities.(f) Reports to congress.—(1) In general.— Not later than 3 years after the date of the enactment of the Health Equity and Accountability Act of 2026, and once 2 years thereafter, the Secretary shall, in consultation with patient groups, nonprofit organizations, medical societies, and other relevant governmental and nongovernmental entities, submit to Congress a report that—(A) catalogs, with respect to asthma prevention, management, and surveillance—(i) the activities of the Federal Government, including an assessment of the progress of the Federal Government and States, with respect to achieving the goals of the Healthy People 2030 initiative; and(ii) the activities of other entities that participate in the program under this section, including nonprofit organizations, patient advocacy groups, and medical societies; and(B) makes recommendations for the future direction of asthma activities, in consultation with researchers from the National Institutes of Health and other member bodies of the Asthma Disparities Subcommittee, including—(i) a description of how the Federal Government may improve its response to asthma, including identifying any barriers that may exist;(ii) a description of how the Federal Government may continue, expand, and improve its private-public partnerships with respect to asthma, including identifying any barriers that may exist;(iii) identification of steps that may be taken to reduce the—(I) morbidity, mortality, and overall prevalence of asthma;(II) financial burden of asthma on society;(III) burden of asthma on disproportionately affected areas, particularly those in medically underserved populations (as defined in section 330(b)(3)); and(IV) burden of asthma as a chronic disease that can be worsened by environmental exposures;(iv) the identification of programs and policies that have achieved the steps described under clause (iii), and steps that may be taken to expand such programs and policies to benefit larger populations; and(v) recommendations for future research and interventions.(2) Subsequent reports.—(A) Congressional request.— During the 5-year period following the submission of the second report under paragraph (1), the Secretary shall submit updates and revisions of the report upon the request of the Congress.(B) Five-year reevaluation.— At the end of the 5-year period referred to in subparagraph (A), the Secretary shall—(i) evaluate the analyses and recommendations made in previous reports; and(ii) determine whether an additional report is needed and if so submit such an updated report to the Congress, including appropriate recommendations.(g) Authorization of appropriations funding.— In addition to any other authorization of appropriations that is available to the Centers for Disease Con

    The bill says: Section 317I of the Public Health Service Act (42 U.S.C. 247b–10) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 247b-10)

  724. 22 U.S.C. 2151b-3rewrittenby H.R. 9877 Sec. 7701

    104B. Assistance to combat tuberculosis.—(a) Policy.—(1) In general.— It is a major objective of the foreign assistance program of the United States to help end the TB public health emergency through accelerated actions—(A) to support the diagnosis and treatment of all adults and children with all forms of TB; and(B) to prevent new TB infections from occurring.(2) Support for global plans and objectives.— In countries in which the United States Government has established foreign assistance programs under this Act, particularly in countries with the highest burden of TB and other countries with high rates of infection and transmission of TB, it is the policy of the United States—(A) to support the objectives of the World Health Organization End TB Strategy, including its goals—(i) to reduce TB deaths by 95 percent by 2035;(ii) to reduce the TB incidence rate by 90 percent by 2035; and(iii) to reduce the number of families facing catastrophic health costs due to TB by 100 percent by 2035;(B) to support the Stop TB Partnership’s Global Plan to End TB 2023–2030, including by providing support for—(i) developing and using innovative new technologies and therapies to increase active case finding and rapidly diagnose and treat children and adults with all forms of TB, alleviate suffering, and ensure TB treatment completion;(ii) expanding diagnosis and treatment in line with the goals established by the Political Declaration of the High-Level Meeting of the General Assembly on the Fight Against Tuberculosis, including—(I) successfully treating 40,000,000 people with active TB by 2023, including 3,500,000 children, and 1,500,000 people with drug-resistant TB; and(II) diagnosing and treating latent tuberculosis infection, in support of the global goal of providing preventive therapy to at least 30,000,000 people by 2023, including 4,000,000 children younger than 5 years of age, 20,000,000 household contacts of people affected by TB, and 6,000,000 people living with HIV;(iii) ensuring high-quality TB care by closing gaps in care cascades, implementing continuous quality improvement at all levels of care, and providing related patient support; and(iv) sustainable procurements of TB commodities to avoid interruptions in supply, the procurement of commodities of unknown quality, or payment of excessive commodity costs in countries impacted by TB; and(C) to ensure, to the greatest extent practicable, that United States funding supports activities that simultaneously emphasize—(i) the development of comprehensive person-centered programs, including diagnosis, treatment, and prevention strategies to ensure that—(I) all people sick with TB receive quality diagnosis and treatment through active case finding; and(II) people at high risk for TB infection are found and treated with preventive therapies in a timely manner;(ii) robust TB infection control practices are implemented in all congregate settings, including hospitals and prisons;(iii) the deployment of diagnostic and treatment capacity—(I) in areas with the highest TB burdens; and(II) for highly at-risk and impoverished populations, including patient support services;(iv) program monitoring and evaluation based on critical TB indicators, including indicators relating to infection control, the numbers of patients accessing TB treatment and patient support services, and preventative therapy for those at risk, including all close contacts, and treatment outcomes for all forms of TB;(v) training and engagement of health care workers on the use of new diagnostic tools and therapies as they become available, and increased support for training frontline health care workers to support expanded TB active case finding, contact tracing, and patient support services;(vi) coordination with domestic agencies and organizations to support an aggressive research agenda to develop vaccines as well as new tools to diagnose, treat, and prevent TB globally;(vii) linkages with the private sector on—(I) research and development of a vaccine, and on new tools for diagnosis and treatment of TB;(II) improving current tools for diagnosis and treatment of TB, including telehealth solutions for prevention and treatment; and(III) training healthcare professionals on use of the newest and most effective diagnostic and therapeutic tools;(viii) the reduction of barriers to care, including stigma and treatment and diagnosis costs, including through—(I) training health workers;(II) sensitizing policy makers;(III) requiring that all relevant grants and funding agreements include access and affordability provisions;(IV) supporting education and empowerment campaigns for TB patients regarding local TB services;(V) monitoring barriers to accessing TB services; and(VI) increasing support for patient-led and community-led TB outreach efforts;(ix) support for country-level, sustainable accountability mechanisms and capacity to measure progress and ensure that commitments made by governments and relevant stakeholders are met; and(x) support for the integration of TB diagnosis, treatment, and prevention activities into primary health care, as appropriate.(b) Definitions.— In this section:(1) Appropriate congressional committees.— The term appropriate congressional committees means the Committee on Foreign Relations of the Senate and the Committee on Foreign Affairs of the House of Representatives.(2) End tb strategy.— The term End TB Strategy means the strategy to eliminate TB that was approved by the World Health Assembly in May 2014, and is described in "The End TB Strategy: Global Strategy and Targets for Tuberculosis Prevention, Care and Control After 2015".(3) Global alliance for tuberculosis drug development.— The term Global Alliance for Tuberculosis Drug Development means the public-private partnership that bring together leaders in health, science, philanthropy, and private industry to devise new approaches to TB.(4) Global tuberculosis dru

    The bill says: Section 104B of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b–3) is amended to read as follows:

    Bill text · Current law (22 U.S.C. 2151b-3)

  725. 42 U.S.C. 285c-5(c)(3)(B)changedby H.R. 9877 Sec. 7901A(a)

    The bill says: in subparagraph (B), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 285c-5)

  726. 42 U.S.C. 285c-5(c)(3)(C)changedby H.R. 9877 Sec. 7901A(a)

    The bill says: in subparagraph (C), by striking "and" at the end; and

    Bill text · Current law (42 U.S.C. 285c-5)

  727. 42 U.S.C. 285c-5(c)(3)added (D)by H.R. 9877 Sec. 7901A(a)

    (D) improving data science through improvement in bioinformatics, data integration, and data sharing;(E) defining the chronic kidney disease mechanism and identifying new therapeutic targets for chronic kidney disease using specific tools, including mapping the genetic architecture of kidney function and disease and translating genetic maps to disease-causing genes and mechanisms, especially among minority populations;(F) improving models of human disease including better humanized animal models, improved reproducibility, and functional characterization of kidney organoids, and accelerating the development of in vivo imaging technologies; and(G) developing cell-specific drug delivery systems and gene editing, including targeted systems for the delivery of therapeutic compounds to specific kidney compartments or cell types and accelerating the implementation of gene editing and gene therapy for the treatment of kidney diseases in vivo; and

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285c-5)

  728. 42 U.S.C. 285c-3added (c)by H.R. 9877 Sec. 7901A(b)

    (c) Report by kidney, urologic, and hematologic diseases coordinating committee.—(1) In general.— The Kidney, Urologic, and Hematologic Diseases Coordinating Committee, in coordination with the Chronic Kidney Disease Initiative at the Centers for Disease Control and Prevention, shall—(A) prepare and submit to the Congress, not later than 6 months after the date of enactment of this subsection, a report on Federal research and public health activities with respect to kidney disease in minority populations; and(B) develop and submit to the Congress, the Secretary, the Director of the National Institutes of Health, and the Advisory Board established under section 430 for the diseases for which the Committee was established, not later than 1 year after the date of enactment of this subsection, an effective and comprehensive Federal plan (including all appropriate Federal health programs) to address kidney disease in minority populations.(2) Contents.— The report under paragraph (1)(A) shall at minimum address each of the following:(A) Research on kidney disease in minority populations, including such research on—(i) genetic, behavioral, and environmental factors;(ii) prevention and complications among individuals within these populations who have already developed kidney disease;(iii) the delivery of evidenced-based care for all chronic kidney disease stages, especially in underrepresented and underserved populations;(iv) expanding support for a root-cause analysis approach to disparities, including causes, detection, and management of chronic kidney disease for underserved populations;(v) developing research teams that engage with community organizations to develop and implement interventions which halt or delay development and progression of chronic kidney disease; and(vi) continued support of observational studies of kidney disease measures and outcomes.(B) Surveillance and data collection on kidney disease in minority populations, including with respect to—(i) efforts to better determine the prevalence of kidney disease among Asian-American, Native Hawaiian, and Pacific Islander subgroups; and(ii) efforts to coordinate data collection on the American Indian population.(C) Community-based interventions to address kidney disease targeting minority populations, including—(i) the evidence bases for such interventions;(ii) the cultural appropriateness of such interventions; and(iii) efforts to educate the public on the causes and consequences of kidney disease.(D) Education and training programs for health professionals (including community health workers) on the prevention and management of kidney disease and its related complications that are supported by the Health Resources and Services Administration, including such programs supported by the Bureau of Health Workforce, the Bureau of Primary Health Care, and the Health Systems Bureau. This shall include—(i) identification of effective strategies to increase implementation of proven therapies to slow chronic kidney disease incidence and progression, especially in high-risk underrepresented populations; and(ii) identification of effective practice improvement strategies in large and small health systems to reduce chronic kidney disease incidence and progression.

    The bill says: Section 429 of the Public Health Services Act (42 U.S.C. 285c–3) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285c-3)

  729. 42 U.S.C. 1395rr(b)(14)added (J)by H.R. 9877 Sec. 7901A–2(a)

    (J)(i) With respect to staff-assisted home dialysis (as defined in clause (iv)(IV)) furnished on or after the date that is 1 year after the date of the enactment of this subparagraph, subject to the succeeding provisions of this subparagraph, the Secretary shall increase the single payment that would otherwise apply under this paragraph for renal dialysis services by the add-on payment amount established pursuant to clause (iii).(ii)(I) Subject to subclause (II), staff-assisted home dialysis may only be furnished—(aa) with respect to an initializing patient (as defined in clause (iv)(I)) or a returning patient (as defined in clause (iv)(III)), for a period of up to 90 days, referred to as the "initial period" , which may be extended as determined necessary by the care team of the individual in not more than 2 intervals of up to 30 days each, each of which is referred to as an "extended interval"; and(bb) with respect to a temporary assistance patient (as defined in clause (iv)(V)), for any 30-day period as determined necessary by the care team of the individual, notwithstanding whether such an individual receives any routine dialysis respite care during such period.(II) Notwithstanding subclause (I), staff-assisted home dialysis may be furnished for as long as the Secretary determines appropriate to an individual who—(aa) is blind;(bb) has a cognitive or neurological impairment (including a stroke, Alzheimer’s Disease, dementia, amyotrophic lateral sclerosis, or any other impairment determined by the Secretary); or(cc) has any other illness or injury that reduces mobility (including cerebral palsy, spinal cord injuries, an injury or illness that requires the individual to be on a ventilator, or any other illness or injury determined by the Secretary).(iii) The Secretary shall, by regulation, establish an add-on payment amount for staff-assisted home dialysis to determine the amounts payable to a qualified provider (as defined in clause (iv)(II)) for assisting in the furnishing of staff-assisted home dialysis on a frequency as determined by the Secretary and in consultation with clinicians, patients, and care partners to ensure maximum patient choice, access, and flexibility. In establishing the add-on payment under this clause, the Secretary shall consult with stakeholders, including providers of renal dialysis services, individuals receiving home dialysis, qualified providers, private insurance payers, and Medicare Advantage plans under part C.(iv) In this subparagraph:(I) The term initializing patient means an individual who initiates a home dialysis modality, including home hemodialysis and peritoneal dialysis.(II) The term qualified provider means a trained professional (as determined by the Secretary, including a registered or licensed practical nurse and a certified patient care technician) who—(aa) furnishes renal dialysis services;(bb) meets requirements (as determined by the Secretary) that ensure competency in patient care and modality usage; and(cc) during a period described in clause (ii)(I), provides in-person assistance to an individual for an appropriate number of dialysis sessions, as determined by the care team of the individual based on the needs of the individual, caregiver availability, prescription, and mode of home dialysis.(III) The term returning patient means an individual who is returning to home dialysis after a period of hospitalization or other non-home dialysis modality.(IV)(aa) The term staff-assisted home dialysis means dialysis furnished by the individual in a home, residence, or other approved setting with the assistance of a qualified provider, the frequency of which is determined by the qualified provider in coordination with the individual, the care partner, and the care team of the individual and outlined in a patient plan of care.(bb) In this subclause, the term care partner means a friend or family member who is designated by the individual who is trained to assist the individual with the furnishing of home dialysis.(cc) In this subclause, the term patient plan of care has the meaning given such term in section 494.90 of title 42, Code of Federal Regulations (or any successor regulations).(V) The term temporary assistance patient means an individual who is receiving home dialysis and is temporarily unable to perform functions necessary to self-furnish unassisted home dialysis due to illness, injury, caregiver unavailability, or other temporary circumstances not to exceed 30 days.

    The bill says: Section 1881(b)(14) of the Social Security Act (42 U.S.C. 1395rr(b)(14)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395rr)

  730. 42 U.S.C. 1395rr(b)(5)(C)changedby H.R. 9877 Sec. 7901A–2(b)

    The bill says: in subparagraph (C), by striking at the end "and";

    Bill text · Current law (42 U.S.C. 1395rr)

  731. 42 U.S.C. 1395rr(b)(5)(D)changedby H.R. 9877 Sec. 7901A–2(b)

    The bill says: in subparagraph (D), by striking the period at the end and inserting a semicolon; and

    Bill text · Current law (42 U.S.C. 1395rr)

  732. 42 U.S.C. 1395rr(b)(5)added (E)by H.R. 9877 Sec. 7901A–2(b)

    (E) educate individuals on the opportunity to receive staff-assisted home dialysis (as defined in paragraph (14)(J)(iv)(IV)) during the periods described in paragraph (14)(J)(ii); and(F) provide for registered or licensed nurses, certified patient care technicians, or other qualified providers (as determined by a physician) to train individuals and their care partners in skills and procedures needed to furnish staff-assisted home dialysis, including—(i) in a group-training environment with other individuals and their care partners when appropriate and in accordance with Federal regulations (concerning the privacy of individually identifiable health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996;(ii) via telehealth (following an initial period of in-person competency training, in accordance with standards specified by the Secretary);(iii) through interdisciplinary team training (as described in the interpretive guidance relating to tag number V590 of "Advance Copy—End Stage Renal Disease (ESRD) Program Interpretive Guidance Version 1.1" (published on October 3, 2008)); and(iv) in the home or residence of an individual, in a dialysis facility, in a stand-alone training facility, or the place in which the individual has been approved to perform home dialysis by the care team.

    The bill says: by adding at the end the following new subparagraphs:

    Bill text · Current law (42 U.S.C. 1395rr)

  733. 42 U.S.C. 1395rr(h)(2)(A)(iv)(II)changedby H.R. 9877 Sec. 7901A–2(c)

    The bill says: in subclause (II), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395rr)

  734. 42 U.S.C. 1395rr(h)(2)(A)(iv)(III)changedby H.R. 9877 Sec. 7901A–2(c)

    The bill says: in subclause (III), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1395rr)

  735. 42 U.S.C. 1395rr(h)(2)(A)(iv)added (IV)by H.R. 9877 Sec. 7901A–2(c)

    (IV) patient quality of life for all individuals utilizing dialysis regardless of modality, with the intent of measuring and improving patient quality of life on dialysis.

    The bill says: by adding at the end the following new subclause:

    Bill text · Current law (42 U.S.C. 1395rr)

  736. 42 U.S.C. 254d(a)(3)(D)changedby H.R. 9877 Sec. 7901A–6(a)

    The bill says: Section 331(a)(3)(D) of the Public Health Service Act (42 U.S.C. 254d(a)(3)(D)) is amended by inserting "nephrology," after "dentistry,".

    Bill text · Current law (42 U.S.C. 254d)

  737. 42 U.S.C. 254l(a)(2)changedby H.R. 9877 Sec. 7901A–6(b)

    The bill says: Section 338A(a)(2) of the Public Health Service Act (42 U.S.C. 254l(a)(2)) is amended by inserting ", which may include kidney health professionals" before the period at the end.

    Bill text · Current law (42 U.S.C. 254l)

  738. 42 U.S.C. 254l-1(a)(2)changedby H.R. 9877 Sec. 7901A–6(c)

    The bill says: Section 338B(a)(2) of the Public Health Service Act (42 U.S.C. 254l–1(a)(2)) is amended by inserting ", which may include kidney health professionals" before the period at the end.

    Bill text · Current law (42 U.S.C. 254l-1)

  739. 42 U.S.C. 1395ss(s)(2)(A)changedby H.R. 9877 Sec. 7901A–7(a)

    (i) 65 years of age or older and is enrolled for benefits under part B; or(ii) is entitled to benefits under 226A(b) and is enrolled for benefits under part B.

    The bill says: in subparagraph (A), by striking "is 65" and all that follows through the period at the end and inserting the following: “is—

    Bill text · Current law (42 U.S.C. 1395ss)

  740. 42 U.S.C. 1395ss(s)(2)(D)changedby H.R. 9877 Sec. 7901A–7(a)

    The bill says: in subparagraph (D), in the matter preceding clause (i), by inserting "(or is entitled to benefits under 226A(b))" after "is 65 years of age or older"; and

    Bill text · Current law (42 U.S.C. 1395ss)

  741. 42 U.S.C. 1395ss(s)(3)(B)(ii)changedby H.R. 9877 Sec. 7901A–7(a)

    The bill says: in clause (ii), by inserting "(or is entitled to benefits under 226A(b))" after "is 65 years of age or older"; and

    Bill text · Current law (42 U.S.C. 1395ss)

  742. 42 U.S.C. 1395ss(s)(3)(B)(vi)changedby H.R. 9877 Sec. 7901A–7(a)

    The bill says: in clause (vi), by inserting "(or under 226A(b))" after "at age 65".

    Bill text · Current law (42 U.S.C. 1395ss)

  743. 42 U.S.C. 300gg-8(i)(6)(F)changedby H.R. 9877 Sec. 7901B–1(b)

    The bill says: Section 1128A(i)(6)(F) of the Social Security Act (42 U.S.C. 1320a–7a(i)(6)(F)) is amended by inserting "(including remuneration offered or transferred to an individual to promote the participation in an approved clinical trial, as defined in subsection (d) of the first section 2709 of the Public Health Service Act (42 U.S.C. 300gg–8) (relating to coverage for individuals participating in approved clinical trials), as so designated by section 1563(c)(10)(C) of the Patient Protection and Affordable Care Act, that is registered with the database of clinical trials maintained by the National Library of Medicine (or any successor database), so long as such remuneration facilitates equitable inclusion of patients from all relevant demographic and socioeconomic populations and is related to patient participation in the approved clinical trial)" after "promotes access to care".

    Bill text · Current law (42 U.S.C. 300gg-8)

  744. 21 U.S.C. 360bbb-8crenumberedby H.R. 9877 Sec. 7901B–3(a)

    The bill says: by redesignating subsections (b) and (c) as subsections (c) and (d), respectively; and

    Bill text · Current law (21 U.S.C. 360bbb-8c)

  745. 21 U.S.C. 360bbb-8cadded (b)by H.R. 9877 Sec. 7901B–3(a)

    (b) Collection, submission, and use of data.—(1) In general.— The Secretary shall—(A) for any drug for which an exemption is granted for investigational use under section 505(i) of this Act or section 351(a) of the Public Health Service Act, require the sponsor of the drug to collect standardized patient experience data as part of the clinical trials conducted pursuant to such exemption;(B) require any application for the approval or licensing of such drug under section 505(b) of this Act or section 351(a) of the Public Health Service Act to include—(i) the standardized patient experience data so collected; and(ii) such related information as the Secretary may require; and(C) consider patient experience data and related information that is submitted pursuant to subparagraph (B) in deciding whether to approve or license, as applicable, the drug involved.(2) Applicability.— Paragraph (1) applies only with respect to drugs for which a request for an exemption described in paragraph (1)(A) is submitted on or after the date of the enactment of the Health Equity and Accountability Act of 2026, or an application under section 505(b) of this Act or section 351(a) of the Public Health Service Act is filed, as applicable, on or after the day that is 2 years after the date of the enactment of the Health Equity and Accountability Act of 2026.

    The bill says: by inserting after subsection (a) the following:

    Bill text · Current law (21 U.S.C. 360bbb-8c)

  746. 42 U.S.C. 1395x(s)(2)(MM)changedby H.R. 9877 Sec. 7901C(a)

    The bill says: in subparagraph (MM), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395x)

  747. 42 U.S.C. 1395x(s)(2)changedby H.R. 9877 Sec. 7901C(a)

    The bill says: by inserting "and" at the end of subparagraph (NN); and

    Bill text · Current law (42 U.S.C. 1395x)

  748. 42 U.S.C. 1395x(s)(2)added (OO)by H.R. 9877 Sec. 7901C(a)

    (OO) multi-cancer early detection screening tests (as defined in subsection (ttt));

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  749. 42 U.S.C. 1395xadded (ttt)by H.R. 9877 Sec. 7901C(a)

    (ttt) Multi-Cancer early detection screening tests.— The term multi-cancer early detection screening test means any of the following tests, approved or cleared by the Food and Drug Administration, furnished to an individual for the purpose of early detection of cancer across many cancer types (as categorized in the Annual Report to the Nation on the Status of Cancer issued by the National Cancer Institute):(1) A genomic sequencing blood or blood product test that includes the analysis of cell-free nucleic acids.(2) Such other equivalent tests (which are based on urine or another sample of biological material) as the Secretary determines appropriate.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  750. 42 U.S.C. 1395l(h)(1)(A)addedby H.R. 9877 Sec. 7901C(b)

    The bill says: in paragraph (1)(A), by inserting after "(including" the following: "multi-cancer early detection screening tests under section 1861(ttt) and including"; and

    Bill text · Current law (42 U.S.C. 1395l)

  751. 42 U.S.C. 1395l(h)added (10)by H.R. 9877 Sec. 7901C(b)

    (10) No payment may be made under this part for a multi-cancer early detection screening test (as defined in section 1861(ttt)) for an individual if such a test was furnished to the individual during the previous 11 months.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395l)

  752. 42 U.S.C. 1395y(a)(1)(O)changedby H.R. 9877 Sec. 7901C(b)

    The bill says: in subparagraph (O), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395y)

  753. 42 U.S.C. 1395y(a)(1)(P)changedby H.R. 9877 Sec. 7901C(b)

    The bill says: in subparagraph (P), by striking the semicolon at the end and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1395y)

  754. 42 U.S.C. 1395y(a)(1)added (Q)by H.R. 9877 Sec. 7901C(b)

    (Q) in the case of multi-cancer early detection screening tests (as defined in section 1861(ttt)), which are performed more frequently than is covered under section 1833(h)(10);

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395y)

  755. 42 U.S.C. 1395y(a)(7)changedby H.R. 9877 Sec. 7901C(b)

    The bill says: in paragraph (7), by striking "or (P)" and inserting "(P), or (Q)".

    Bill text · Current law (42 U.S.C. 1395y)

  756. 42 U.S.C. 280gadded 399V–14by H.R. 9877 Sec. 7901C–1(a)

    399V–14. Peripheral artery disease education program.—(a) Establishment.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, in collaboration with the Administrator of the Centers for Medicare & Medicaid Services and the Administrator of the Health Resources and Services Administration, shall establish and coordinate a peripheral artery disease education program to support, develop, and implement educational initiatives and outreach strategies that inform health care professionals and the public about the existence of peripheral artery disease and methods to reduce amputations related to such disease, particularly with respect to at-risk populations.(b) Authorization of appropriations.— There is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2031.

    The bill says: Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 7504, is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280g)

  757. 42 U.S.C. 1395x(s)(2)(NN)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: in subparagraph (NN), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395x)

  758. 42 U.S.C. 1395x(s)(2)(OO)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: in subparagraph (OO), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1395x)

  759. 42 U.S.C. 1395x(s)(2)added (PP)by H.R. 9877 Sec. 7901C–1(b)

    (PP) peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in subsection (uuu)).

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  760. 42 U.S.C. 1395xadded (uuu)by H.R. 9877 Sec. 7901C–1(b)

    (uuu) Peripheral artery disease screening test; at-Risk beneficiary.—(1) The term peripheral artery disease screening test means—(A) noninvasive physiologic studies of extremity arteries (commonly referred to as ankle-brachial index testing);(B) arterial duplex scans of lower extremity arteries vascular; and(C) such other items and services as the Secretary determines, in consultation with relevant stakeholders, to be appropriate for screening for peripheral artery disease for at-risk beneficiaries.(2) The term at-risk beneficiary means an individual entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B—(A) who is 65 years of age or older;(B) who is at least 50 years of age but not older than 64 years of age with risk factors for atherosclerosis (such as diabetes mellitus, a history of smoking, hyperlipidemia, and hypertension) or a family history of peripheral artery disease;(C) who is younger than 50 years of age with diabetes mellitus and 1 additional risk factor for atherosclerosis; or(D) with a known atherosclerotic disease in another vascular bed such as coronary, carotid, subclavian, renal, or mesenteric artery stenosis, or abdominal aortic aneurysm.(3) The Secretary shall, in consultation with appropriate organizations, establish standards regarding the frequency for peripheral artery disease screening tests described in subsection (s)(2)(PP) for purposes of coverage under this title.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395x)

  761. 42 U.S.C. 1395x(ww)(2)renumberedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by redesignating subparagraph (O) as subparagraph (P); and

    Bill text · Current law (42 U.S.C. 1395x)

  762. 42 U.S.C. 1395x(ww)(2)added (O)by H.R. 9877 Sec. 7901C–1(b)

    (O) Peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in subsection (uuu)).

    The bill says: by inserting after subparagraph (N) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395x)

  763. 42 U.S.C. 1395l(a)(1)(N)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: in subparagraph (N), by inserting "and other than peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(uuu))" after "other than personalized prevention plan services (as defined in section 1861(hhh)(1))";

    Bill text · Current law (42 U.S.C. 1395l)

  764. 42 U.S.C. 1395l(a)(1)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by striking "and" before "(KK)"; and

    Bill text · Current law (42 U.S.C. 1395l)

  765. 42 U.S.C. 1395l(a)(1)addedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by inserting before the semicolon at the end the following: ", and (LL) with respect to peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(uuu)), the amount paid shall be 100 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848"; and

    Bill text · Current law (42 U.S.C. 1395l)

  766. 42 U.S.C. 1395l(a)(2)(G)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: in subparagraph (G), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395l)

  767. 42 U.S.C. 1395l(a)(2)(H)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: in subparagraph (H), by inserting " and" at the end; and

    Bill text · Current law (42 U.S.C. 1395l)

  768. 42 U.S.C. 1395l(a)(2)added (I)by H.R. 9877 Sec. 7901C–1(b)

    (I) with respect to peripheral artery disease screening tests (as defined in paragraph (1) of section 1861(uuu)) furnished by an outpatient department of a hospital to at-risk beneficiaries (as defined in paragraph (2) of such section), the amount determined under paragraph (1)(EE),

    The bill says: by inserting after subparagraph (H) the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395l)

  769. 42 U.S.C. 1395l(b)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by striking "and" before "(14)"; and

    Bill text · Current law (42 U.S.C. 1395l)

  770. 42 U.S.C. 1395l(b)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by inserting ", and (15) such deductible shall not apply with respect to peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(uuu))" before the period at the end.

    Bill text · Current law (42 U.S.C. 1395l)

  771. 42 U.S.C. 1395l(t)(1)(B)(iv)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by striking ", or personalized" and inserting ", personalized"; and

    Bill text · Current law (42 U.S.C. 1395l)

  772. 42 U.S.C. 1395l(t)(1)(B)(iv)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by inserting ", or peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(uuu))" after "personalized prevention plan services (as defined in section 1861(hhh)(1))".

    Bill text · Current law (42 U.S.C. 1395l)

  773. 42 U.S.C. 1395w-4(j)(3)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: Section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w–4(j)(3)), as amended by section 4251(c)(4), is amended by inserting ", (2)(PP)," after "(2)(KK)".

    Bill text · Current law (42 U.S.C. 1395w-4)

  774. 42 U.S.C. 1395y(a)(1)(P)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: in subparagraph (P), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395y)

  775. 42 U.S.C. 1395y(a)(1)(Q)changedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: in subparagraph (Q), by striking the semicolon at the end and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1395y)

  776. 42 U.S.C. 1395y(a)(1)added (R)by H.R. 9877 Sec. 7901C–1(b)

    (R) in the case of peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1861(uuu)), which are performed more frequently than is covered under such section;

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395y)

  777. 42 U.S.C. 1395m(n)renumberedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by redesignating subparagraphs (A) and (B) of paragraph (1) as clauses (i) and (ii), respectively, and moving the margins of such clauses, as so redesignated, 2 ems to the right;

    Bill text · Current law (42 U.S.C. 1395m)

  778. 42 U.S.C. 1395m(n)renumberedby H.R. 9877 Sec. 7901C–1(b)

    The bill says: by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and moving the margins of such subparagraphs, as so redesignated, 2 ems to the right;

    Bill text · Current law (42 U.S.C. 1395m)

  779. 42 U.S.C. 1395m(n)changedby H.R. 9877 Sec. 7901C–1(b)

    Certain Preventive Services.—(1) In general.— Notwithstanding any other provision of this title

    The bill says: by striking "Certain Preventive Services" and all that follows through "any other provision of this title" and inserting:

    Bill text · Current law (42 U.S.C. 1395m)

  780. 42 U.S.C. 1395m(n)added (2)by H.R. 9877 Sec. 7901C–1(b)

    (2) Inapplicability.— The Secretarial authority described in paragraph (1) shall not apply with respect to preventive services described in section 1861(ww)(2)(O).

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395m)

  781. 42 U.S.C. 1396d(a)(33)changedby H.R. 9877 Sec. 7901C–1(c)

    The bill says: in paragraph (33), by striking "and" after the semicolon;

    Bill text · Current law (42 U.S.C. 1396d)

  782. 42 U.S.C. 1396d(a)renumberedby H.R. 9877 Sec. 7901C–1(c)

    The bill says: by redesignating paragraph (34) as paragraph (35); and

    Bill text · Current law (42 U.S.C. 1396d)

  783. 42 U.S.C. 1396d(a)added (34)by H.R. 9877 Sec. 7901C–1(c)

    (34) peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in subsection (ss)); and

    The bill says: by inserting after paragraph (33) the following new paragraph:

    Bill text · Current law (42 U.S.C. 1396d)

  784. 42 U.S.C. 1396dadded (ss)by H.R. 9877 Sec. 7901C–1(c)

    (ss) Peripheral artery disease screening test; at-Risk beneficiary.—(1) Peripheral artery disease screening test.— The term peripheral artery disease screening test means—(A) noninvasive physiologic studies of extremity arteries (commonly referred to as ankle-brachial index testing);(B) arterial duplex scans of lower extremity arteries vascular; and(C) such other items and services as the Secretary determines, in consultation with relevant stakeholders, to be appropriate for screening for peripheral artery disease for at-risk beneficiaries.(2) At-risk beneficiary.— The term at-risk beneficiary means an individual enrolled under a State plan (or a waiver of such plan)—(A) who is 65 years of age or older;(B) who is at least 50 years of age but not older than 64 years of age with risk factors for atherosclerosis (such as diabetes mellitus, a history of smoking, hyperlipidemia, and hypertension) or a family history of peripheral artery disease;(C) who is younger than 50 years of age with diabetes mellitus and one additional risk factor for atherosclerosis; or(D) with a known atherosclerotic disease in another vascular bed such as coronary, carotid, subclavian, renal, or mesenteric artery stenosis, or abdominal aortic aneurysm.(3) Frequency.— The Secretary shall, in consultation with appropriate organizations, establish standards regarding the frequency for peripheral artery disease screening tests described in subsection (a)(34) for purposes of coverage under a State plan under this title.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1396d)

  785. 42 U.S.C. 1396o-1(b)(3)(B)added (xv)by H.R. 9877 Sec. 7901C–1(c)

    (xv) Peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1905(ss)).

    The bill says: Section 1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o–1(b)(3)(B)), as amended by section 7305(b)(2), is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1396o-1)

  786. 42 U.S.C. 1396a(a)(10)(A)changedby H.R. 9877 Sec. 7901C–1(c)

    The bill says: Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)), as amended by section 2007(d)(2), is amended by striking "and (32)" and inserting "(32), and (34)".

    Bill text · Current law (42 U.S.C. 1396a)

  787. 42 U.S.C. 1395madded (bb)by H.R. 9877 Sec. 7901C–1(e)

    (bb) Disallowance of payment for nontraumatic amputation services furnished without anatomical testing services.—(1) In general.— In the case of nontraumatic amputation services furnished by a supplier on or after January 1, 2027, to an individual entitled to, or enrolled for, benefits under part A and enrolled for benefits under this part, for which payment is made under this part, payment may only be made under this part if—(A) such supplier furnishes anatomical testing services to such individual during the 3-month period preceding the date on which such nontraumatic amputation services is furnished; or(B) such individual has a pre-existing dysfunctional or unsalvageable limb, life-threatening sepsis, intractable infection, extensive gangrene or necrotic tissue loss beyond salvage, a poor functional status, severe dementia, or a short life expectancy after shared decision making with a health care team and patient, family, or caregiver.(2) Definitions.— In this subsection:(A) Anatomical testing services.— The term anatomical testing services means arterial duplex scanning, computed tomography angiography, and magnetic resonance angiography.(B) Nontraumatic amputation services.— The term nontraumatic amputation services means amputations as a result of atherosclerotic vascular disease or a related comorbidity of such disease (including diabetes).

    The bill says: Section 1834 of the Social Security Act (42 U.S.C. 1395m), as amended by section 4221(b)(2), is amended by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 1395m)

  788. 42 U.S.C. 1395l(dd)(1)changedby H.R. 9877 Sec. 7901C–2(1)

    The bill says: in paragraph (1), by striking "and before January 1, 2030,"; and

    Bill text · Current law (42 U.S.C. 1395l)

  789. 42 U.S.C. 1395l(dd)(2)changedby H.R. 9877 Sec. 7901C–2(2)

    The bill says: in paragraph (2), by striking subparagraph (C) and inserting the following:

    Bill text · Current law (42 U.S.C. 1395l)

  790. 42 U.S.C. 1395x(s)(2)(V)changedby H.R. 9877 Sec. 7901C–3(a)

    The bill says: in subsection (s)(2)(V), by striking "in the case of" and all that follows through "organizations"; and

    Bill text · Current law (42 U.S.C. 1395x)

  791. 42 U.S.C. 1395x(vv)(1)changedby H.R. 9877 Sec. 7901C–3(a)

    The bill says: by striking "disease management" and inserting "the prevention, management, or treatment of a disease or condition specified in paragraph (4)"; and

    Bill text · Current law (42 U.S.C. 1395x)

  792. 42 U.S.C. 1395x(vv)(1)changedby H.R. 9877 Sec. 7901C–3(a)

    (A) physician (as defined in subsection (r)(1));(B) physician assistant;(C) nurse practitioner;(D) clinical nurse specialist (as defined in subsection (aa)(5)(B)); or(E) in the case of such services furnished to manage such a disease or condition that is an eating disorder, a clinical psychologist (as defined by the Secretary).

    The bill says: by striking "by a physician" and all that follows through the period at the end and inserting the following: “by a—

    Bill text · Current law (42 U.S.C. 1395x)

  793. 42 U.S.C. 1395x(vv)added (4)by H.R. 9877 Sec. 7901C–3(a)

    (4) For purposes of paragraph (1), the diseases and conditions specified in this paragraph are the following:(A) Diabetes and prediabetes.(B) A renal disease.(C) Obesity (as defined for purposes of subsection (yy)(2)(C) or as otherwise defined by the Secretary).(D) Hypertension.(E) Dyslipidemia.(F) Malnutrition.(G) Eating disorders.(H) Cancer.(I) Gastrointestinal diseases, including celiac disease.(J) HIV.(K) AIDS.(L) Cardiovascular disease.(M) Any other disease or condition—(i) specified by the Secretary relating to unintentional weight loss;(ii) for which the Secretary determines the services described in paragraph (1) to be medically necessary and appropriate for the prevention, management, or treatment of such disease or condition, consistent with any applicable recommendations of the United States Preventive Services Task Force; or(iii) for which the Secretary determines the services described in paragraph (1) are medically necessary, consistent with either protocols established by registered dietitians or nutrition professional organizations or with accepted clinical guidelines identified by the Secretary.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395x)

  794. 42 U.S.C. 1395y(a)(1)(Q)changedby H.R. 9877 Sec. 7901C–3(b)

    The bill says: in subparagraph (Q), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1395y)

  795. 42 U.S.C. 1395y(a)(1)(R)changedby H.R. 9877 Sec. 7901C–3(b)

    The bill says: in subparagraph (R), by striking the semicolon at the end and inserting ", and"; and

    Bill text · Current law (42 U.S.C. 1395y)

  796. 42 U.S.C. 1395y(a)(1)added (S)by H.R. 9877 Sec. 7901C–3(b)

    (S) in the case of medical nutrition therapy services (as defined in section 1861(vv)), which are not furnished for the prevention, management, or treatment of a disease or condition specified in paragraph (4) of such section;

    The bill says: by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395y)

  797. 42 U.S.C. 1395ww(d)(5)added (N)by H.R. 9877 Sec. 7901C–4(a)

    (N)(i)(I) Effective for discharges beginning on or after October 1, 2027, or such sooner date as specified by the Secretary, subject to subclause (II), the Secretary shall, after notice and opportunity for public comment (in the publications required by subsection (e)(5) for a fiscal year or otherwise), provide for an additional payment under a mechanism (separate from the mechanism established under subparagraph (K)), with respect to such discharges involving any DISARM antimicrobial drug, in an amount equal to—(aa) the amount payable under section 1847A for such drug during the calendar quarter in which the discharge occurred; or(bb) if no amount for such drug is determined under section 1847A, an amount to be determined by the Secretary in a manner similar to the manner in which payment amounts are determined under section 1847A based on information submitted by the manufacturer or sponsor of such drug (as required under clause (v)).(II) In determining the amount payable under section 1847A for purposes of items (aa) and (bb) of subclause (I), subparagraphs (A) and (B) of subsection (b)(1) of such section shall be applied by substituting "102 percent" for "106 percent" each place it appears and paragraph (8)(B) of such section shall be applied by substituting "2 percent" for "6 percent".(ii) For purposes of this subparagraph, a DISARM antimicrobial drug is—(I) a drug—(aa) that—(AA) is approved by the Food and Drug Administration;(BB) is designated by the Food and Drug Administration as a qualified infectious disease product under subsection (d) of section 505E of the Federal Food, Drug, and Cosmetic Act ( 21 U.S.C. 355f(d)); and(CC) has received an extension of its exclusivity period pursuant to subsection (a) of such section; and(bb) that has been designated by the Secretary pursuant to the process established under clause (iv)(I)(bb); or(II) an antibacterial or antifungal biological product—(aa) that is licensed for use, or an antibacterial or antifungal biological product for which an indication is first licensed for use, by the Food and Drug Administration on or after June 5, 2014, under section 351(a) of the Public Health Service Act for human use to treat serious or life-threatening infections, as determined by the Food and Drug Administration, including those caused by, or likely to be caused by—(AA) an antibacterial or antifungal resistant pathogen, including novel or emerging infectious pathogens; or(BB) a qualifying pathogen (as defined under section 505E(f) of the Federal Food, Drug, and Cosmetic Act ( 21 U.S.C. 355f(f))); and(bb) has been designated by the Secretary pursuant to the process established under clause (iv)(I)(bb).(iii) The mechanism established pursuant to clause (i) shall provide that the additional payment under clause (i) shall— For purposes of this clause, in the case of a similar reporting program described in item (aa), a subsection (d) hospital shall be treated as participating in such a program if the entity maintaining such program identifies to the Secretary such hospital as so participating.(I) with respect to a discharge, only be made to a subsection (d) hospital that, as determined by the Secretary—(aa) is participating in the National Healthcare Safety Network Antimicrobial Use and Resistance Module of the Centers for Disease Control and Prevention; and(bb) has an antimicrobial stewardship program that aligns with the Core Elements of Hospital Antibiotic Stewardship Programs of the Centers for Disease Control and Prevention or the Antimicrobial Stewardship Standard set by the Joint Commission; and(II) apply to discharges occurring on or after October 1 of the year in which the drug or biological product is designated by the Secretary as a DISARM antimicrobial drug.(iv)(I) The mechanism established pursuant to clause (i) shall provide for a process for—(aa) a manufacturer or sponsor of a drug or biological product to request the Secretary to designate the drug or biological product as a DISARM antimicrobial drug; and(bb) the designation (and removal of such designation) by the Secretary of drugs and biological products as DISARM antimicrobial drugs.(II) A designation of a drug or biological product as a DISARM antimicrobial drug may be revoked by the Secretary if the Secretary determines that—(aa) the drug or biological product no longer meets the requirements for a DISARM antimicrobial drug under clause (ii);(bb) the request for such designation contained an untrue statement of material fact; or(cc) clinical or other information that was not available to the Secretary at the time such designation was made shows that—(AA) such drug or biological product is unsafe for use or not shown to be safe for use for individuals who are entitled to benefits under part A; or(BB) an alternative to such drug or biological product is an advance that substantially improves the diagnosis or treatment of such individuals.(III) Not later than October 1, 2026, the Secretary shall publish in the Federal Register a list of the DISARM antimicrobial drugs designated under this subparagraph pursuant to the process established under subclause (I)(bb). The Secretary shall annually update such list.(v)(I) For purposes of determining additional payment amounts under clause (i), a manufacturer or sponsor of a drug or biological product that submits a request described in clause (iv)(I)(aa) shall submit to the Secretary information described in section 1927(b)(3)(A)(iii).(II) The penalties for failure to provide timely information under clause (i) of subparagraph (C) section 1927(b)(3) and for providing false information under clause (ii) of such subparagraph shall apply to manufacturers and sponsors of a drug or biological product under this section with respect to information under subclause (I) in the same manner as such penalties apply to manufacturers under such clauses with respect to information under subparagraph (A) of such section.

    The bill says: Section 1886(d)(5) of the Social Security Act (42 U.S.C. 1395ww(d)(5)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 1395ww)

  798. 42 U.S.C. 1395x(ddd)added (4)by H.R. 9877 Sec. 7901C–5(a)

    (4)(A) Subject to subparagraph (B), the Secretary may, in addition to qualified primary care physicians and other primary care practitioners, cover intensive behavioral therapy for obesity furnished by any of the following:(i) A physician (as defined in subsection (r)(1)) who is not a qualified primary care physician.(ii) Any other appropriate health care provider (including a physician assistant, nurse practitioner, or clinical nurse specialist (as those terms are defined in subsection (aa)(5)), a clinical psychologist, a registered dietitian or nutrition professional (as defined in subsection (vv))).(iii) An evidence-based, community-based lifestyle counseling program approved by the Secretary.(B) In the case of intensive behavioral therapy for obesity furnished by a provider described in clause (ii) or (iii) of subparagraph (A), the Secretary may only cover such therapy if such therapy is furnished—(i) upon referral from, and in coordination with, a physician or primary care practitioner operating in a primary care setting or any other setting specified by the Secretary; and(ii) in an office setting, a hospital outpatient department, a community-based site that complies with the Federal regulations concerning the privacy of individually identifiable health information promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, or another setting specified by the Secretary.(C) In order to ensure a collaborative effort, the coordination described in subparagraph (B)(i) shall include the health care provider or lifestyle counseling program communicating to the referring physician or primary care practitioner any recommendations or treatment plans made regarding the therapy.

    The bill says: Section 1861(ddd) of the Social Security Act (42 U.S.C. 1395x(ddd)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395x)

  799. 42 U.S.C. 1395w-102(e)(2)(A)changedby H.R. 9877 Sec. 7901C–5(b)

    The bill says: by striking "and other than" and inserting "other than"; and

    Bill text · Current law (42 U.S.C. 1395w-102)

  800. 42 U.S.C. 1395w-102(e)(2)(A)addedby H.R. 9877 Sec. 7901C–5(b)

    The bill says: by inserting after "benzodiazepines)," the following: "and other than subparagraph (A) of such section if the drug is used for the treatment of obesity (as defined in section 1861(yy)(2)(C)) or for weight loss management for an individual who is overweight (as defined in section 1861(yy)(2)(F)(i)) and has 1 or more related comorbidities,".

    Bill text · Current law (42 U.S.C. 1395w-102)

  801. 42 U.S.C. 285e-2(a)(1)changedby H.R. 9877 Sec. 7901C–6(a)

    (a)(1) The Director of the Institute—(A) may;

    The bill says: by striking "(a)(1) The Director of the Institute may" and inserting the following:

    Bill text · Current law (42 U.S.C. 285e-2)

  802. 42 U.S.C. 285e-2(a)(1)changedby H.R. 9877 Sec. 7901C–6(a)

    The bill says: by striking "disease." and inserting "disease; and"; and

    Bill text · Current law (42 U.S.C. 285e-2)

  803. 42 U.S.C. 285e-2(a)(1)added (B)by H.R. 9877 Sec. 7901C–6(a)

    (B) beginning January 1, 2027, shall enter into cooperative agreements and make grants to public or private nonprofit entities under this subsection for the planning, establishment, and operation of new such centers that are located in areas with a higher concentration of minority groups (as determined under section 444(d)(3)(D)), such as entities that are historically Black colleges and universities, Hispanic-serving institutions, Tribal colleges and universities, or centers of excellence for other minority populations.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-2)

  804. 42 U.S.C. 285e-2(b)added (3)by H.R. 9877 Sec. 7901C–6(a)

    (3) Federal payments made under a cooperative agreement or grant under subsection (a) from funds made available under section 7901C–6(g) of the Health Equity and Accountability Act of 2026 shall, with respect to Alzheimer’s disease, be used in part to establish and operate diagnostic and treatment clinics designed—(A) to meet the special needs of minority and rural populations and other underserved populations; and(B) to operate clinical trials.

    The bill says: Section 445(b) of the Public Health Service Act (42 U.S.C. 285e–2(b)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-2)

  805. 42 U.S.C. 285e-2(b)added (4)by H.R. 9877 Sec. 7901C–6(a)

    (4) Federal payments made under a cooperative agreement or grant under subsection (a) shall be used to establish engagement centers to carry out public outreach, education efforts, and dissemination of information for members of minority groups about clinical trial participation. Activities funded pursuant to the preceding sentence shall include—(A) using established mechanisms to encourage members of minority groups to participate in clinical trials on Alzheimer’s disease;(B) expanding education efforts to make members of minority groups aware of ongoing clinical trials;(C) working with trial sponsors to increase the number of recruitment events for members of minority groups;(D) conducting outreach to national, State, and local physician professional organizations, especially for members of such organizations who are primary care physicians or physicians who specialize in dementia, to increase awareness of clinical research opportunities for members of minority groups; and(E) using community-based participatory research methodologies to engage with minority populations.

    The bill says: Section 445(b) of the Public Health Service Act (42 U.S.C. 285e–2(b)), as amended by paragraph (1)(B), is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-2)

  806. 42 U.S.C. 285e-1(c)changedby H.R. 9877 Sec. 7901C–6(a)

    The bill says: by striking "(c) The Director" and inserting "(c)(1) The Director"; and

    Bill text · Current law (42 U.S.C. 285e-1)

  807. 42 U.S.C. 285e-1(c)added (2)by H.R. 9877 Sec. 7901C–6(a)

    (2) The Director of the Institute, acting through the Resource Centers for Minority Aging Research of the Institute, shall carry out public outreach, education efforts, and dissemination of information for members of minority groups about participation in clinical research on Alzheimer’s disease carried out or supported under this subpart.

    The bill says: by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 285e-1)

  808. 42 U.S.C. 285e-10aadded (d)by H.R. 9877 Sec. 7901C–6(b)

    (d) Enhancing the participation of principal investigators and researchers who are members of underrepresented populations.—(1) In general.— The Director of the Institute shall enhance diversity in the conduct or support of clinical research on Alzheimer’s disease under this subpart by encouraging the participation of individuals from groups that are underrepresented in the biomedical, clinical, behavioral, and social sciences as principal investigators of such clinical research, as researchers for such clinical research, or both.(2) Training for principal investigators.— The Director of the Institute shall provide training for principal investigators who are members of a minority group with respect to skills for—(A) the design and conduct of clinical research and clinical protocols;(B) applying for grants for clinical research; and(C) such other areas as the Director of the Institute determines to be appropriate.

    The bill says: Section 445I of the Public Health Service Act (42 U.S.C. 285e–10a) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-10a)

  809. 42 U.S.C. 285e-4(a)changedby H.R. 9877 Sec. 7901C–6(b)

    The bill says: Section 445B(a) of the Public Health Service Act (42 U.S.C. 285e–4(a)) is amended by inserting ", including senior researchers who are members of a minority group" before the period at the end of the first sentence.

    Bill text · Current law (42 U.S.C. 285e-4)

  810. 42 U.S.C. 285e-1(d)changedby H.R. 9877 Sec. 7901C–6(c)

    The bill says: by striking "(d) The Director" and inserting "(d)(1) The Director"; and

    Bill text · Current law (42 U.S.C. 285e-1)

  811. 42 U.S.C. 285e-1(d)added (2)by H.R. 9877 Sec. 7901C–6(c)

    (2) In conducting or supporting clinical research on Alzheimer’s disease for purposes of this subpart, in addition to requirements otherwise imposed under this title, including under section 492B, the Director of the Institute shall increase the participation of members of minority groups in such clinical research through one or more of the activities described in paragraph (3).(3)(A) The Director of the Institute shall provide incentives for the support of clinical research on Alzheimer’s disease with clinical trial sites established in areas with a higher concentration of minority groups, including rural areas if practicable.(B) In determining whether to conduct or support clinical research on Alzheimer’s disease, the Director of the Institute shall encourage the conduct of clinical research with clinical trial sites in areas described in subparagraph (A) as a higher-level priority criterion among the criteria established to evaluate whether to conduct or support clinical research.(C) In determining the amount of funding to be provided for the conduct or support of such clinical research, the Director of the Institute shall provide additional funding for the conduct of such clinical research with clinical trial sites in areas described in subparagraph (A).(D) In determining whether an area is an area with a higher concentration of minority groups, the Director of the Institute—(i) shall consider the most recent data collected by the Bureau of the Census; and(ii) may also consider—(I) data from the Centers for Medicare & Medicaid Services on the incidence of Alzheimer’s disease in the United States by region; and(II) such other data as the Director determines appropriate.(4) In order to facilitate the participation of members of minority groups in clinical research supported under this subpart, in addition to activities described in paragraph (3), the Director of the Institute shall—(A) ensure that such clinical research uses community-based participatory research methodologies; and(B) encourage the use of remote health technologies, including telehealth, remote patient monitoring, and mobile technologies, that reduce or eliminate barriers to participation of members of minority groups in such clinical research.(5)(A) Clinical research on Alzheimer’s disease conducted or supported under this subpart shall ensure that such research includes outreach activities designed to increase the participation of members of minority groups in such research.(B)(i) Each applicant for a grant under this subpart for clinical research on Alzheimer’s disease shall submit to the Director of the Institute in the application for such grant—(I) a budget for outreach activities to members of minority populations with respect to participation in such clinical research; and(II) a description of the plan to conduct such outreach.(ii) The Director of the Institute shall encourage applicants for, and recipients of, grants under this subpart to conduct clinical research on Alzheimer’s disease to engage with community-based organizations to increase participation of minority populations in such research.(6) For purposes of this subpart:(A) The term clinical research includes a clinical trial.(B) The term minority group has the meaning given such term under section 492B(g).

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-1)

  812. 42 U.S.C. 285e-10aadded (e)by H.R. 9877 Sec. 7901C–6(d)

    (e) Participant eligibility criteria.— The Director of the Institute shall take such actions as are necessary to ensure that clinical research on Alzheimer’s disease conducted or supported under this subpart is designed with eligibility criteria that ensure the clinical trial population reflects the diversity of the prospective patient population. Such actions may include the following:(1) Examination of criteria.—(A) In general.— An examination of each exclusion criterion to determine if the criterion is necessary to ensure the safety of trial participants or to achieve the study objectives.(B) Modification of criteria.— In the case of an exclusion criterion that is not necessary to ensure the safety of trial participants or to achieve the study objectives—(i) encouraging the modification or elimination of the criterion; or(ii) encouraging tailoring the criterion as narrowly as possible to avoid unnecessary limits to the population of the clinical study.(2) Requirement for strong justification for exclusion.— A review of each exclusion criterion to ensure that populations are included in clinical trials, such as older adults, individuals with a mild form of disease, individuals at the extremes of the weight range, or children, unless there is a strong clinical or scientific justification to exclude them.(3) Use of adaptive design.— Encouraging the use of an adaptive clinical trial design that—(A) starts with a defined population where there are concerns about safety; and(B) may expand to a broader population based on initial data from the trial and external data.

    The bill says: Section 445I of the Public Health Service Act (42 U.S.C. 285e–10a), as amended by subsection (b)(1), is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-10a)

  813. 42 U.S.C. 285e-1added (e)by H.R. 9877 Sec. 7901C–6(e)

    (e)(1) The Director of the Institute, acting through the Office of Special Populations and in consultation with the Division of Extramural Activities, shall support resource information and technical assistance to grantees under section 445 (relating to Alzheimer’s disease centers), other grantees, and prospective grantees, designed to increase the participation of minority populations in clinical research on Alzheimer’s disease conducted or supported under this subpart.(2) The resource information and technical assistance provided under paragraph (1) shall include the maintenance of a central resource library in order to collect, prepare, analyze, and disseminate information relating to strategies and best practices used by recipients of grants under this subpart and other researchers in the development of the clinical research designed to increase the participation of minority populations in such clinical research.

    The bill says: Section 444 of the Public Health Service Act (42 U.S.C. 285e–1) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-1)

  814. 42 U.S.C. 285e-1added (f)by H.R. 9877 Sec. 7901C–6(f)

    (f)(1)(A) The Director of the Institute shall submit annual reports to the Congress on the impact of the amendments made to this subpart by the Health Equity and Accountability Act of 2026.(B) The Secretary shall transmit a copy of each such report to the Advisory Council on Alzheimer’s Research, Care, and Services established under section 2(e) of the National Alzheimer’s Project Act.(2) In each report under paragraph (1), the Director of the Institute shall include information and data on the following matters with respect to clinical trials on Alzheimer’s disease conducted during the preceding year:(A) The number of participants who are members of a minority group in such clinical trials.(B) The number of such clinical trials for which incentives under subsection (d)(3) were made available, the nature of such incentives, the amount of increased funding (if any) made available for research on Alzheimer’s disease, and the training provided to principal investigators who are members of a minority group and the amount of funding (if any) for such training.(C) The number of such clinical trials for which the principal investigator is a member of a minority group.(D) The number of such clinical trials for which a significant percentage of researchers are members of a minority group.(E) Modifications to patient eligibility criteria in clinical trial designs under section 445I(e).(F) Outreach and education efforts conducted under section 445(b)(4).(3) The Director of the Institute shall make each report under paragraph (1) available to the public, including through posting on the appropriate website of the Department of Health and Human Services.

    The bill says: Section 444 of the Public Health Service Act (42 U.S.C. 285e–1), as amended by subsection (e), is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285e-1)

  815. 42 U.S.C. 284added 409Kby H.R. 9877 Sec. 7901D–1

    409K. Rare diseases health equity.—(a) Expansion, intensification, and coordination of activities.—(1) In general.— The Director of NIH shall expand, intensify, and coordinate research and other activities of the National Institutes of Health with respect to rare diseases health equity.(2) Allocations by Director of NIH.— With respect to amounts appropriated to carry out this section for a fiscal year, the Director of NIH shall allocate the amounts among the national research institutes that are carrying out paragraph (1).(b) Coordinating Committee.—(1) In general.— The Secretary shall maintain a coordinating committee with respect to rare diseases health equity (referred to in this section as the "Coordinating Committee") to coordinate activities across the National Institutes and with other Federal health programs and activities relating to rare diseases health equity.(2) Composition.— The Coordinating Committee shall be composed of—(A) the directors (or their designees) of each of the national research institutes involved in research with respect to rare diseases and minority health or health equity; and(B) representatives of all other Federal departments and agencies whose programs involve health functions or responsibilities relevant to such rare diseases, including the Centers for Disease Control and Prevention and the Food and Drug Administration.(3) Chair.—(A) In general.— With respect to rare diseases health equity, the Chair of the Coordinating Committee shall serve as the principal advisor to the Secretary, the Assistant Secretary for Health, and the Director of NIH, and shall provide advice to the Director of the Centers for Disease Control and Prevention, the Commissioner of Food and Drugs, and other relevant agencies.(B) Director of NIH.— The Chair of the Coordinating Committee shall be directly responsible to the Director of NIH.(c) Plan for NIH Activities.—(1) In general.— Not later than 1 year after the date of the enactment of this section, the Coordinating Committee shall develop a plan for conducting and supporting research and education on rare diseases health equity, and rare diseases or conditions in minority populations, through the national research institutes. The Coordinating Committee shall periodically review and revise the plan. The plan shall—(A) provide for a broad range of research and education activities relating to biomedical, psychosocial, and rehabilitative issues, including studies of the disproportionate impact of such diseases or conditions on minority populations;(B) identify priorities among the programs and activities of the National Institutes of Health regarding such diseases or conditions; and(C) reflect input from a broad range of scientists, patients, and advocacy groups.(2) Certain elements of plan.— The plan under paragraph (1) shall, with respect to rare diseases or conditions in minority populations, provide for the following as appropriate:(A) Research to determine the reasons underlying the incidence and prevalence of the diseases or conditions, including among subpopulations.(B) Basic research concerning the etiology and causes of the diseases or conditions.(C) Epidemiological studies to address the frequency and natural history of the diseases or conditions, including any differences among the sexes and among racial and ethnic groups.(D) The development of improved screening techniques.(E) Clinical research for the development and evaluation of new treatments, including new biological agents.(F) Information and education programs for health care professionals and the public.(3) Implementation of plan.— The Director of NIH shall ensure that programs and activities of the National Institutes of Health regarding rare diseases or conditions in minority populations are implemented in accordance with the plan under paragraph (1).(d) Definitions.— In this section:(1) The term minority has the meaning given such term in section 464z–3.(2) The term rare disease or condition has the meaning given such term in section 526 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bb).

    The bill says: Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 284)

  816. 42 U.S.C. 285tadded 464z–7by H.R. 9877 Sec. 7901D–2

    464z–7. Collaborative comprehensive plan to address rare diseases and conditions in minority populations.— Not later than 180 days after the date of enactment of this section, the Director of NIH, the Director of the Institute, the Director of the National Center for Advancing Translational Sciences, the Director of the National Heart, Lung, and Blood Institute, and the directors of the other agencies of the National Institutes of Health in collaboration (and in consultation with the advisory council for the Institute) shall—(1) develop a comprehensive Federal plan to address rare diseases and conditions in minority populations (as those terms are defined in section 409K), including a strategy to increase diversity in genetic programs at the program for Therapeutics for Rare and Neglected Diseases at the National Institutes of Health;(2) conduct or support through grants or cooperative agreements basic, clinical, and translational research on rare diseases and conditions in minority populations, including research on—(A) early detection, diagnosis, and treatment of such diseases and conditions in such populations; and(B) improving the quality of life for individuals with rare diseases or conditions and their families;(3) conduct or support clinical training programs for physicians and other health care practitioners with respect to detecting, diagnosing, and treating such diseases and conditions in such populations; and(4) develop guidance for increasing participation of health professionals who are members of minority groups (as defined in section 464z–3) in research conducted or supported by the National Institutes of Health on such diseases and conditions in such populations.

    The bill says: Subpart 20 of part C of title IV of the Public Health Service Act (42 U.S.C. 285t et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 285t)

  817. 42 U.S.C. 300u-6(b)added (11)by H.R. 9877 Sec. 7901D–3

    (11) In coordination with the Director of the Centers for Disease Control and Prevention, award grants to public and private nonprofit entities to—(A) collect, analyze, and report data on rare diseases and conditions in minority populations, including on epidemiological data with respect to incidence of such diseases and conditions in such populations;(B) conduct outreach and engagement activities with the minority populations impacted by such rare diseases and conditions by—(i) improving health literacy with respect to rare diseases and conditions;(ii) disseminating information on health and community services related to rare diseases and conditions; and(iii) providing information regarding the maintenance of rare diseases and conditions.(12) Submit to Congress, on a biannual basis (beginning not later than 2 years after the date of the enactment of the HEARD Act), a report describing the activities carried out pursuant to paragraph (11).

    The bill says: Section 1707(b) of the Public Health Service Act (42 U.S.C. 300u–6(b)) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300u-6)

  818. 42 U.S.C. 288added 487Eby H.R. 9877 Sec. 7901D–5

    487E. Increasing minority representation in research on rare diseases and conditions.—(a) Grant program.— In carrying out section 487, the Secretary may award grants to eligible entities involved in research on rare diseases and minority health to establish programs to increase the recruitment and retention of members of minority groups to conduct research in matters relating to the cause, diagnosis, prevention, and treatment of rare diseases or conditions, including by expanding the number of internships and mentoring opportunities.(b) Eligible entities.— In subsection (a), the term eligible entities means accredited schools of allopathic medicine, osteopathic medicine, and nursing, and other health professional training programs.

    The bill says: Part G of title IV of the Public Health Service Act (42 U.S.C. 288 et seq.) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 288)

  819. 42 U.S.C. 243added 317Zby H.R. 9877 Sec. 7901D–7

    317Z. Research and awareness campaigns with respect to rare diseases and conditions in minority populations.—(a) Research.— The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall conduct or support research and carry out public health awareness campaigns with respect to rare diseases and conditions in minority populations (as defined in section 409K).(b) Awareness campaign.— The Secretary shall, directly or through grants or contracts, establish a public education program in cooperation with existing national public awareness campaigns to increase awareness about rare diseases and conditions in minority populations through culturally and linguistically appropriate information campaigns about prevention and management of rare diseases and conditions.

    The bill says: Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317Y of such Act, as added by section 7502, the following:

    Bill text · Current law (42 U.S.C. 243)

  820. 25 U.S.C. 1621added 227by H.R. 9877 Sec. 7901D–9

    227 Tribal epidemiology center grant program.—(a) In general.— The Secretary, acting through the Service, shall award grants to Tribal Epidemiology Centers and Tribal and Urban Indian Health Centers to support clinically and culturally appropriate research and other activities with respect to rare diseases and conditions in Native American or Tribal communities.(b) Permissible activities.— The activities funded through a grant under subsection (a) may include coordination of data collection on the prevention, diagnosis, treatment, and care of rare diseases and conditions by health care professionals serving American Indian and Alaska Native populations.

    The bill says: Title II of the Indian Health Care Improvement Act (25 U.S.C. 1621 et seq.) is amended by adding at the end the following:

    Bill text · Current law (25 U.S.C. 1621)

  821. 42 U.S.C. 281added 426Aby H.R. 9877 Sec. 7901F

    426A. Centers of Excellence on Rare Kidney Disease Research in the National Institute of Diabetes and Digestive and Kidney Diseases.—(a) Cooperative agreements and grants.—(1) In general.— The Director of the Institute may enter into cooperative agreements with, and make grants to, public and private nonprofit entities to pay all or part of the cost of planning, establishing, or strengthening, and providing basic operating support for, regional centers of excellence for rare kidney diseases, including primary glomerular disease. Such centers of excellence shall be known as NIDDK Centers of Excellence on Rare Kidney Disease Research (referred to in this section as "Centers of Excellence").(2) Purposes of centers.— The purposes of the Centers of Excellence funded pursuant to paragraph (1) shall be—(A) to conduct research on the causes, etiology, symptoms, diagnosis, progression, and treatment of rare kidney diseases, including glomerular diseases;(B) to increase public awareness of rare kidney diseases, particularly in rural and underserved communities; and(C) to develop resources for clinical research into, training in, and demonstration of diagnostic, prevention, control, and treatment methods for, rare kidney diseases.(3) Policies.— A cooperative agreement or grant under paragraph (1) shall be entered into in accordance with policies established by the Director of the National Institutes of Health.(b) Coordination with other institutes.— The Director of the Institute shall coordinate the activities under this section with similar activities that are related to rare kidney disease and conducted by other national research institutes, centers, and agencies of the National Institutes of Health and by the Food and Drug Administration.(c) Use of funds.— An entity that enters into a cooperative agreement or receives a grant under subsection (a) may use funds received through such agreement or grant—(1) to cover patient care costs required to conduct research described in subsection (a)(2)(A);(2) to provide, for the purpose described in subsection (a)(2)(B)—(A) clinical training and continuing education for health professionals and related personnel with respect to rare kidney diseases; and(B) information programs for the public, with respect to rare kidney diseases; and(3) to provide, for the purpose described in subsection (a)(2)(B)—(A) for education of members of the public, particularly through outreach to rural and underserved communities, on the diagnosis (including through routine urinalysis and through genetic testing), prevention, control, and treatment of rare kidney diseases; and(B) for education of individuals diagnosed with rare kidney diseases on renal diet and lifestyle, genetic testing, and programs to promote urinalysis, and on mental and emotional health resources for families of rare kidney disease patients.(d) Research funded.— Research conducted using funds awarded through a cooperative agreement or grant under this section—(1) shall include study of genotype-phenotype relation to disease progression; and(2) with respect the populations studied in such research, may not include any consideration of quality-adjusted life years or disability adjusted life years, or other similar mechanisms that discriminate against individuals with disabilities in value and cost-effectiveness assessments.(e) Period of support; additional periods.— The period of support for a center of excellence under subsection (a) may not exceed 5 years, except that such period may be extended by the Director of the Institute for additional periods of not more than 5 years for each center if—(1) the operations of such center have been reviewed by an appropriate technical and scientific peer review group established by the Director of the Institute; and(2) such group has recommended to the Director of the Institute that such period should be extended.(f) Authorization of appropriations.— To carry out this section, there are authorized to be appropriated $6,000,000 for each of fiscal years 2027 through 2031.

    The bill says: Subpart 3 of part C of title IV of the Public Health Service Act (42 U.S.C. 281 et seq.) is amended by inserting after section 426 (42 U.S.C. 285c) the following new section:

    Bill text · Current law (42 U.S.C. 281)

  822. 42 U.S.C. 293k(b)(3)(E)changedby H.R. 9877 Sec. 7901F–2(a)

    The bill says: by striking "and individuals" and inserting ", individuals"; and

    Bill text · Current law (42 U.S.C. 293k)

  823. 42 U.S.C. 293k(b)(3)(E)changedby H.R. 9877 Sec. 7901F–2(a)

    The bill says: by inserting ", and individuals with kidney disease (including rare kidney disease)" after "disabilities".

    Bill text · Current law (42 U.S.C. 293k)

  824. 42 U.S.C. 293(b)renumberedby H.R. 9877 Sec. 7901F–2(b)

    The bill says: by redesignating paragraph (7) as paragraph (8);

    Bill text · Current law (42 U.S.C. 293)

  825. 42 U.S.C. 293(b)(6)(B)changedby H.R. 9877 Sec. 7901F–2(b)

    The bill says: in paragraph (6)(B), by striking "; and" and inserting a semicolon; and

    Bill text · Current law (42 U.S.C. 293)

  826. 42 U.S.C. 293(b)added (7)by H.R. 9877 Sec. 7901F–2(b)

    (7) to award fellowships, which may include stipends, for postgraduate training in the field of nephrology, for the purposes of—(A) increasing providers’ knowledge of issues related to prevention, diagnosis, and treatment of rare kidney disease for populations disproportionately impacted by the disease, including the prevalence of the gene APOL1;(B) improving the quality of rare kidney disease prevention, diagnosis, and treatment delivered to racial and ethnic minorities; and(C) increasing the number of nephrologists trained to provide care to such populations; and

    The bill says: by inserting after paragraph (6) the following:

    Bill text · Current law (42 U.S.C. 293)

  827. 42 U.S.C. 1395rr(f)added (9)by H.R. 9877 Sec. 7901F–3

    (9)(A) The Secretary shall conduct experiments to evaluate methods for treating rare kidney disease, giving particular attention to treatments that would delay or eliminate the need for dialysis and transplant.(B) The Secretary shall conduct a comprehensive study of methods to increase public awareness of rare kidney disease.(C) The Secretary shall submit to Congress, not later than 24 months after the date of the enactment of the Health Equity and Accountability Act of 2026, a report on the experiments and study conducted under subparagraphs (A) and (B). Such report shall include recommendations for legislative changes that the Secretary finds necessary or desirable as a result of such experiments and study.

    The bill says: Section 1881(f) of the Social Security Act (42 U.S.C. 1395rr(f)) is amended by adding at the end the following new paragraph:

    Bill text · Current law (42 U.S.C. 1395rr)

  828. 42 U.S.C. 300jj-11(c)(6)(C)changedby H.R. 9877 Sec. 8102(d)

    The bill says: in the heading by inserting ", racial and ethnic minority communities," after "health disparities";

    Bill text · Current law (42 U.S.C. 300jj-11)

  829. 42 U.S.C. 300jj-11(c)(6)(C)changedby H.R. 9877 Sec. 8102(d)

    The bill says: by inserting ", in communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)), including people with disabilities in such groups," after "communities with health disparities";

    Bill text · Current law (42 U.S.C. 300jj-11)

  830. 42 U.S.C. 300jj-11(c)(6)(C)changedby H.R. 9877 Sec. 8102(d)

    The bill says: by striking "The National Coordinator" and inserting the following:

    Bill text · Current law (42 U.S.C. 300jj-11)

  831. 42 U.S.C. 300jj-11(c)(6)(C)added (ii)by H.R. 9877 Sec. 8102(d)

    (ii) Criteria.— In any publication under clause (i), the National Coordinator shall include best practices for encouraging partnerships between the Federal Government, States, private entities, national nonprofit intermediaries, and community-based organizations to expand outreach and education for and the adoption of certified EHR technology in communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)), while also maintaining the accessibility requirements of section 508 of the Rehabilitation Act of 1973 to encourage patient involvement in patient health care. The National Coordinator shall—(I) not later than 6 months after the submission of the report required under section 8302(b) of the Health Equity and Accountability Act of 2026, establish criteria for evaluating the impact of health information technology on communities with a high proportion of individuals from racial and ethnic minority groups (as so defined) taking into account the findings in such report; and(II) not later than 1 year after the submission of such report, publish the results of an evaluation of such impact.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 300jj-11)

  832. 42 U.S.C. 300jj-31(a)changedby H.R. 9877 Sec. 8201(1)

    The bill says: in subsection (a), in the matter preceding paragraph (1), by inserting ", including with respect to communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g))" before the colon at the end; and

    Bill text · Current law (42 U.S.C. 300jj-31)

  833. 42 U.S.C. 300jj-31added (e)by H.R. 9877 Sec. 8201(2)

    (e) Annual report on expenditures.— The National Coordinator shall report annually to Congress on activities and expenditures under this section.

    The bill says: by adding at the end the following new subsection:

    Bill text · Current law (42 U.S.C. 300jj-31)

  834. 42 U.S.C. 300jj-34(e)changedby H.R. 9877 Sec. 8202

    The bill says: Section 3014(e) of the Public Health Service Act (42 U.S.C. 300jj–34(e)) is amended, in the matter preceding paragraph (1), by inserting ", including with respect to communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g))" after "health care provider to".

    Bill text · Current law (42 U.S.C. 300jj-34)

  835. 42 U.S.C. 300jj-38changedby H.R. 9877 Sec. 8203

    The bill says: Section 3018 of the Public Health Service Act (42 U.S.C. 300jj–38) is amended by striking "fiscal years 2009 through 2013" and inserting "fiscal years 2027 through 2032".

    Bill text · Current law (42 U.S.C. 300jj-38)

  836. 42 U.S.C. 300jj-11(c)(6)added (F)by H.R. 9877 Sec. 8301

    (F) Data collection and assessments conducted in coordination with minority-serving institutions.—(i) In general.— In carrying out subparagraph (C) with respect to communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)), the National Coordinator shall, to the greatest extent possible, coordinate with an entity described in clause (ii).(ii) Minority-serving institutions.— For purposes of clause (i), an entity described in this clause is a historically Black college or university, a Hispanic-serving institution, a Tribal College or University, or an Asian-American-, Native American-, or Pacific Islander-serving institution with an accredited public health, health policy, or health services research program.

    The bill says: Section 3001(c)(6) of the Public Health Service Act (42 U.S.C. 300jj–11(c)(6)) is amended by adding at the end the following new subparagraph:

    Bill text · Current law (42 U.S.C. 300jj-11)

  837. 42 U.S.C. 1396b(t)(2)(B)(i)changedby H.R. 9877 Sec. 8401(a)

    (B)(i) a children's hospital, or

    The bill says: in clause (i), by striking ", or" and inserting a semicolon;

    Bill text · Current law (42 U.S.C. 1396b)

  838. 42 U.S.C. 1396b(t)(2)(B)(ii)changedby H.R. 9877 Sec. 8401(a)

    The bill says: in clause (ii), by striking the period at the end and inserting a semicolon; and

    Bill text · Current law (42 U.S.C. 1396b)

  839. 42 U.S.C. 1396b(t)(2)(B)added (iii)by H.R. 9877 Sec. 8401(a)

    (iii) a rehabilitation facility (as defined in section 1886(j)(1)) that furnishes acute or subacute rehabilitation services;(iv) a long-term care hospital described in section 1886(d)(1)(B)(iv); or(v) a home health agency (as defined in section 1861(o)).

    The bill says: by inserting after clause (ii) the following new clauses:

    Bill text · Current law (42 U.S.C. 1396b)

  840. 42 U.S.C. 1396b(t)(3)(B)(v)rewrittenby H.R. 9877 Sec. 8402(a)

    The bill says: Section 1903(t)(3)(B)(v) of the Social Security Act (42 U.S.C. 1396b(t)(3)(B)(v)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1396b)

  841. 42 U.S.C. 1395m(m)(4)(C)(i)changedby H.R. 9877 Sec. 8501(1)

    The bill says: in clause (i), in the matter preceding subclause (I), by striking "clause (iii)" and inserting "clauses (iii) and (iv)"; and

    Bill text · Current law (42 U.S.C. 1395m)

  842. 42 U.S.C. 1395m(m)(4)(C)added (iv)by H.R. 9877 Sec. 8501(2)

    (iv) Removal of geographic requirements.— The geographic requirements described in clause (i) shall not apply with respect to telehealth services furnished on or after the first day after the end of the period for which clause (iii) applies.

    The bill says: by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1395m)

  843. 42 U.S.C. 1395m(m)(4)(C)(ii)(X)rewrittenby H.R. 9877 Sec. 8502(a)

    (X)(aa) Prior to the date described in item (bb), the home of an individual but only for purposes of section 1881(b)(3)(B) or telehealth services described in paragraph (7) or clause (iii).(bb) On or after the first day after the end of the period for which clause (iii) applies, the home of an individual.

    The bill says: Section 1834(m)(4)(C)(ii)(X) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)(X)) is amended to read as follows:

    Bill text · Current law (42 U.S.C. 1395m)

  844. 42 U.S.C. 1395m(m)(4)(C)(ii)added (XII)by H.R. 9877 Sec. 8502(b)

    (XII) Any other site determined appropriate by the Secretary at which an eligible telehealth individual is located at the time a telehealth service is furnished via a telecommunications system.

    The bill says: Section 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the following new subclause:

    Bill text · Current law (42 U.S.C. 1395m)

  845. 42 U.S.C. 1395m(m)(4)(C)added (v)by H.R. 9877 Sec. 8502(c)

    (v) Requirements for new sites.—(I) In general.— The Secretary may establish requirements for the furnishing of telehealth services at sites described in clause (ii)(XII) to provide for beneficiary and program integrity protections.(II) Clarification.— Nothing in this clause shall be construed to preclude the Secretary from establishing requirements for other originating sites described in clause (ii).

    The bill says: Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)), as amended by section 8501, is amended by adding at the end the following new clause:

    Bill text · Current law (42 U.S.C. 1395m)

  846. 42 U.S.C. 1395m(m)(2)(B)(ii)changedby H.R. 9877 Sec. 8502(d)

    The bill says: in the heading, by striking "if originating site is the home" and inserting "for certain sites"; and

    Bill text · Current law (42 U.S.C. 1395m)

  847. 42 U.S.C. 1395m(m)(2)(B)(ii)changedby H.R. 9877 Sec. 8502(d)

    The bill says: by striking "paragraph (4)(C)(ii)(X)" and inserting "subclause (X) or (XII) of paragraph (4)(C)".

    Bill text · Current law (42 U.S.C. 1395m)

  848. 42 U.S.C. 1975a(a)(1)changedby H.R. 9877 Sec. 9004(a)

    The bill says: in paragraph (1), by striking "and" at the end;

    Bill text · Current law (42 U.S.C. 1975a)

  849. 42 U.S.C. 1975a(a)(2)changedby H.R. 9877 Sec. 9004(a)

    The bill says: in paragraph (2), by striking the period at the end and inserting "; and"; and

    Bill text · Current law (42 U.S.C. 1975a)

  850. 42 U.S.C. 1975a(a)added (3)by H.R. 9877 Sec. 9004(a)

    (3) shall, with respect to activities carried out in health care and correctional facilities, toward the goal of eliminating health disparities between the general population and members of minority groups based on race or color, promote coordination of such activities of—(A) the Office of Justice Programs of the Department of Justice, including the Office for Civil Rights within that Office;(B) the Office for Civil Rights within the Department of Health and Human Services; and(C) the Office of Minority Health within the Department of Health and Human Services.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1975a)

  851. 42 U.S.C. 1975cchangedby H.R. 9877 Sec. 9004(b)

    The bill says: Section 5 of the Civil Rights Commission Act of 1983 (42 U.S.C. 1975c) is amended by striking the first sentence and inserting the following: "For the purpose of carrying out this Act, there are authorized to be appropriated $30,000,000 for fiscal year 2027, and such sums as may be necessary for each of the fiscal years 2028 through 2032.".

    Bill text · Current law (42 U.S.C. 1975c)

  852. 20 U.S.C. 1087-53added (f)by H.R. 9877 Sec. 10016

    (f) Notification regarding SNAP.—(1) In general.— An institution receiving a grant under this part shall send a notification (by email or other electronic means) to each eligible student informing the student of their potential eligibility for participation in SNAP and the process for obtaining more information, confirming eligibility, and accessing benefits under that program. The notification shall be developed by the Secretary of Education in consultation with the Secretary of Agriculture, and shall include details on eligibility requirements for participation in SNAP that a student must satisfy. The notification shall be, to the extent practicable, specific to the student’s State of residence and shall provide contact information for the local office where an application for SNAP may be made.(2) Evidence of participation in federally financed work-study program.— The notification under paragraph (1) shall include an official document confirming that the recipient is an eligible student sufficient for purposes of demonstrating that the exclusion from ineligibility for participation in SNAP under section 6(e)(4) of the Food and Nutrition Act of 2008 (7 U.S.C. 2015(e)(4)) applies to the student.(3) Guidance.— The Secretary of Education, in consultation with the Secretary of Agriculture, shall provide guidance to States and institutions of higher education on how to identify and communicate with students who are likely to be eligible for SNAP, including those eligible for a State or federally financed work-study program.(4) Definitions.— For purposes of this subsection:(A) The term "eligible student" means a student receiving work-study assistance under this part.(B) The term "SNAP" means the supplemental nutrition assistance program (as defined in section 3(t) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(t))).

    The bill says: Section 443 of the Higher Education Act of 1965 (20 U.S.C. 1087–53) is amended by adding at the end the following:

    Bill text · Current law (20 U.S.C. 1087-53)

  853. 42 U.S.C. 280b(a)(1)changedby H.R. 9877 Sec. 10101(a)

    research, including data collection, relating to—(A) the causes, mechanisms, prevention, diagnosis, and treatment of injuries, including with respect to gun violence; and(B) rehabilitation from such injuries;

    The bill says: in subsection (a)(1), by striking "research relating to the causes, mechanisms, prevention, diagnosis, treatment of injuries, and rehabilitation from injuries;" and inserting the following:

    Bill text · Current law (42 U.S.C. 280b)

  854. 42 U.S.C. 280badded (c)by H.R. 9877 Sec. 10101(a)

    (c) No advocacy or promotion of gun control.— Nothing in this section shall be construed to—(1) authorize the Secretary to give assistance, make grants, or enter into cooperative agreements or contracts for the purpose of advocating or promoting gun control; or(2) permit a recipient of any assistance, grant, cooperative agreement, or contract under this section to use such assistance, grant, agreement, or contract for the purpose of advocating or promoting gun control.

    The bill says: by adding at the end the following:

    Bill text · Current law (42 U.S.C. 280b)

  855. 7 U.S.C. 2012(f)changedby H.R. 9877 Sec. 10202(a)

    The bill says: Section 3(f) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(f)) is amended, in the second sentence, by striking "24" and inserting "36".

    Bill text · Current law (7 U.S.C. 2012)

  856. 7 U.S.C. 2014(e)(5)changedby H.R. 9877 Sec. 10202(b)

    The bill says: in the paragraph heading, by striking "Excess medical" and inserting "Medical";

    Bill text · Current law (7 U.S.C. 2014)

  857. 7 U.S.C. 2014(e)(5)(A)changedby H.R. 9877 Sec. 10202(b)

    The bill says: in subparagraph (A), by striking "an excess medical" and all that follows through the period at the end and inserting "a standard medical deduction or a medical expense deduction of actual costs for the allowable medical expenses incurred by the elderly or disabled member, exclusive of special diets.";

    Bill text · Current law (7 U.S.C. 2014)

  858. 7 U.S.C. 2014(e)(5)(B)(i)changedby H.R. 9877 Sec. 10202(b)

    The bill says: in subparagraph (B)(i), by striking "excess"; and

    Bill text · Current law (7 U.S.C. 2014)

  859. 7 U.S.C. 2014(e)(5)added (D)by H.R. 9877 Sec. 10202(b)

    (D) Standard medical expense deduction amount.—(i) In general.— Except as provided in clause (ii), the standard medical expense deduction shall be equal to—(I) for fiscal year 2027, $155; and(II) for each subsequent fiscal year, the applicable amount for the immediately preceding fiscal year, as adjusted to reflect changes for the 12-month period ending the preceding June 30 in the Consumer Price Index for All Urban Consumers: Medical Care published by the Bureau of Labor Statistics of the Department of Labor.(ii) Exception.— For any fiscal year, a State agency may establish a greater standard medical expense deduction than the deduction described in clause (i) if the greater deduction satisfies the applicable cost-neutrality standards established by the Secretary for that fiscal year.

    The bill says: by adding at the end the following:

    Bill text · Current law (7 U.S.C. 2014)

  860. 7 U.S.C. 2017(a)changedby H.R. 9877 Sec. 10202(c)

    The bill says: Section 8(a) of the Food and Nutrition Act of 2008 (7 U.S.C. 2017(a)) is amended, in the proviso, by striking "8 percent" and inserting "1/3".

    Bill text · Current law (7 U.S.C. 2017)

  861. 7 U.S.C. 2012(j)changedby H.R. 9877 Sec. 10203(a)

    The bill says: in the matter preceding paragraph (1), by striking the subsection designation and all that follows through "who" and inserting the following:

    Bill text · Current law (7 U.S.C. 2012)

  862. 7 U.S.C. 2012(j)(2)(B)changedby H.R. 9877 Sec. 10203(a)

    The bill says: in paragraph (2)(B), by inserting "(which includes medical assistance provided to an individual described in section 1902(e)(14)(D)(i)(III) of that Act (42 U.S.C. 1396a(e)(14)(D)(i)(III)))" after "(42 U.S.C. 1396 et seq.)".

    Bill text · Current law (7 U.S.C. 2012)

  863. 7 U.S.C. 2011added 31by H.R. 9877 Sec. 10203(b)

    31 Elderly simplified application program.—(a) In general.— Not later than 180 days after the date of enactment of this section, the Secretary shall establish a program, to be known as the "elderly simplified application program" (referred to in this section as ESAP), under which a State, in carrying out the supplemental nutrition assistance program, may elect to implement a streamlined application and certification process for households in which all adult members—(1) are elderly or disabled members; and(2) have no earned income.(b) Certification period.— The certification period for participants in ESAP shall be 36 months.(c) Income and other data verification.—(1) In general.— A State agency determining the eligibility for an applicant household under ESAP shall, notwithstanding section 11(e)(3)—(A) to the maximum extent practicable, use data matching for income verification and household size; and(B)(i) allow self-declaration by the applicant of the information required under section 273.2(f) of title 7, Code of Federal Regulations (or a successor regulation); but(ii) verify, prior to certification of the household, factors of eligibility provided by the applicant that the State agency determines are questionable.(2) Accountability and fraud prevention.— In carrying out paragraph (1), a State agency shall establish accountability and fraud protection measures to deter fraud and ensure the integrity of ESAP and the supplemental nutrition assistance program.(d) Interviews.—(1) In general.— Notwithstanding section 11(e)(6)(A), for recertification of a household under ESAP, a State agency shall not require an interview unless requested by the household.(2) Virtual interviews.— An interview under paragraph (1) may be conducted virtually.(e) Guidance.— Prior to the establishment of ESAP under subsection (a), the Administrator of the Food and Nutrition Service shall develop guidance for States, including by consulting with States, to carry out ESAP, which shall include—(1) general implementation guidelines;(2) reporting requirements;(3) quality control requirements; and(4) best practices.

    The bill says: The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) is amended by adding at the end the following:

    Bill text · Current law (7 U.S.C. 2011)

  864. 7 U.S.C. 2011added 32by H.R. 9877 Sec. 10203(c)

    32 Combined application program.—(a) In general.— Not later than 180 days after the date of enactment of this section, the Secretary, in coordination with the Commissioner of Social Security, shall establish a program, to be known as the "combined application program" (referred to in this section as CAP), under which a State, in carrying out the supplemental nutrition assistance program, may elect to implement a streamlined application process for households in which all adult members are applicants for or recipients of benefits under title II of the Social Security Act (42 U.S.C. 401 et seq.) on the basis of a disability or supplemental security income under title XVI of that Act (42 U.S.C. 1381 et seq.).(b) Purposes.— The purposes of CAP are—(1) to reduce the need for households described in subsection (a) to have in-person interviews with State offices administering the supplemental nutrition assistance program; and(2) to increase participation in the supplemental nutrition assistance program by simplifying the application process for the supplemental nutrition assistance program through increased automation and simplified calculation of benefits.(c) CAP models.— The Secretary, in coordination with the Commissioner of the Social Security Administration, shall offer, at a minimum, each of the following models for States to implement CAP:(1) Standard model.—(A) In general.— Under the standard model, the Commissioner of the Social Security Administration and the State agency administering the supplemental nutrition assistance program shall coordinate—(i) to develop a simplified joint application process for the supplemental nutrition assistance program that uses standardized benefit amounts or standardized shelter expenses, in accordance with this paragraph; and(ii) to conduct outreach to adult members receiving supplemental security income under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.) that are not receiving benefits under the supplemental nutrition assistance program.(B) Standardized benefit amounts.—(i) In general.— Under the standardized model described in subparagraph (A), applicants shall receive a standardized or automated benefit level under the supplemental nutrition assistance program based on the shelter expenses and other income of the applicants.(ii) Minimum standardized benefit levels.— At a minimum, there shall be in effect 2 standardized benefit levels under clause (i), including, as determined by the State—(I) a level for participants with low shelter expenses; and(II) a level for participants with high shelter expenses.(iii) Comparable amount.— A State shall ensure that the amount provided under a standardized benefit level under clause (i) is comparable to an amount that a participant would otherwise receive under the supplemental nutrition assistance program.(iv) Referral.— A State shall refer a household described in subsection (a) to the supplemental nutrition assistance program instead of enrolling that household in CAP if the standardized amount that the household would receive under CAP would be significantly less than the amount of benefits that the household would receive under the supplemental nutrition assistance program.(C) Standardized shelter expenses.— In computing an excess shelter expense deduction under section 5(e)(6), a State agency may use a standard utility allowance in accordance with regulations promulgated by the Secretary.(2) Modified model.— Under the modified model, a State agency administering the supplemental nutrition assistance program shall—(A) conduct outreach to prospective participants in the supplemental nutrition assistance program using information from the Social Security Administration to identify households described in subsection (a) that are not participants in the supplemental nutrition assistance program; and(B) send to those households simplified application forms for the supplemental nutrition assistance program.

    The bill says: The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) (as amended by subsection (b)) is amended by adding at the end the following:

    Bill text · Current law (7 U.S.C. 2011)

  865. 7 U.S.C. 2011added 33by H.R. 9877 Sec. 10204

    33 Enrollment and outreach pilot program for older adults, kinship families, and adults with disabilities.—(a) Definitions.— In this section:(1) Disability.— The term disability has the meaning given the term in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102).(2) Eligible entity.— The term eligible entity means—(A) a State or local government agency;(B) an Indian tribe or Tribal organization;(C) a nonprofit organization, including a public or nonprofit provider of services;(D) a community-based organization; and(E) an educational provider.(3) Kinship family.— The term kinship family means a family in which a child resides with, and is being raised by, a grandparent, another extended family member, or an adult with whom the child has a close family-like relationship, such as a godparent or a close family friend.(4) Older adult.— The term older adult has the meaning given the term older individual in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002).(5) Pilot program.— The term pilot program means the Enrollment and Outreach Pilot Program for Older Adults, Kinship Families, and Adults with Disabilities established under subsection (b).(b) Establishment.— Not later than 180 days after the date of enactment of this section, the Secretary shall establish a pilot program, to be known as the "Enrollment and Outreach Pilot Program for Older Adults, Kinship Families, and Adults with Disabilities", under which the Secretary shall award grants to eligible entities—(1) to raise awareness among older adults, kinship families, and adults with disabilities of the availability, eligibility requirements, application procedures, and benefits of the supplemental nutrition assistance program; and(2) to support older adults, kinship families, and adults with disabilities in enrolling in the supplemental nutrition assistance program.(c) Priority.— In awarding grants under the pilot program, the Secretary shall give priority to—(1) eligible entities that—(A) provide services to older adults or adults with disabilities;(B) provide services to kinship families, including kinship navigator programs;(C) have experience implementing programs that receive funding under the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.);(D) have experience implementing programs administered by the Food and Nutrition Service; or(E) receive, plan to receive, or demonstrate an ability to partner with a program that receives, funding under—(i) the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.);(ii) the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.); or(iii) 1 or more nutrition programs administered by the Secretary; and(2) projects that will—(A) serve communities with—(i) high rates of food insecurity or malnutrition; or(ii) low food access;(B) serve rural communities, indigenous communities, or communities of color;(C) serve members of the lesbian, gay, bisexual, transgender, and queer community;(D) serve adults with limited English proficiency;(E) serve veterans;(F) serve residents in federally subsidized housing, including federally subsidized housing units for older adults and adults with disabilities;(G) serve residents living in housing serving kinship families; and(H) incorporate nutrition education activities that promote healthy eating and active lifestyles.(d) Eligible activities.— An eligible entity receiving a grant under the pilot program shall use the grant to carry out 1 or more of the following activities:(1) Application assistance, including—(A) eligibility prescreening;(B) assistance in completing an application for the supplemental nutrition assistance program;(C) assistance in obtaining application verification documents;(D) medical expense deduction counseling; and(E) translation of materials and bilingual accommodation.(2) Tailored dissemination of information relating to the supplemental nutrition assistance program, including through—(A) community-based outreach workshops and events;(B) a toll-free hotline to provide information relating to Federal, State, and local food resources;(C) informational websites and other social media sites; and(D) printed or digital informational content.(3) Transportation, including—(A) transportation to or from a local office of the supplemental nutrition assistance program; and(B) administration of vouchers or similar items for the transportation described in subparagraph (A).(4) Identification, implementation, analysis, and dissemination of replicable and scalable models for increasing enrollment in the supplemental nutrition assistance program among older adults, kinship families, and adults with disabilities.(e) Grants.—(1) Maximum amount.— A grant awarded under the pilot program to an eligible entity for a fiscal year shall be—(A) not less than $50,000; and(B) not more than $250,000.(2) Duration.— An eligible entity may be awarded a grant under the pilot program for not more than 5 years.(f) Evaluation.— Not later than 2 years after the date of establishment of the pilot program, the Secretary shall conduct an evaluation of the pilot program.(g) Funding.—(1) In general.— In addition to amounts otherwise available, there is appropriated, out of any funds in the Treasury not otherwise appropriated, $12,250,000, to remain available until expended, to carry out the pilot program, of which not more than $250,000 shall be used to carry out the evaluation under subsection (f).(2) Administrative costs.— Of the amounts made available under paragraph (1) (excluding the amount made available to carry out subsection (f)), not more than 3 percent may be used by the Secretary for administrative costs.

    The bill says: The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) (as amended by section 10203(c)) is amended by adding at the end the following:

    Bill text · Current law (7 U.S.C. 2011)

  866. 7 U.S.C. 2011added 34by H.R. 9877 Sec. 10205

    34 Food delivery.—(a) Definitions.— In this section:(1) Covered retail food store.— The term covered retail food store means a retail food store, a public or private nonprofit meal delivery service, or a public or nonprofit meal delivery provider participating in the supplemental nutrition assistance program that is unable to cover the cost of food delivery for participants of the supplemental nutrition assistance program.(2) Employee.— The term employee has the meaning given the term in section 3 of the Fair Labor Standards Act of 1938 (29 U.S.C. 203).(b) Program modifications.—(1) In general.— In carrying out the supplemental nutrition assistance program, the Secretary shall—(A) notify retail food stores participating in the supplemental nutrition assistance program of existing opportunities through which the retail food stores can deliver food to program participants, including by—(i) allowing an EBT card to be swiped with a mobile device on delivery of food to the home; and(ii) preparing food for pickup;(B) authorize public-private partnerships between the Department of Agriculture, retail food stores participating in the supplemental nutrition assistance program, and community-based organizations to provide free or low-cost food delivery, including through the use of private funds;(C) in the case of a covered retail food store, use funds made available under subparagraph (E) of paragraph (3) to provide, in accordance with that paragraph, free grocery delivery for participants in the supplemental nutrition assistance program who are older adults or adults with disabilities (as those terms are defined in section 33(a)) who are unable to shop for food or lack safe and accessible transportation options to the covered retail food store; and(D) require each State to submit to the Secretary a plan that describes the methods by which the State will—(i) work with retail food stores participating in the supplemental nutrition assistance program and other community-based partners to establish a process for food delivery for program participants;(ii) administer the reimbursements described in paragraph (3), including timing, eligibility, and distribution processes; and(iii) ensure that retail food stores participating in the supplemental nutrition assistance program that are reimbursed for delivery costs under paragraph (3) adhere to the requirements described in subparagraph (B) of that paragraph.(2) State plans.— Not later than 10 days after the date on which the Secretary receives a State plan under paragraph (1)(D), the Secretary shall—(A) determine whether to approve or disapprove the State plan; and(B) make publicly available on the website of the Department of Agriculture—(i) the State plan;(ii) the determination made under subparagraph (A) with respect to that plan; and(iii) any guidance issued to the State with respect to that plan.(3) Reimbursement of covered retail food stores.—(A) In general.— Notwithstanding any other provision of law (including sections 274.7(f) and 278.2(b) of title 7, Code of Federal Regulations (or successor regulations), and any other regulations), subject to the availability of funds, a State agency shall reimburse a covered retail food store for the cost of food delivery to participants described in paragraph (1)(C) if—(i) the covered retail food store meets the requirements under subparagraph (B); and(ii) the majority of the number of food items delivered by the covered retail food store are eligible for redemption using benefits under the supplemental nutrition assistance program, regardless of whether the delivery includes nonfood items, subject to the condition that those nonfood items shall be of de minimis value.(B) Requirements.— A covered retail food store may receive reimbursement for the cost of food delivery to participants described in paragraph (1)(C) if the following requirements are met:(i) Food delivery is performed by employees of the covered retail food store or employees of an entity contracted by the covered retail food store to perform deliveries.(ii) Before any employee described in clause (i) begins making food deliveries, that employee receives employer-provided health and safety training that reflects the most recent guidelines of the Centers for Disease Control and Prevention.(iii) All employees described in clause (i) performing deliveries are paid at a rate that is not less than the greater of—(I) the minimum wage rate established under section 6(a)(1) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(a)(1)); and(II) the minimum wage rate established by the applicable State or locality in which the employee works.(iv) The covered retail food store meets the size standard determined by the Small Business Administration for a supermarket or other grocery retailer or a convenience retailer under section 121.201 of title 13, Code of Federal Regulations (or a successor regulation).(v) The covered retail food store does not—(I) charge the supplemental nutrition assistance program participant for delivery costs for which the covered retail food store will be reimbursed;(II) require minimum purchase thresholds in order to provide free delivery;(III) restrict delivery times to least-favorable windows for those participants; or(IV) charge surge pricing.(C) Reimbursable costs.— Reimbursable costs under subparagraph (A) include costs associated with purchasing point-of-sale devices or receiving technical assistance relating to point-of-sale devices.(D) Maximum reimbursement per delivery.— The maximum amount of reimbursement under subparagraph (A) for a food delivery fee shall be $10 per delivery, which may be adjusted by the Secretary for inflation.(E) Authorization of appropriations.— There is authorized to be appropriated to the Secretary $500,000,000 for fiscal year 2027, and each fiscal year thereafter, to remain available until expended, to cover the cost of food delivery described in paragraph

    The bill says: The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) (as amended by section 10204) is amended by adding at the end the following:

    Bill text · Current law (7 U.S.C. 2011)

  867. 7 U.S.C. 612c(a)changedby H.R. 9877 Sec. 10206(a)

    The bill says: in subsection (a), in the first sentence, by striking "2023" and inserting "2031"; and

    Bill text · Current law (7 U.S.C. 612c)

  868. 7 U.S.C. 612cadded (d)by H.R. 9877 Sec. 10206(a)

    (d) Funds.— In addition to amounts otherwise available, there is appropriated, out of any funds in the Treasury not otherwise appropriated, to carry out the program under this section $10,000,000 for each of fiscal years 2027 through 2031.

    The bill says: by adding at the end the following:

    Bill text · Current law (7 U.S.C. 612c)

  869. 7 U.S.C. 612cchangedby H.R. 9877 Sec. 10206(b)

    The bill says: by striking "2023" each place it appears and inserting "2031";

    Bill text · Current law (7 U.S.C. 612c)

  870. 7 U.S.C. 612c(g)(1)changedby H.R. 9877 Sec. 10206(b)

    to—(A) low-income persons aged 60 and older; and(B) low-income adults with disabilities (as defined in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102)).

    The bill says: in paragraph (1), by striking "to low-income persons aged 60 and older." and inserting the following:

    Bill text · Current law (7 U.S.C. 612c)

  871. 7 U.S.C. 612c(g)renumberedby H.R. 9877 Sec. 10206(b)

    The bill says: by redesignating paragraph (2) as paragraph (3);

    Bill text · Current law (7 U.S.C. 612c)

  872. 7 U.S.C. 612c(g)added (2)by H.R. 9877 Sec. 10206(b)

    (2) Income eligibility.— For purposes of paragraph (1), a low-income individual described in subparagraph (A) or (B) of that paragraph shall have a gross income level that is less than 185 percent of the Federal poverty line.

    The bill says: by inserting after paragraph (1) the following:

    Bill text · Current law (7 U.S.C. 612c)

  873. 7 U.S.C. 612c(g)(B)changedby H.R. 9877 Sec. 10206(b)

    The bill says: in subparagraph (B) of paragraph (3) (as so redesignated), in the matter preceding clause (i), by striking "of—" and all that follows through the period at the end of clause (ii) and inserting "of 36 months."; and

    Bill text · Current law (7 U.S.C. 612c)

  874. 7 U.S.C. 612c(i)changedby H.R. 9877 Sec. 10206(b)

    The bill says: by inserting "or low-income adults with disabilities described in subsection (g)(1)(B)" after "elderly persons"; and

    Bill text · Current law (7 U.S.C. 612c)

  875. 7 U.S.C. 612c(i)changedby H.R. 9877 Sec. 10206(b)

    The bill says: by striking "to each elderly participant in, or applicant for, the commodity supplemental food program for the elderly" and inserting "to each participant in, or applicant for, such a program".

    Bill text · Current law (7 U.S.C. 612c)

  876. 7 U.S.C. 3007(a)changedby H.R. 9877 Sec. 10207(a)

    The bill says: by striking "Of the funds" and inserting the following:

    Bill text · Current law (7 U.S.C. 3007)

  877. 7 U.S.C. 3007(a)(1)changedby H.R. 9877 Sec. 10207(a)

    The bill says: in paragraph (1) (as so designated), by inserting "(referred to in this section as the Secretary)" after "Agriculture"; and

    Bill text · Current law (7 U.S.C. 3007)

  878. 7 U.S.C. 3007(a)added (2)by H.R. 9877 Sec. 10207(a)

    (2) Authorization of appropriations.— There are authorized to be appropriated to the Secretary to carry out and expand the seniors farmers' market nutrition program—(A) not less than $60,000,000 for fiscal year 2027;(B) not less than $70,000,000 for fiscal year 2028; and(C) not less than $100,000,000 for each of fiscal years 2029 through 2031.

    The bill says: by adding at the end the following:

    Bill text · Current law (7 U.S.C. 3007)

  879. 7 U.S.C. 3007(b)(1)changedby H.R. 9877 Sec. 10207(a)

    The bill says: in subsection (b)(1), by inserting "and adults with disabilities (as defined in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102))" before the semicolon at the end;

    Bill text · Current law (7 U.S.C. 3007)

  880. 7 U.S.C. 3007renumberedby H.R. 9877 Sec. 10207(a)

    The bill says: by redesignating subsections (c) through (f) as subsections (f) through (i), respectively; and

    Bill text · Current law (7 U.S.C. 3007)

  881. 7 U.S.C. 3007added (c)by H.R. 9877 Sec. 10207(a)

    (c) Benefit amounts.— Under the seniors farmers' market nutrition program—(1) the minimum individual benefit shall be $35; and(2) the maximum individual benefit shall be $80.(d) Certification period.— The certification period for participants in the seniors farmers' market nutrition program shall be 36 months.(e) Modernization grants.—(1) In general.— Not later than 180 days after the date of enactment of the Senior Hunger Prevention Act, the Secretary shall establish a grant program under which the Secretary shall award grants to State agencies, including Tribal organizations (as defined in section 3 of the Food and Nutrition Act of 2008 (7 U.S.C. 2012)) and territories, that administer the senior farmers’ market nutrition program to modernize program operations, including—(A) by transitioning from paper-based coupons to an electronic transaction technology, such as a web-based service or installable software; and(B) by increasing benefit use at farmers’ markets.(2) Grant amount.—(A) In general.— The amount of a grant awarded under paragraph (1) shall not exceed $350,000.(B) Supplies.— Not more than $25,000 may be used to carry out subparagraph (F) of paragraph (3).(3) Eligible expenses.— An entity receiving a grant under paragraph (1) may use the grant for—(A) costs associated with the procurement of electronic transaction technology;(B) planning costs, including personnel costs, relating to electronic transaction technology procurement and implementation;(C) costs associated with evaluating the impact of transitioning from coupon-based operations to an electronic transaction technology;(D) training, outreach, and promotional material costs, including the costs associated with translating materials;(E) maintenance and operation of electronic transaction technology procured using the grant during the period of performance of the grant;(F) subject to paragraph (2)(B), the purchase of supplies needed to perform electronic transactions onsite; and(G) additional costs associated with modernizing program operations, as determined appropriate by the Secretary.(4) Reports.— Each entity that receives a grant under paragraph (1) shall submit to the Secretary and the Administrator of the Food and Nutrition Service quarterly performance progress reports on the use of the grant.(5) Authorization of appropriations.— There is authorized to be appropriated to the Secretary to carry out this subsection $15,000,000 for fiscal year 2027 and each fiscal year thereafter.

    The bill says: by inserting after subsection (b) the following:

    Bill text · Current law (7 U.S.C. 3007)

  882. 7 U.S.C. 3007added 4403by H.R. 9877 Sec. 10208

    4403 Infrastructure funding for farmers’ markets; local procurement pilot program.—(a) Definitions.— In this section:(1) Disability.— The term disability has the meaning given the term in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102).(2) Older adult.— The term older adult has the meaning given the term older individual in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002).(3) Secretary.— The term Secretary means the Secretary of Agriculture.(b) Infrastructure funding for farmers’ markets.—(1) Definition of eligible entity.— In this subsection, the term eligible entity means an entity that—(A) is—(i) an agricultural cooperative or other agricultural business entity or a producer network or association, including a community-supported agriculture network or association;(ii) a local or Tribal government;(iii) a nonprofit corporation;(iv) a public benefit corporation;(v) an economic development corporation;(vi) a regional farmers’ market authority;(vii) a food council; or(viii) any other entity as determined by the Secretary; and(B) can demonstrate financial need, as determined by the Secretary.(2) Establishment.— Not later than 180 days after the date of enactment of the Senior Hunger Prevention Act, the Secretary shall establish a program under which the Secretary shall provide financial assistance, in the form of loans, loan guarantees, and grants, to eligible entities for—(A) the establishment of new farmers’ markets;(B) the improvement or rehabilitation of existing farmers’ markets, including by adding or improving payment technologies used in those farmers’ markets; and(C) the expansion of community supported agriculture to serve older adults and adults with disabilities.(3) Requirements.— An eligible entity that receives financial assistance under paragraph (2) shall be required—(A) to host farmers’ markets or related activities at locations accessible—(i) by public transportation;(ii) by paratransit; or(iii) through transportation services provided under the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.); and(B) to reserve not less than 50 percent of the floor area of an applicable farmers’ market for the sale of products that are produced locally, as determined by the Secretary, by—(i) farmers, ranchers, or aquaculture, mariculture, or fisheries operators; or(ii) associations of farmers, ranchers, or aquaculture, mariculture, or fisheries operators.(4) Cost sharing.— The non-Federal share of a grant provided under this subsection shall be 20 percent of the amount of the grant, which may comprise transportation costs, volunteer contributions, and in-kind staffing.(5) Funding.— Of the funds of the Commodity Credit Corporation, the Secretary shall use to carry out this subsection $50,000,000 for each of fiscal years 2027 through 2031.(c) Local procurement pilot program.—(1) Definitions.— In this subsection:(A) Agricultural producer.— The term agricultural producer includes—(i) an agricultural cooperative;(ii) a person engaged in farming, ranching, or aquaculture;(iii) a person engaged in the packing of a food product; and(iv) a person engaged in the minimal processing of a food product, as determined by the Secretary.(B) Eligible entity.— The term eligible entity means an entity that—(i)(I) coordinates enrollment in, and distribution of, benefits under the seniors farmers’ market nutrition program; or(II) demonstrates an ability to partner with an entity that coordinates enrollment in and distribution of benefits under the seniors farmers’ market nutrition program; and(ii) is—(I) a public or nonprofit provider of nutrition services or support to older adults or adults with disabilities, including—(aa) an Aging and Disability Resource Center (as defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002));(bb) an area agency on aging (as defined in that section);(cc) a State health insurance program;(dd) a State unit on aging;(ee) a center for independent living;(ff) a community health center;(gg) a multipurpose senior center; and(hh) federally subsidized housing, including federally subsidized housing units for older adults and adults with disabilities; or(II) a local, State, or national parks and recreation department.(2) Establishment.— Not later than 180 days after the date of enactment of the Senior Hunger Prevention Act, the Secretary shall establish a pilot program under which the Secretary shall award grants to eligible entities to contract with agricultural producers that will grow produce to support the local procurement and contracting of produce for eligible entities.(3) Priority.— In awarding grants under paragraph (2), the Secretary shall give priority to an eligible entity that will use grant funds to benefit underserved communities, including communities that are located in areas of concentrated poverty with limited access to fresh locally or regionally grown food.(4) Methods.— Under a contract described in paragraph (2), an agricultural producer may grow produce through traditional or controlled environmental agriculture.(5) Evaluation.— Not later than 2 years after the date of establishment of the pilot program under paragraph (2), the Secretary shall conduct an evaluation of the pilot program.(6) Funding.—(A) In general.— Of the funds of the Commodity Credit Corporation, the Secretary shall use to carry out this subsection $350,000 for each of fiscal years 2027 through 2031.(B) Administrative costs.— Of the amounts made available under subparagraph (A) for a fiscal year, not more than 5 percent may be used for administrative costs.(C) Evaluation.— In addition to amounts made available under subparagraph (A), there is appropriated to the Secretary, out of any funds in the Treasury not otherwise appropriated, $25,000 to carry out paragraph (5).

    The bill says: The Farm Security and Rural Investment Act of 2002 is amended by inserting after section 4402 (7 U.S.C. 3007) the following:

    Bill text · Current law (7 U.S.C. 3007)

  883. 7 U.S.C. 2015removedby H.R. 9877 Sec. 10211(a)

    The bill says: by striking subsection (o); and

    Bill text · Current law (7 U.S.C. 2015)

  884. 7 U.S.C. 2015renumberedby H.R. 9877 Sec. 10211(a)

    The bill says: by redesignating subsections (p) through (s) as subsections (o) through (r), respectively.

    Bill text · Current law (7 U.S.C. 2015)

  885. 7 U.S.C. 2014(a)changedby H.R. 9877 Sec. 10211(b)

    The bill says: Section 5(a) of the Food and Nutrition Act of 2008 (7 U.S.C. 2014(a)) is amended, in the second sentence, by striking "(r)" and inserting "(q)".

    Bill text · Current law (7 U.S.C. 2014)

  886. 7 U.S.C. 2015(d)(4)(B)(ii)(I)(bb)(DD)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in subparagraph (B)(ii)(I)(bb)(DD), by striking "or subsection (o)"; and

    Bill text · Current law (7 U.S.C. 2015)

  887. 7 U.S.C. 2015(d)(4)(N)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in subparagraph (N), by striking "or subsection (o)" each place it appears.

    Bill text · Current law (7 U.S.C. 2015)

  888. 7 U.S.C. 2016(i)(1)changedby H.R. 9877 Sec. 10211(b)

    The bill says: Section 7(i)(1) of the Food and Nutrition Act of 2008 (7 U.S.C. 2016(i)(1)) is amended by striking "section 6(o)(2) of this Act or".

    Bill text · Current law (7 U.S.C. 2016)

  889. 7 U.S.C. 2025(h)(1)(B)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in subparagraph (B), in the matter preceding clause (i), by striking "that—" and all that follows through the period at the end of clause (ii) and inserting "that is determined and adjusted by the Secretary.";

    Bill text · Current law (7 U.S.C. 2025)

  890. 7 U.S.C. 2025(h)(1)removedby H.R. 9877 Sec. 10211(b)

    The bill says: by striking subparagraph (E);

    Bill text · Current law (7 U.S.C. 2025)

  891. 7 U.S.C. 2025(h)(1)renumberedby H.R. 9877 Sec. 10211(b)

    The bill says: by redesignating subparagraph (F) as subparagraph (E); and

    Bill text · Current law (7 U.S.C. 2025)

  892. 7 U.S.C. 2025(h)(1)(ii)(III)(ee)(AA)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in clause (ii)(III)(ee)(AA) of subparagraph (E) (as so redesignated), by striking ", individuals subject to the requirements under section 6(o),"; and

    Bill text · Current law (7 U.S.C. 2025)

  893. 7 U.S.C. 2025(h)(5)(C)(ii)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in clause (ii), by adding "and" at the end;

    Bill text · Current law (7 U.S.C. 2025)

  894. 7 U.S.C. 2025(h)(5)(C)(iii)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in clause (iii), by striking "; and" and inserting a period; and

    Bill text · Current law (7 U.S.C. 2025)

  895. 7 U.S.C. 2025(h)(5)(C)removedby H.R. 9877 Sec. 10211(b)

    The bill says: by striking clause (iv).

    Bill text · Current law (7 U.S.C. 2025)

  896. 26 U.S.C. 51(d)(8)(A)(ii)(I)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in subclause (I), by striking ", or" at the end and inserting a period;

    Bill text · Current law (26 U.S.C. 51)

  897. 26 U.S.C. 51(d)(8)(A)(ii)changedby H.R. 9877 Sec. 10211(b)

    The bill says: in the matter preceding subclause (I), by striking "family—" and all that follows through "receiving" in subclause (I) and inserting "family receiving"; and

    Bill text · Current law (26 U.S.C. 51)

  898. 26 U.S.C. 51(d)(8)(A)(ii)changedby H.R. 9877 Sec. 10211(b)

    The bill says: by striking subclause (II).

    Bill text · Current law (26 U.S.C. 51)

  899. 29 U.S.C. 3113(a)(2)removedby H.R. 9877 Sec. 10211(b)

    The bill says: by striking subparagraph (D); and

    Bill text · Current law (29 U.S.C. 3113)

  900. 29 U.S.C. 3113(a)(2)renumberedby H.R. 9877 Sec. 10211(b)

    The bill says: by redesignating subparagraphs (E) through (K) as subparagraphs (D) through (J), respectively.

    Bill text · Current law (29 U.S.C. 3113)

  901. 29 U.S.C. 3151(b)(2)(B)removedby H.R. 9877 Sec. 10211(b)

    The bill says: by striking clause (iv); and

    Bill text · Current law (29 U.S.C. 3151)

  902. 29 U.S.C. 3151(b)(2)(B)renumberedby H.R. 9877 Sec. 10211(b)

    The bill says: by redesignating clauses (v) through (vii) as clauses (iv) through (vi), respectively.

    Bill text · Current law (29 U.S.C. 3151)

  903. 7 U.S.C. 2012(r)changedby H.R. 9877 Sec. 10212(a)

    The bill says: in subsection (r), by inserting "the Commonwealth of Puerto Rico," after "Guam,"; and

    Bill text · Current law (7 U.S.C. 2012)

  904. 7 U.S.C. 2012(u)(3)(B)changedby H.R. 9877 Sec. 10212(a)

    The bill says: in subsection (u)(3)(B), by striking "Guam and" and inserting "Guam, the Commonwealth of Puerto Rico, and" after "Guam,".

    Bill text · Current law (7 U.S.C. 2012)

  905. 7 U.S.C. 2014(b)changedby H.R. 9877 Sec. 10212(b)

    The bill says: in subsection (b), in the first sentence, by inserting "the Commonwealth of Puerto Rico," after "Guam,";

    Bill text · Current law (7 U.S.C. 2014)

  906. 7 U.S.C. 2014(c)(1)changedby H.R. 9877 Sec. 10212(b)

    The bill says: in paragraph (1), by striking "and Guam," and inserting "Guam, and the Commonwealth of Puerto Rico,"; and

    Bill text · Current law (7 U.S.C. 2014)

  907. 7 U.S.C. 2014(c)changedby H.R. 9877 Sec. 10212(b)

    The bill says: in the undesignated matter at the end, by striking "States or Guam" and inserting "States, Guam, or the Commonwealth of Puerto Rico"; and

    Bill text · Current law (7 U.S.C. 2014)

  908. 7 U.S.C. 2014(e)(1)(A)changedby H.R. 9877 Sec. 10212(b)

    The bill says: in paragraph (1)(A), by inserting "the Commonwealth of Puerto Rico," after "Hawaii," each place it appears; and

    Bill text · Current law (7 U.S.C. 2014)

  909. 7 U.S.C. 2014(e)(6)(B)changedby H.R. 9877 Sec. 10212(b)

    The bill says: in paragraph (6)(B), in the matter preceding clause (i), by inserting "the Commonwealth of Puerto Rico," after "Guam,".

    Bill text · Current law (7 U.S.C. 2014)

  910. 7 U.S.C. 2028added (f)by H.R. 9877 Sec. 10212(d)

    (f) Transition of Puerto Rico to supplemental nutrition assistance program.—(1) Request for participation.— The Commonwealth of Puerto Rico may submit to the Secretary a request to participate in the supplemental nutrition assistance program, which shall include a plan of operation described in section 11(d), including a description of the date on which the Commonwealth of Puerto Rico intends to begin participation in the supplemental nutrition assistance program.(2) Certification by Secretary.—(A) In general.— On submission of a request by the Commonwealth of Puerto Rico under paragraph (1), the Secretary shall certify the Commonwealth of Puerto Rico as qualified to participate in the supplemental nutrition assistance program if the Secretary—(i) approves the plan of operation submitted with the request, in accordance with this subsection; and(ii) approves the applications described in paragraph (4) in accordance with that paragraph.(B) Deadline.— The Secretary shall certify or deny the request of the Commonwealth of Puerto Rico under paragraph (1) not later than 90 days after the date on which the Secretary receives the request.(C) Submission to Congress.— The Secretary shall submit a certification under subparagraph (A) to Congress.(3) Determination of plan of operation.—(A) Approval.— The Secretary shall approve a plan of operation submitted with a request under paragraph (1) if the plan satisfies the requirements under this Act.(B) Disapproval.— If the Secretary does not approve a plan of operation submitted with a request under paragraph (1), the Secretary shall provide a statement that describes each requirement under this Act that is not satisfied by the plan.(4) Approval of retail food stores.— If the Secretary approves a plan of operation under paragraph (3)(A) for the Commonwealth of Puerto Rico, the Secretary shall accept applications from retail food stores located in the Commonwealth of Puerto Rico to be authorized under section 9 to participate in the supplemental nutrition assistance program.(5) Family Market Program.— Notwithstanding subsection (g), the Secretary shall allow the Commonwealth of Puerto Rico to continue to carry out under the supplemental nutrition assistance program the Family Market Program established pursuant to this section.(6) Temporary funding.— If the Commonwealth of Puerto Rico has a request under paragraph (1) pending before the Secretary (including a plan of operation pending under paragraph (3)), the Commonwealth of Puerto Rico shall receive block grants under this section, in amounts determined by the Secretary, until the date on which the Secretary certifies the Commonwealth of Puerto Rico under paragraph (2)(B).(7) Authorization of appropriations.— There are authorized to be appropriated to the Secretary such sums as are necessary to carry out this subsection for fiscal year 2027, to remain available until expended.(g) Technical infrastructure implementation.—(1) In general.— The Commonwealth of Puerto Rico may request from the Secretary a 1-time grant to pay for the cost of the technology infrastructure necessary to implement the supplemental nutrition assistance program, including the cost of information technology, information technology personnel, and training relating to program implementation.(2) Application.— In making a request under paragraph (1), the Commonwealth of Puerto Rico shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including—(A) a description of the costs to be paid for by the grant; and(B) a plan for implementing the technology infrastructure described in paragraph (1)—(i) within 1 year of receiving the grant; and(ii) that is reasonably cost efficient, as determined by the Secretary.(3) Determination.—(A) Time limit.— The Secretary shall approve or deny an application submitted under paragraph (2) not later than 90 days after the date on which the application is submitted.(B) Denial.— If the Secretary denies an application submitted under paragraph (2), the Commonwealth of Puerto Rico may amend the plan described in subparagraph (B) of that paragraph, in coordination with the Secretary, to resubmit to the Secretary for approval.(4) Funding.—(A) In general.— There is appropriated to the Secretary, out of funds in the Treasury not otherwise appropriated, $112,500,000 to carry out this subsection, to remain available until 3 years after the date of enactment of this subsection.(B) Reversion of funds.— Any funds appropriated to the Secretary under subparagraph (A) that remain available by the date described in that subparagraph shall revert to the Treasury.(h) Termination of effectiveness.—(1) In general.— Subsections (a) through (e) shall cease to be effective with respect to the Commonwealth of Puerto Rico on the date described in paragraph (2) if the Secretary submits to Congress a certification under subsection (f)(2)(C) for the Commonwealth of Puerto Rico.(2) Date described.— The date referred to in paragraph (1) is the date established by the Commonwealth of Puerto Rico in the applicable plan of operation submitted to the Secretary under subsection (f)(1).

    The bill says: Section 19 of the Food and Nutrition Act of 2008 (7 U.S.C. 2028) is amended by adding at the end the following:

    Bill text · Current law (7 U.S.C. 2028)

  911. 42 U.S.C. 1773(a)changedby H.R. 9877 Sec. 10311(a)

    The bill says: by striking "is hereby" and inserting "are"; and

    Bill text · Current law (42 U.S.C. 1773)

  912. 42 U.S.C. 1773(a)changedby H.R. 9877 Sec. 10311(a)

    The bill says: by inserting "to provide free breakfast to all children enrolled at those schools" before "in accordance".

    Bill text · Current law (42 U.S.C. 1773)

  913. 42 U.S.C. 1773(b)(1)(A)(i)changedby H.R. 9877 Sec. 10311(b)

    The bill says: in subparagraph (A)(i), by striking subclause (II) and inserting the following:

    Bill text · Current law (42 U.S.C. 1773)

  914. 42 U.S.C. 1773(b)(1)changedby H.R. 9877 Sec. 10311(b)

    (B) Payment amounts.—(i) In general.— The national average payment for each free breakfast shall be $2.80, adjusted annually for inflation in accordance with clause (ii) and rounded in accordance with clause (iii).(ii) Inflation adjustment.—(I) In general.— The annual inflation adjustment under clause (i) shall reflect changes in the cost of operating the free breakfast program under this section, as indicated by the change in the Consumer Price Index for food away from home for all urban consumers.(II) Basis.— Each inflation annual adjustment under clause (i) shall reflect the changes in the Consumer Price Index for food away from home for the most recent 12-month period for which those data are available.(iii) Rounding.— On July 1, 2027, and annually thereafter, the national average payment rate for free breakfast shall be—(I) adjusted to the nearest lower-cent increment; and(II) based on the unrounded amounts for the preceding 12-month period.

    The bill says: by striking subparagraph (B) and inserting the following:

    Bill text · Current law (42 U.S.C. 1773)

  915. 42 U.S.C. 1773(b)(1)removedby H.R. 9877 Sec. 10311(b)

    The bill says: by striking subparagraphs (C) and (E); and

    Bill text · Current law (42 U.S.C. 1773)

  916. 42 U.S.C. 1773(b)(1)renumberedby H.R. 9877 Sec. 10311(b)

    The bill says: by redesignating subparagraph (D) as subparagraph (C);

    Bill text · Current law (42 U.S.C. 1773)

  917. 42 U.S.C. 1773(b)removedby H.R. 9877 Sec. 10311(b)

    The bill says: by striking paragraphs (2) and (3);

    Bill text · Current law (42 U.S.C. 1773)

  918. 42 U.S.C. 1773(b)renumberedby H.R. 9877 Sec. 10311(b)

    The bill says: by redesignating paragraphs (4) and (5) as paragraphs (2) and (3), respectively; and

    Bill text · Current law (42 U.S.C. 1773)

  919. 42 U.S.C. 1773(b)(3)changedby H.R. 9877 Sec. 10311(b)

    The bill says: in paragraph (3) (as so redesignated), by striking "paragraph (3) or (4)" and inserting "paragraph (2)".

    Bill text · Current law (42 U.S.C. 1773)

  920. 42 U.S.C. 1773changedby H.R. 9877 Sec. 10311(c)

    The bill says: Section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773) is amended by striking subsection (c) and inserting the following:

    Bill text · Current law (42 U.S.C. 1773)

  921. 42 U.S.C. 1773changedby H.R. 9877 Sec. 10311(d)

    The bill says: Section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773) is amended by striking subsection (d) and inserting the following:

    Bill text · Current law (42 U.S.C. 1773)

  922. 42 U.S.C. 1793(a)changedby H.R. 9877 Sec. 10311(d)

    a school—(1) participating in the free breakfast program under section 4, or seeking to initiate a free breakfast program under that section; and(2) not less than 40 percent of the students of which are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))

    The bill says: Section 23(a) of the Child Nutrition Act of 1966 (42 U.S.C. 1793(a)) is amended by striking "a school in severe need, as described in section 4(d)(1)" and inserting the following:

    Bill text · Current law (42 U.S.C. 1793)

  923. 42 U.S.C. 1773(e)(1)(A)changedby H.R. 9877 Sec. 10311(e)

    The bill says: in paragraph (1)(A), in the second sentence, by striking "free or" and all that follows through the period at the end and inserting "free to all children enrolled at a school participating in the school breakfast program."; and

    Bill text · Current law (42 U.S.C. 1773)

  924. 42 U.S.C. 1773(e)(2)changedby H.R. 9877 Sec. 10311(e)

    The bill says: in paragraph (2), in the second sentence, by striking "the full charge to the student for a breakfast meeting the requirements of this section or".

    Bill text · Current law (42 U.S.C. 1773)

  925. 42 U.S.C. 1773added (f)by H.R. 9877 Sec. 10311(f)

    (f) Prohibition on breakfast shaming.— A school or school food authority shall not—(1) physically segregate for the purpose of debt shaming or otherwise discriminate against any child participating in the free breakfast program under this section; or(2) overtly identify a child described in paragraph (1) by a special token or ticket, an announced or published list of names, or any other means.

    The bill says: Section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773) is amended by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1773)

  926. 42 U.S.C. 1789(b)changedby H.R. 9877 Sec. 10311(g)

    The bill says: Section 20(b) of the Child Nutrition Act of 1966 (42 U.S.C. 1789(b)) is amended by striking "by this section" and all that follows through the period at the end and inserting "by this section.".

    Bill text · Current law (42 U.S.C. 1789)

  927. 42 U.S.C. 1771changedby H.R. 9877 Sec. 10311(h)

    The bill says: by striking "or reduced price" each place it appears;

    Bill text · Current law (42 U.S.C. 1771)

  928. 42 U.S.C. 1771changedby H.R. 9877 Sec. 10311(h)

    The bill says: by striking "and reduced price" each place it appears; and

    Bill text · Current law (42 U.S.C. 1771)

  929. 42 U.S.C. 1771changedby H.R. 9877 Sec. 10311(h)

    The bill says: by striking "a reduced price" each place it appears.

    Bill text · Current law (42 U.S.C. 1771)

  930. 42 U.S.C. 1753(b)(1)(A)changedby H.R. 9877 Sec. 10321(1)

    The bill says: in subparagraph (A), by striking "of this Act"; and

    Bill text · Current law (42 U.S.C. 1753)

  931. 42 U.S.C. 1753(b)(1)(B)changedby H.R. 9877 Sec. 10321(1)

    The bill says: in subparagraph (B), by striking "of this subsection"; and

    Bill text · Current law (42 U.S.C. 1753)

  932. 42 U.S.C. 1753(b)changedby H.R. 9877 Sec. 10321(2)

    (2) Payment amounts.—(A) In general.— The national average payment for each free lunch shall be $4.63, adjusted annually for inflation in accordance with subparagraph (C) and rounded in accordance with subparagraph (D).(B) Additional payment for local food.—(i) In general.— During a school year, a school food authority shall receive an additional payment described in clause (ii) if the State certifies that the school food authority served meals (including breakfasts, lunches, suppers, and supplements) during the preceding school year not less than 25 percent of which were made with farm products that were—(I) produced and distributed—(aa) in the State in which the school food authority is located; or(bb) not more than 250 miles from the location of the school food authority; and(II) marketed to consumers—(aa) directly; or(bb) through an intermediated channel (such as a food hub or cooperative).(ii) Payment amount.—(I) In general.— The additional payment amount under this subparagraph shall be—(aa) $0.30 for each free lunch and supper;(bb) $0.21 for each free breakfast; and(cc) $0.08 for each free supplement.(II) Adjustments.— Each additional payment amount under subclause (I) shall be adjusted annually in accordance with subparagraph (C) and rounded in accordance with subparagraph (D).(iii) Disbursement.— The State agency shall disburse funds made available under this subparagraph to school food authorities eligible to receive additional reimbursement.(C) Inflation adjustment.—(i) In general.— The annual inflation adjustment under subparagraphs (A) and (B)(ii) shall reflect changes in the cost of operating the free lunch program under this Act, as indicated by the change in the Consumer Price Index for food away from home for all urban consumers.(ii) Basis.— Each annual inflation adjustment under subparagraphs (A) and (B)(ii) shall reflect the changes in the Consumer Price Index for food away from home for the most recent 12-month period for which those data are available.(D) Rounding.— On July 1, 2027, and annually thereafter, the national average payment rate for free lunch and the additional payment amount for free breakfast, lunch, supper, and supplement under subparagraph (B) shall be—(i) adjusted to the nearest lower-cent increment; and(ii) based on the unrounded amounts for the preceding 12-month period.

    The bill says: by striking paragraphs (2) and (3) and inserting the following:

    Bill text · Current law (42 U.S.C. 1753)

  933. 42 U.S.C. 1758changedby H.R. 9877 Sec. 10322(a)

    The bill says: Section 9 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758) is amended by striking subsection (b) and inserting the following:

    Bill text · Current law (42 U.S.C. 1758)

  934. 42 U.S.C. 1758(c)changedby H.R. 9877 Sec. 10322(a)

    The bill says: in subsection (c), in the third sentence, by striking "or at a reduced cost"; and

    Bill text · Current law (42 U.S.C. 1758)

  935. 42 U.S.C. 1758(e)changedby H.R. 9877 Sec. 10322(a)

    The bill says: in subsection (e), by striking ", reduced price,".

    Bill text · Current law (42 U.S.C. 1758)

  936. 42 U.S.C. 1769(b)changedby H.R. 9877 Sec. 10322(a)

    (a) Extension of eligibility of certain school districts To receive cash or commodity letters of credit assistance for school lunch programs.—(1) In general.— On

    The bill says: in subsection (b), by striking "(b)(1) Upon" and inserting the following:

    Bill text · Current law (42 U.S.C. 1769)

  937. 42 U.S.C. 1769(c)changedby H.R. 9877 Sec. 10322(a)

    (b) Alternative counting and claiming procedures.—(1) In general.— The

    The bill says: in subsection (c), by striking "(c)(1) The" and inserting the following:

    Bill text · Current law (42 U.S.C. 1769)

  938. 42 U.S.C. 1769(g)changedby H.R. 9877 Sec. 10322(a)

    The bill says: in subsection (g), by striking the subsection designation and heading and inserting the following:

    Bill text · Current law (42 U.S.C. 1769)

  939. 42 U.S.C. 1769removedby H.R. 9877 Sec. 10322(a)

    The bill says: by striking subsection (j); and

    Bill text · Current law (42 U.S.C. 1769)

  940. 42 U.S.C. 1769renumberedby H.R. 9877 Sec. 10322(a)

    The bill says: by redesignating subsections (h), (i), and (k) as subsections (d), (e), and (f), respectively.

    Bill text · Current law (42 U.S.C. 1769)

  941. 42 U.S.C. 1766(r)(5)changedby H.R. 9877 Sec. 10322(a)

    The bill says: Section 17(r)(5) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1766(r)(5)) is amended by striking "18(h)" and inserting "18(d)".

    Bill text · Current law (42 U.S.C. 1766)

  942. 42 U.S.C. 1769a(i)(2)changedby H.R. 9877 Sec. 10322(a)

    The bill says: Section 19(i)(2) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769a(i)(2)) is amended by striking "State that received funding under section 18(f) on the day before the date of enactment of the Food, Conservation, and Energy Act of 2008" and inserting "State that, on the day before the date of enactment of the Food, Conservation, and Energy Act of 2008 (Public Law 110–246; 122 Stat. 1651), received funding under section 18(f) (as in effect on the day before that date of enactment)".

    Bill text · Current law (42 U.S.C. 1769a)

  943. 7 U.S.C. 7633(b)(2)changedby H.R. 9877 Sec. 10322(a)

    The bill says: Section 413(b)(2) of the Agricultural Research, Extension, and Education Reform Act of 1998 (7 U.S.C. 7633(b)(2)) is amended by striking "section 18(g) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769(g))" and inserting "subsection (c) of section 18 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769)".

    Bill text · Current law (7 U.S.C. 7633)

  944. 42 U.S.C. 1769iremovedby H.R. 9877 Sec. 10322(a)

    The bill says: by striking subsection (b); and

    Bill text · Current law (42 U.S.C. 1769i)

  945. 42 U.S.C. 1769irenumberedby H.R. 9877 Sec. 10322(a)

    The bill says: by redesignating subsection (c) as subsection (b).

    Bill text · Current law (42 U.S.C. 1769i)

  946. 42 U.S.C. 1758(b)(1)changedby H.R. 9877 Sec. 10322(a)

    The bill says: Section 1154(a)(2)(A)(i) of title 10, United States Code, is amended by striking "in accordance with section 9(b)(1) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758(b)(1)".

    Bill text · Current law (42 U.S.C. 1758)

  947. 42 U.S.C. 1396a(a)changedby H.R. 9877 Sec. 10322(a)

    The bill says: Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended by striking paragraph (7) and inserting the following:

    Bill text · Current law (42 U.S.C. 1396a)

  948. 42 U.S.C. 1758arepealedby H.R. 9877 Sec. 10322(a)

    The bill says: Section 4301 of the Food, Conservation, and Energy Act of 2008 (42 U.S.C. 1758a) is repealed.

    Bill text · Current law (42 U.S.C. 1758a)

  949. 42 U.S.C. 1786(d)(2)(A)removedby H.R. 9877 Sec. 10322(a)

    The bill says: by striking clause (i); and

    Bill text · Current law (42 U.S.C. 1786)

  950. 42 U.S.C. 1786(d)(2)(A)renumberedby H.R. 9877 Sec. 10322(a)

    The bill says: by redesignating clauses (ii) and (iii) as clauses (i) and (ii), respectively; and

    Bill text · Current law (42 U.S.C. 1786)

  951. 42 U.S.C. 1786(d)(3)removedby H.R. 9877 Sec. 10322(a)

    The bill says: by striking subparagraph (D);

    Bill text · Current law (42 U.S.C. 1786)

  952. 42 U.S.C. 1786(d)(3)renumberedby H.R. 9877 Sec. 10322(a)

    The bill says: by redesignating subparagraphs (E) and (F) as subparagraphs (D) and (E), respectively; and

    Bill text · Current law (42 U.S.C. 1786)

  953. 42 U.S.C. 1786(d)(3)(D)changedby H.R. 9877 Sec. 10322(a)

    The bill says: in subparagraph (D) (as so redesignated), by striking "clause (ii) or (iii)" and inserting "clause (i) or (ii)"; and

    Bill text · Current law (42 U.S.C. 1786)

  954. 42 U.S.C. 1786(f)(17)changedby H.R. 9877 Sec. 10322(a)

    The bill says: in subsection (f)(17), by striking "Notwithstanding subsection (d)(2)(A)(i), not later" and inserting "Not later".

    Bill text · Current law (42 U.S.C. 1786)

  955. 42 U.S.C. 1758changedby H.R. 9877 Sec. 10322(b)

    The bill says: Section 9 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758) is amended by striking subsection (d) and inserting the following:

    Bill text · Current law (42 U.S.C. 1758)

  956. 42 U.S.C. 1759arepealedby H.R. 9877 Sec. 10323(a)

    The bill says: Section 11 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1759a) is repealed.

    Bill text · Current law (42 U.S.C. 1759a)

  957. 42 U.S.C. 1755(a)(2)changedby H.R. 9877 Sec. 10323(b)

    The bill says: in subsection (a)(2), by striking "sections 11 and 13" and inserting "section 13"; and

    Bill text · Current law (42 U.S.C. 1755)

  958. 42 U.S.C. 1755(e)(1)changedby H.R. 9877 Sec. 10323(b)

    The bill says: in subsection (e)(1), in the matter preceding subparagraph (A), by striking "section 4, this section, and section 11" and inserting "this section and section 4".

    Bill text · Current law (42 U.S.C. 1755)

  959. 42 U.S.C. 1756(d)changedby H.R. 9877 Sec. 10323(b)

    The bill says: Section 7(d) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1756(d)) is amended by striking "or 11".

    Bill text · Current law (42 U.S.C. 1756)

  960. 42 U.S.C. 1757(g)changedby H.R. 9877 Sec. 10323(b)

    The bill says: Section 8(g) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1757(g)) is amended by striking "and under section 11 of this Act".

    Bill text · Current law (42 U.S.C. 1757)

  961. 42 U.S.C. 1760(f)changedby H.R. 9877 Sec. 10323(b)

    The bill says: Section 12(f) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1760(f)) is amended by striking "11,".

    Bill text · Current law (42 U.S.C. 1760)

  962. 42 U.S.C. 1766(a)(1)(A)changedby H.R. 9877 Sec. 10323(b)

    The bill says: in paragraph (1)(A), by striking "4, 11, and 17" and inserting "4 and 17"; and

    Bill text · Current law (42 U.S.C. 1766)

  963. 42 U.S.C. 1766(a)(2)(A)changedby H.R. 9877 Sec. 10323(b)

    The bill says: in paragraph (2)(A), by striking "sections 4 and 11" and inserting "section 4".

    Bill text · Current law (42 U.S.C. 1766)

  964. 7 U.S.C. 2011(j)(3)changedby H.R. 9877 Sec. 10323(b)

    The bill says: by striking "or served under section 11(a)(1) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1760(d), 1759(a)(1))" and inserting "of the Richard B. Russell National School Lunch Act (42 U.S.C. 1760(d))"; and

    Bill text · Current law (7 U.S.C. 2011)

  965. 7 U.S.C. 2011(j)(3)changedby H.R. 9877 Sec. 10323(b)

    The bill says: by striking "or reduced price".

    Bill text · Current law (7 U.S.C. 2011)

  966. 42 U.S.C. 1760(l)(4)removedby H.R. 9877 Sec. 10324(1)

    The bill says: by striking subparagraph (D); and

    Bill text · Current law (42 U.S.C. 1760)

  967. 42 U.S.C. 1760(l)(4)renumberedby H.R. 9877 Sec. 10324(1)

    The bill says: by redesignating subparagraphs (E) through (M) as subparagraphs (D) through (L), respectively;

    Bill text · Current law (42 U.S.C. 1760)

  968. 42 U.S.C. 1760removedby H.R. 9877 Sec. 10324(2)

    The bill says: by striking subsection (p); and

    Bill text · Current law (42 U.S.C. 1760)

  969. 42 U.S.C. 1760renumberedby H.R. 9877 Sec. 10324(3)

    The bill says: by redesignating subsections (q) and (r) as subsections (p) and (q), respectively.

    Bill text · Current law (42 U.S.C. 1760)

  970. 42 U.S.C. 1761(a)(1)(A)(i)(I)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in subclause (I), by striking "have been determined eligible for free or reduced price school meals under this Act and the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.)" and inserting "are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))";

    Bill text · Current law (42 U.S.C. 1761)

  971. 42 U.S.C. 1761(a)(1)(A)(i)(II)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in subclause (II), by striking "are eligible for free or reduced price school meals under this Act and the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.)" and inserting "are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))";

    Bill text · Current law (42 U.S.C. 1761)

  972. 42 U.S.C. 1761(a)(1)(A)(i)(III)(bb)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in subclause (III)(bb), by striking "meet the income standards for free or reduced price school meals under this Act and the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.)" and inserting "are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))";

    Bill text · Current law (42 U.S.C. 1761)

  973. 42 U.S.C. 1761(a)(1)(A)(i)(IV)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in subclause (IV), by striking "are eligible for free or reduced price school meals under this Act and the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.)" and inserting "are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))"; and

    Bill text · Current law (42 U.S.C. 1761)

  974. 42 U.S.C. 1761(a)(1)(A)(i)(V)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in subclause (V), by striking "are eligible for free or reduced price school meals under this Act and the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.)" and inserting "are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))";

    Bill text · Current law (42 U.S.C. 1761)

  975. 42 U.S.C. 1761(a)(2)added (C)by H.R. 9877 Sec. 10325(1)

    (C) Waiver.— If the Secretary determines that a program requirement under this section limits the access of children to meals served under this section, the Secretary may waive that program requirement.(D) Eligibility.— All children shall be eligible to participate in the program under this section.

    The bill says: in paragraph (2), by adding at the end the following:

    Bill text · Current law (42 U.S.C. 1761)

  976. 42 U.S.C. 1761(a)(5)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in paragraph (5), by striking "only for" and all that follows through the period at the end and inserting "for meals served to all children."; and

    Bill text · Current law (42 U.S.C. 1761)

  977. 42 U.S.C. 1761(a)(13)(C)(ii)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in subparagraph (C)(ii), by striking "eligible for a free or reduced price lunch under this Act or a free or reduced price breakfast under section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773)" and inserting "an economically disadvantaged student (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))"; and

    Bill text · Current law (42 U.S.C. 1761)

  978. 42 U.S.C. 1761(a)(13)(D)(ii)changedby H.R. 9877 Sec. 10325(1)

    The bill says: in subparagraph (D)(ii), by striking "eligible for free or reduced price lunch under this Act or free or reduced price breakfast under section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773)" and inserting "economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))";

    Bill text · Current law (42 U.S.C. 1761)

  979. 42 U.S.C. 1761(b)(2)changedby H.R. 9877 Sec. 10325(2)

    The bill says: in subsection (b)(2), by striking "may only serve" and all that follows through "migrant children";

    Bill text · Current law (42 U.S.C. 1761)

  980. 42 U.S.C. 1761changedby H.R. 9877 Sec. 10325(3)

    (c) Payments.—(1) In general.— Payments shall be made to service institutions for meals served—(A) during the months of May through September;(B) during school vacation at any time during an academic school year;(C) during a teacher in-service day; and(D) on days that school is closed due to a natural disaster, building repair, court order, or similar cause, as determined by the Secretary.(2) Limitation on payments.— A service institution shall receive payments under this section for not more than 3 meals and 1 supplement per child per day.

    The bill says: by striking subsection (c) and inserting the following:

    Bill text · Current law (42 U.S.C. 1761)

  981. 42 U.S.C. 1761(f)(3)changedby H.R. 9877 Sec. 10325(4)

    The bill says: in subsection (f)(3), by striking ", except that" and all that follows through "of this section".

    Bill text · Current law (42 U.S.C. 1761)

  982. 42 U.S.C. 1762(b)(2)(A)(i)changedby H.R. 9877 Sec. 10326(1)

    The bill says: in subsection (b)(2)(A)(i), by striking "$40" and inserting "$60";

    Bill text · Current law (42 U.S.C. 1762)

  983. 42 U.S.C. 1762(c)(1)(A)changedby H.R. 9877 Sec. 10326(2)

    The bill says: in subparagraph (A), by striking "directly certified" and all that follows through "this section" and inserting "an economically disadvantaged student (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))";

    Bill text · Current law (42 U.S.C. 1762)

  984. 42 U.S.C. 1762(c)(1)removedby H.R. 9877 Sec. 10326(2)

    The bill says: by striking subparagraph (B); and

    Bill text · Current law (42 U.S.C. 1762)

  985. 42 U.S.C. 1762(c)(1)renumberedby H.R. 9877 Sec. 10326(2)

    The bill says: by redesignating subparagraphs (C) through (E) as subparagraphs (B) through (D), respectively;

    Bill text · Current law (42 U.S.C. 1762)

  986. 42 U.S.C. 1762(f)(3)changedby H.R. 9877 Sec. 10326(3)

    The bill says: in paragraph (3), in the matter preceding subparagraph (A), by striking "processes—" and all that follows through "to reliably" in subparagraph (B) and inserting "processes to reliably"; and

    Bill text · Current law (42 U.S.C. 1762)

  987. 42 U.S.C. 1762(f)(4)changedby H.R. 9877 Sec. 10326(3)

    The bill says: in paragraph (4), in the matter preceding subparagraph (A), by striking "by—" and all that follows through "establishing" in subparagraph (B) and inserting "by establishing"; and

    Bill text · Current law (42 U.S.C. 1762)

  988. 42 U.S.C. 1762(h)changedby H.R. 9877 Sec. 10326(4)

    The bill says: in subsection (h), by striking paragraph (2) and inserting the following:

    Bill text · Current law (42 U.S.C. 1762)

  989. 42 U.S.C. 1766(a)(2)changedby H.R. 9877 Sec. 10327(1)

    The bill says: in subsection (a)(2), by striking subparagraph (B) and inserting the following:

    Bill text · Current law (42 U.S.C. 1766)

  990. 42 U.S.C. 1766changedby H.R. 9877 Sec. 10327(2)

    (c) Free meals.— Notwithstanding any other provision of law—(1) all meals and supplements served under the program authorized under this section shall be provided for free to participants of the program; and(2) an institution that serves those meals and supplements shall be reimbursed—(A) in the case of breakfast, at the rate established for free breakfast under section 4(b)(1)(B)(i) of the Child Nutrition Act of 1966 (42 U.S.C. 1773(b)(1)(B)(i));(B) in the case of lunch, at the rate established for free lunch under section 4(b)(2)(A); and(C) in the case of a supplemental meal, $1.20, adjusted for inflation in accordance with section 4(b)(2)(C).

    The bill says: by striking subsection (c) and inserting the following:

    Bill text · Current law (42 U.S.C. 1766)

  991. 42 U.S.C. 1766(f)(2)changedby H.R. 9877 Sec. 10327(3)

    The bill says: in paragraph (2), by striking subparagraph (B) and inserting the following:

    Bill text · Current law (42 U.S.C. 1766)

  992. 42 U.S.C. 1766(f)removedby H.R. 9877 Sec. 10327(3)

    The bill says: by striking paragraph (3); and

    Bill text · Current law (42 U.S.C. 1766)

  993. 42 U.S.C. 1766(f)renumberedby H.R. 9877 Sec. 10327(3)

    The bill says: by redesignating paragraph (4) as paragraph (3);

    Bill text · Current law (42 U.S.C. 1766)

  994. 42 U.S.C. 1766(o)removedby H.R. 9877 Sec. 10327(4)

    The bill says: by striking paragraph (4); and

    Bill text · Current law (42 U.S.C. 1766)

  995. 42 U.S.C. 1766(o)renumberedby H.R. 9877 Sec. 10327(4)

    The bill says: by redesignating paragraphs (5) and (6) as paragraphs (4) and (5), respectively; and

    Bill text · Current law (42 U.S.C. 1766)

  996. 42 U.S.C. 1766(r)changedby H.R. 9877 Sec. 10327(5)

    The bill says: in the subsection heading, by striking "Program for at-risk school children" and inserting "Afterschool meal and snack program";

    Bill text · Current law (42 U.S.C. 1766)

  997. 42 U.S.C. 1766(r)changedby H.R. 9877 Sec. 10327(5)

    The bill says: by striking "at-risk school" each place it appears and inserting "eligible";

    Bill text · Current law (42 U.S.C. 1766)

  998. 42 U.S.C. 1766(r)(1)changedby H.R. 9877 Sec. 10327(5)

    The bill says: in the paragraph heading, by striking "at-risk school" and inserting "eligible"; and

    Bill text · Current law (42 U.S.C. 1766)

  999. 42 U.S.C. 1766(r)(1)(B)changedby H.R. 9877 Sec. 10327(5)

    The bill says: in subparagraph (B), by striking "operated" and all that follows through the period at the end and inserting a period; and

    Bill text · Current law (42 U.S.C. 1766)

  1000. 42 U.S.C. 1766(r)(4)(A)changedby H.R. 9877 Sec. 10327(5)

    for—(i) not more than 1 meal and 1 supplement per child per day served on a regular school day; and(ii) not more than 3 meals and 1 supplement per child per day served on any day other than a regular school day.

    The bill says: in paragraph (4)(A), by striking "only for" and all that follows through the period at the end and inserting the following:

    Bill text · Current law (42 U.S.C. 1766)

  1001. 42 U.S.C. 1766achangedby H.R. 9877 Sec. 10328(1)

    The bill says: in the section heading, by striking "Meal supplements" and inserting "Meals and supplements";

    Bill text · Current law (42 U.S.C. 1766a)

  1002. 42 U.S.C. 1766a(a)(1)changedby H.R. 9877 Sec. 10328(2)

    The bill says: in subsection (a)(1), by striking "meal supplements" and inserting "free meals and supplements";

    Bill text · Current law (42 U.S.C. 1766a)

  1003. 42 U.S.C. 1766a(b)changedby H.R. 9877 Sec. 10328(3)

    The bill says: in subsection (b), by inserting "meals and" before "supplements"; and

    Bill text · Current law (42 U.S.C. 1766a)

  1004. 42 U.S.C. 1766achangedby H.R. 9877 Sec. 10328(4)

    (c) Reimbursement.—(1) In general.—(A) Meals.— A free meal provided under this section to a child shall be reimbursed at a rate of $4.63, adjusted annually for inflation in accordance with paragraph (3)(A) and rounded in accordance with paragraph (3)(B).(B) Supplements.— A free supplement provided under this section to a child shall be reimbursed at the rate at which free supplements are reimbursed under section 17(c)(2)(C).(2) Limitation to reimbursements.— An institution may claim reimbursement under this section for not more than 1 meal and 1 supplement per day per child served on a regular school day.(3) Inflation; rounding.—(A) Inflation adjustment.—(i) In general.— The annual inflation adjustment under paragraph (1)(A) shall reflect changes in the cost of operating the program under this section, as indicated by the change in the Consumer Price Index for food away from home for all urban consumers.(ii) Basis.— Each inflation annual adjustment under paragraph (1)(A) shall reflect the changes in the Consumer Price Index for food away from home for the most recent 12-month period for which those data are available.(B) Rounding.— On July 1, 2027, and annually thereafter, the reimbursement rate for a free meal under this section shall be—(i) adjusted to the nearest lower-cent increment; and(ii) based on the unrounded amounts for the preceding 12-month period.

    The bill says: by striking subsection (c) and inserting the following:

    Bill text · Current law (42 U.S.C. 1766a)

  1005. 42 U.S.C. 1769(5)changedby H.R. 9877 Sec. 10329(1)

    The bill says: in paragraph (5) of subsection (c) (as redesignated by section 10322(a)(2)(B)(i)(III)), by striking subparagraph (B) and inserting the following:

    Bill text · Current law (42 U.S.C. 1769)

  1006. 42 U.S.C. 1769(1)(A)(ii)changedby H.R. 9877 Sec. 10329(2)

    The bill says: in paragraph (1)(A)(ii) of subsection (d) (as redesignated by section 10322(a)(2)(B)(i)(V)), by striking "eligible for free or reduced price meals under this Act" and inserting "economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))".

    Bill text · Current law (42 U.S.C. 1769)

  1007. 42 U.S.C. 1769a(d)(1)changedby H.R. 9877 Sec. 10330(1)

    The bill says: in the matter preceding subparagraph (A), by striking "paragraph (2) of this subsection and";

    Bill text · Current law (42 U.S.C. 1769a)

  1008. 42 U.S.C. 1769a(d)(1)(A)changedby H.R. 9877 Sec. 10330(1)

    The bill says: in subparagraph (A), in the matter preceding clause (i), by striking "school—" and all that follows through "submits" in clause (ii) and inserting "school that submits";

    Bill text · Current law (42 U.S.C. 1769a)

  1009. 42 U.S.C. 1769a(d)(1)(B)changedby H.R. 9877 Sec. 10330(1)

    The bill says: in subparagraph (B), by striking "schools" and all that follows through "Act" and inserting "high-need schools (as defined in section 2211(b) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6631(b)))"; and

    Bill text · Current law (42 U.S.C. 1769a)

  1010. 42 U.S.C. 1769a(d)(1)(D)removedby H.R. 9877 Sec. 10330(1)

    The bill says: by striking clause (i); and

    Bill text · Current law (42 U.S.C. 1769a)

  1011. 42 U.S.C. 1769a(d)(1)(D)renumberedby H.R. 9877 Sec. 10330(1)

    The bill says: by redesignating clauses (ii) through (iv) as clauses (i) through (iii), respectively; and

    Bill text · Current law (42 U.S.C. 1769a)

  1012. 42 U.S.C. 1769a(d)changedby H.R. 9877 Sec. 10330(2)

    The bill says: by striking paragraphs (2) and (3) and inserting the following:

    Bill text · Current law (42 U.S.C. 1769a)

  1013. 42 U.S.C. 1769b-1(a)(1)(B)changedby H.R. 9877 Sec. 10331

    The bill says: Section 21(a)(1)(B) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769b–1(a)(1)(B)) is amended, in the matter preceding clause (i), by striking "certified to receive free or reduced price meals" and inserting "who are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)(5)))".

    Bill text · Current law (42 U.S.C. 1769b-1)

  1014. 42 U.S.C. 1751changedby H.R. 9877 Sec. 10333(1)

    The bill says: by striking "or reduced price" each place it appears;

    Bill text · Current law (42 U.S.C. 1751)

  1015. 42 U.S.C. 1751changedby H.R. 9877 Sec. 10333(2)

    The bill says: by striking "or a reduced price" each place it appears;

    Bill text · Current law (42 U.S.C. 1751)

  1016. 42 U.S.C. 1751changedby H.R. 9877 Sec. 10333(3)

    The bill says: by striking "and reduced price" each place it appears; and

    Bill text · Current law (42 U.S.C. 1751)

  1017. 42 U.S.C. 1751changedby H.R. 9877 Sec. 10333(4)

    The bill says: by striking "a reduced price" each place it appears.

    Bill text · Current law (42 U.S.C. 1751)

  1018. 20 U.S.C. 6313(a)(5)(A)changedby H.R. 9877 Sec. 10341(1)

    The bill says: in subparagraph (A), by striking "the number of children eligible for a free or reduced price lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.)" and inserting "the number of children from low-income backgrounds, identified under subparagraph (D)"; and

    Bill text · Current law (20 U.S.C. 6313)

  1019. 20 U.S.C. 6313(a)(5)added (D)by H.R. 9877 Sec. 10341(2)

    (D) Identification of children from low-income backgrounds.—(i) In general.— A local educational agency or State agency, for the purpose of identifying children from low-income backgrounds enrolled in a school served by a local educational agency, may—(I) maintain a record, with respect to each student for whom the local educational agency provides a free public education that contains the information collected from the survey described in clause (iii);(II) distribute and collect a student survey based on the template developed under clause (iii) to identify children from low-income backgrounds; and(III) utilize direct certification data described in clause (iv)(I) to identify children from low-income backgrounds.(ii) Privacy.—(I) In general.— All individual data collected under this subparagraph shall be protected by the local educational agency or State agency in a manner consistent with all applicable local, State, and Federal privacy laws.(II) Reporting data.— Only aggregated data, which may include data disaggregated at the school, local educational agency, or State level, shall be reported to the Secretary at such time and in such manner as the Secretary may reasonably require.(iii) Survey.— Not later than 180 days after the date of enactment of the Universal School Meals Program Act of 2026, the Secretary, in consultation with the Secretary of Agriculture, shall develop a template survey—(I) to identify children from low-income backgrounds that contains only the information necessary to identify a child as a child from a low-income background by using the criteria of eligibility for a free or reduced priced lunch under the Richard B. Russell National School Lunch Act, as such criteria were in effect on September 30, 2022; and(II) that shall be designed to be easily accessible and in a user-friendly manner.(iv) Transition authority from FRPL to ESEA measures.— The Secretary, in coordination with the Secretary of Agriculture, shall have the authority to take such steps as are necessary to provide for the orderly transition to, and implementation of—(I) activities that are necessary for the continuity of direct certification carried out by local educational agencies and State agencies specified in paragraphs (4), (5), and (15) section 9(b) of the Richard B. Russell National School Lunch Act, as in effect on September 30, 2022, for the purposes of identifying any child eligible for free or reduced priced lunch under such Act, as in effect on such date, as a child from a low-income background;(II) procedures for verification of information collected under this subparagraph, which may include procedures modeled on the requirement specified in section 9(b)(3) of the Richard B. Russell National School Lunch Act, as in effect on September 30, 2022; and(III) data privacy provisions for information collected under this subparagraph, in accordance with the requirements specified in section 9(b)(6) of the Richard B. Russell National School Lunch Act, as in effect on September 30, 2022.(v) Special rule.— For the purposes of subparagraph (A), a local educational agency may determine the number of children from low-income backgrounds enrolled in a school served by such agency using one or more of the following methods:(I) Results from surveys specified in clause (i)(II).(II) Direct certification data specified in clause (i)(III).(III) Utilization of both methods described in subclauses (I) and (II).

    The bill says: by adding at the end the following:

    Bill text · Current law (20 U.S.C. 6313)

  1020. 7 U.S.C. 2020removedby H.R. 9877 Sec. 10351(a)

    The bill says: by striking subsection (u); and

    Bill text · Current law (7 U.S.C. 2020)

  1021. 7 U.S.C. 2020renumberedby H.R. 9877 Sec. 10351(a)

    The bill says: by redesignating subsections (v) through (x) as subsections (u) through (w), respectively.

    Bill text · Current law (7 U.S.C. 2020)

  1022. 7 U.S.C. 2020(e)(8)(F)changedby H.R. 9877 Sec. 10351(a)

    The bill says: in paragraph (8)(F), by striking "or subsection (u)"; and

    Bill text · Current law (7 U.S.C. 2020)

  1023. 7 U.S.C. 2020(e)(26)(B)changedby H.R. 9877 Sec. 10351(a)

    The bill says: in paragraph (26)(B), by striking "(x)" and inserting "(w)".

    Bill text · Current law (7 U.S.C. 2020)

  1024. 7 U.S.C. 2036a(a)changedby H.R. 9877 Sec. 10351(b)

    The bill says: Section 28(a) of the Food and Nutrition Act of 2008 (7 U.S.C. 2036a(a)) is amended by striking paragraph (1) and inserting the following:

    Bill text · Current law (7 U.S.C. 2036a)

  1025. 20 U.S.C. 1021(11)changedby H.R. 9877 Sec. 10352(a)

    (A) In general.— The term high-need school means a school that is in the highest quartile of schools in a ranking of all schools served by a local educational agency, ranked in descending order by percentage of students from low-income families enrolled in such schools, as determined by the local educational agency based on one of the following measures of poverty:(i) The percentage of students aged 5 through 17 in poverty counted in the most recent census data approved by the Secretary.(ii) The percentage of students in families receiving assistance under the State program funded under the program of block grants to States for temporary assistance for needy families established under part A of title IV of the Social Security Act (42 U.S.C. 601 et seq.).(iii) The percentage of students eligible to receive medical assistance under the program of medical assistance established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).(iv) A composite of 2 or more of the measures described in clauses (i) through (iii).

    The bill says: Section 200(11) of the Higher Education Act of 1965 (20 U.S.C. 1021(11)) is amended by striking subparagraph (A) and inserting the following:

    Bill text · Current law (20 U.S.C. 1021)

  1026. 20 U.S.C. 1070a-22(d)(1)changedby H.R. 9877 Sec. 10352(b)

    (A) provide services under this chapter to at least one grade level of students, beginning not later than 7th grade, in a participating school—(i) that has a 7th grade; and(ii) in which—(I) at least 50 percent of the students enrolled are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965); or(II) if an eligible entity determines that it would promote the effectiveness of a program, an entire grade level of students, beginning not later than the 7th grade, reside in public housing, as defined in section 3(b)(1) of the United States Housing Act of 1937 (42 U.S.C. 1437a(b)(1)).

    The bill says: Section 404B(d)(1) of the Higher Education Act of 1965 (20 U.S.C. 1070a–22(d)(1)) is amended by striking subparagraph (A) and inserting the following:

    Bill text · Current law (20 U.S.C. 1070a-22)

  1027. 20 U.S.C. 1090(a)(2)(B)(ii)(XVII)changedby H.R. 9877 Sec. 10352(c)

    The bill says: by striking item (cc); and

    Bill text · Current law (20 U.S.C. 1090)

  1028. 20 U.S.C. 1090(a)(2)(B)(ii)(XVII)renumberedby H.R. 9877 Sec. 10352(c)

    The bill says: by redesignating items (dd) through (jj) as items (cc) through (ii), respectively.

    Bill text · Current law (20 U.S.C. 1090)

  1029. 20 U.S.C. 1161y(b)(1)(B)changedby H.R. 9877 Sec. 10352(d)

    The bill says: in paragraph (1)(B), by striking "qualify for a free or reduced price school lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.)" and inserting "are economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965)"; and

    Bill text · Current law (20 U.S.C. 1161y)

  1030. 20 U.S.C. 1161y(b)(5)changedby H.R. 9877 Sec. 10352(d)

    The bill says: in paragraph (5), by striking "eligible for a free or reduced price school lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.)" and inserting "economically disadvantaged students (as identified under a measure described in section 1113(a)(5) of the Elementary and Secondary Education Act of 1965)".

    Bill text · Current law (20 U.S.C. 1161y)

  1031. 20 U.S.C. 6641(b)(3)(B)removedby H.R. 9877 Sec. 10353(a)

    The bill says: by striking clause (i); and

    Bill text · Current law (20 U.S.C. 6641)

  1032. 20 U.S.C. 6641(b)(3)(B)renumberedby H.R. 9877 Sec. 10353(a)

    The bill says: by redesignating clauses (ii) and (iii) as clauses (i) and (ii), respectively.

    Bill text · Current law (20 U.S.C. 6641)

  1033. 20 U.S.C. 7261(d)(2)removedby H.R. 9877 Sec. 10353(b)

    The bill says: by striking subparagraph (B); and

    Bill text · Current law (20 U.S.C. 7261)

  1034. 20 U.S.C. 7261(d)(2)renumberedby H.R. 9877 Sec. 10353(b)

    The bill says: by redesignating subparagraphs (C) and (D) as subparagraphs (B) and (C), respectively.

    Bill text · Current law (20 U.S.C. 7261)

  1035. 20 U.S.C. 9832(3)changedby H.R. 9877 Sec. 10354

    The bill says: Section 6122(3) of the America COMPETES Act (20 U.S.C. 9832(3)) is amended by striking "data on children eligible for free or reduced-price lunches under the Richard B. Russell National School Lunch Act,".

    Bill text · Current law (20 U.S.C. 9832)

  1036. 29 U.S.C. 3102(36)(A)removedby H.R. 9877 Sec. 10355(1)

    The bill says: by striking clause (iv); and

    Bill text · Current law (29 U.S.C. 3102)

  1037. 29 U.S.C. 3102(36)(A)renumberedby H.R. 9877 Sec. 10355(2)

    The bill says: by redesignating clauses (v) and (vi) as clauses (iv) and (v), respectively.

    Bill text · Current law (29 U.S.C. 3102)

  1038. 42 U.S.C. 1862n(8)removedby H.R. 9877 Sec. 10356(1)

    The bill says: by striking subparagraph (A); and

    Bill text · Current law (42 U.S.C. 1862n)

  1039. 42 U.S.C. 1862n(8)renumberedby H.R. 9877 Sec. 10356(2)

    The bill says: by redesignating subparagraphs (B) and (C) as subparagraphs (A) and (B), respectively.

    Bill text · Current law (42 U.S.C. 1862n)

  1040. 42 U.S.C. 9858m(b)(1)(B)changedby H.R. 9877 Sec. 10357(1)

    The bill says: in paragraph (1)(B), by striking "school lunch factor" and inserting "economically disadvantaged students factor"; and

    Bill text · Current law (42 U.S.C. 9858m)

  1041. 42 U.S.C. 9858m(b)changedby H.R. 9877 Sec. 10357(2)

    The bill says: by striking paragraph (3) and inserting the following:

    Bill text · Current law (42 U.S.C. 9858m)

  1042. 42 U.S.C. 9859c(b)(1)(B)changedby H.R. 9877 Sec. 10358(1)

    The bill says: in paragraph (1)(B), by striking "school lunch factor" and inserting "economically disadvantaged students factor"; and

    Bill text · Current law (42 U.S.C. 9859c)

  1043. 42 U.S.C. 9859c(b)changedby H.R. 9877 Sec. 10358(2)

    The bill says: by striking paragraph (3) and inserting the following:

    Bill text · Current law (42 U.S.C. 9859c)

  1044. 34 U.S.C. 11162changedby H.R. 9877 Sec. 10359

    (i) Free school lunches for incarcerated juveniles.—(1) Definition of eligible juvenile detention center.— In this subsection, the term eligible juvenile detention center does not include any private, for-profit detention center.(2) Free lunch.— A juvenile who is incarcerated in an eligible juvenile detention center is eligible to receive free lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.).(3) Guidance.— Not later than 1 year after the date of enactment of the Universal School Meals Program Act of 2026, the Attorney General, in consultation with the Secretary of Agriculture, shall provide guidance to States relating to the options for school food authorities in the States to apply for reimbursement for free lunches under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) for juveniles who are incarcerated.

    The bill says: Section 252 of the Juvenile Justice and Delinquency Prevention Act of 1974 (34 U.S.C. 11162) is amended by striking subsection (i) and inserting the following:

    Bill text · Current law (34 U.S.C. 11162)

  1045. 42 U.S.C. 300uadded 1707Bby H.R. 9877 Sec. 11002(c)

    1707B. Individual Offices of Health Equity within the Department.—(a) In general.— The head of each agency specified in subsection (b) shall establish within the agency an office to be known as the Office of Health Equity. The head of each such Office shall be a Director appointed by the head of the agency within which the Office is established, and such Director shall report directly to the head of the agency. The head of such agency shall carry out all functions (as this section relates to the agency) acting through such Director.(b) Agencies.— The agencies described in this subsection are each of the following:(1) The Centers for Disease Control and Prevention.(2) The Health Resources and Services Administration.(c) Functions and staff.—(1) CDC.— The Office of Health Equity of the Centers for Disease Control and Prevention established by this section shall—(A) employ not less than the number of staff the Office of Health Equity of the Centers for Disease Control and Prevention operating on January 19, 2025, employed as of such date; and(B) carry out all functions that the Office of Health Equity of the Centers for Disease Control and Prevention operating on January 19, 2025, carried out as of such date.(2) HRSA.— The Office of Health Equity of the Health Resources and Services Administration established by this section shall—(A) employ not less than the number of staff the Office of Health Equity of the Health Resources and Services Administration operating on January 19, 2025, employed as of such date; and(B) carry out all functions that the Office of Health Equity of the Health Resources and Services Administration operating on January 19, 2025, carried out as of such date.(d) Funding.—(1) CDC.— The Secretary shall ensure that any amounts appropriated or otherwise made available for the Office of Health Equity of the Centers for Disease Control and Prevention operating on January 19, 2025, that were retracted or otherwise withheld from such office during the period beginning on January 19, 2025, and ending on the date of enactment of the Health Equity and Accountability Act of 2026 are transferred to, or otherwise reinstated for, the Office of Health Equity of the Centers for Disease Control and Prevention established under this section. Any such amounts shall be used by such Office to carry out subsection (c)(1).(2) HRSA.— The Secretary shall ensure that any amounts appropriated or otherwise made available for the Office of Health Equity of the Health Resources and Services Administration operating on January 19, 2025, that were retracted or otherwise withheld from such office during the period beginning on January 19, 2025, and ending on the date of enactment of the Health Equity and Accountability Act of 2026 are transferred to, or otherwise reinstated for, the Office of Health Equity of the Health Resources and Services Administration established under this section. Any such amounts shall be used by such Office to carry out subsection (c)(2).1707C. Health Equity Advisory Committee.—(a) Establishment.— There is established in the Department of Health and Human Services an advisory committee to be known as the "Health Equity Advisory Committee" (referred to in this section as the "Advisory Committee").(b) Members.— The Advisory Committee shall be composed of 20 members, all of whom shall be appointed by the Secretary not later than 90 days after the date of enactment of the Health Equity and Accountability Act of 2026.(c) Duties.— The Advisory Committee shall—(1) advise the Secretary on the priorities and concerns of populations experiencing health disparities;(2) recommend actions, standards, and methodologies that are data-driven, evidence-based, and culturally and linguistically appropriate for the identification, measurement, and elimination of health disparities;(3) advise the Secretary on the design, collection, analysis, disaggregation, and public reporting of data necessary to identify and monitor health disparities, including data on race, ethnicity, primary language, sexual orientation, gender identity, disability status, and socioeconomic status;(4) review, and recommend revisions to, departmental policies, standards, regulations, and procedures that may create, perpetuate, or fail to mitigate health inequities;(5) assist the Secretary in developing, implementing, and monitoring performance measures related to the advancement of health equity across the programs of the Department;(6) increase public awareness of the existence, causes, and consequences of health disparities;(7) carry out such other duties as the Secretary may assign to advance the purposes of the Health Equity and Accountability Act of 2026; and(8) carry out any other duty that the Health Equity Advisory Committee of the Department of Health and Human Services, operating on January 19, 2025, carried out as of such date.

    The bill says: Title XVII of the Public Health Service Act (42 U.S.C. 300u et seq.) is amended by inserting after section 1707A (42 U.S.C. 300ua–6a) the following:

    Bill text · Current law (42 U.S.C. 300u)

From the bill's official text on GovInfo and the U.S. Code, 2024 edition, which may not yet show changes made since.

What it does

Sourced

The Congressional Research Service hasn't published a summary of this bill yet. They usually follow within weeks of introduction.

Our plain-language breakdown, with what it means for you and the case for and against, is written once a bill starts to move.

What has happened

Sourced
  1. 2026-07-22Introduced in HouseLibrary of Congress

Show all 17 recorded actions

Cosponsors

  • Pete Aguilar D-CA-33
  • Suzanne Bonamici D-OR-1
  • Troy A. Carter D-LA-2
  • Judy Chu D-CA-28
  • Adriano Espaillat D-NY-13
  • Maxwell Frost D-FL-10
  • Jesús G. "Chuy" García D-IL-4
  • Adelita S. Grijalva D-AZ-7
  • Jahana Hayes D-CT-5
  • Pablo José Hernández D-PR-At Large
  • Jonathan L. Jackson D-IL-1
  • Robin L. Kelly D-IL-2
  • Ted Lieu D-CA-36
  • Analilia Mejia D-NJ-11
  • Christian D. Menefee D-TX-18
  • Grace Meng D-NY-6
  • Gwen Moore D-WI-4
  • Eleanor Holmes Norton D-DC-At Large
  • Ayanna Pressley D-MA-7
  • Delia C. Ramirez D-IL-3
  • Emily Randall D-WA-6
  • Andrea Salinas D-OR-6
  • Shri Thanedar D-MI-13
  • Jill N. Tokuda D-HI-2
  • Nydia M. Velázquez D-NY-7
  • Frederica S. Wilson D-FL-24