I 

116TH CONGRESS 

1ST SESSION H. R. 5246 

To direct the Secretary of Health and Human Services to carry out a 

Health in All Policies Demonstration Project, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 21, 2019 

Mr. PASCRELL (for himself, Mr. LEWIS, Ms. SA ́NCHEZ, Mr. DANNY K. DAVIS

of Illinois, Mr. SUOZZI, Mr. PANETTA, and Ms. SEWELL of Alabama) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and 

Means, for a period to be subsequently determined by the Speaker, in 

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To direct the Secretary of Health and Human Services to 

carry out a Health in All Policies Demonstration Project, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Researching and End5 ing Disparities by Understanding and Creating Equity Act 

6 of 2019’’ or the ‘‘REDUCE Act of 2019’’. 


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1 SEC. 2. HEALTH IN ALL POLICIES DEMONSTRATION 

2 PROJECT. 

3 (a) IN GENERAL.—The Secretary of Health and 

4 Human Services (in this section referred to as the ‘‘Sec5 retary’’) acting through the Director of the Centers for 

6 Disease Control and Prevention, and in coordination with 

7 relevant agencies including the Department of Education, 

8 the Department of Agriculture, the Department of Hous9 ing and Urban Development, the Department of Justice, 

10 the Department of Labor, the Environmental Protection 

11 Agency, and the Department of Transportation, shall im12 plement a grant program, to be known as the Health in 

13 All Policies Demonstration Project. 

14 (b) GRANTS.—In carrying out subsection (a), the 

15 Secretary shall award grants to eligible entities to estab16 lish, implement, or enhance, in the jurisdiction of the re17 spective entity, a collaborative, interdisciplinary, and com18 munity-focused approach to improve the health of all com19 munities and people that— 

20 (1) integrates and articulates health consider21 ations in policymaking across sectors; 

22 (2) addresses— 

23 (A) health; 

24 (B) equity; and 

25 (C) sustainability; and 


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1 (3) targets a significant proportion of Medicare 

2 beneficiaries, Medicare-Medicaid dual eligibles, or 

3 long-term care Medicaid recipients. 

4 (c) EVALUATION.—The Secretary shall identify 

5 metrics for evaluating the implementation of a grant 

6 under this section and, using such metrics, evaluate each 

7 grantee on the extent to which the approach implemented 

8 through the grant— 

9 (1) supports intersectoral collaboration; 

10 (2) benefits multiple partners; 

11 (3) engages stakeholders; 

12 (4) creates structural or procedural change; 

13 (5) impacts or relates to a model or demonstra14 tion project administered by the Centers for Medi15 care & Medicaid Services, such as an advanced pay16 ment model; and 

17 (6) provides cost savings, delivers efficiencies, 

18 and improves overall health, including health dis19 parity reduction and health equity improvements. 

20 (d) ELIGIBILITY.—To be eligible to receive a grant 

21 under this section, an entity shall— 

22 (1) be a State, territory of the United States, 

23 Tribe, city, or county; and 


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1 (2) submit an application to the Secretary at 

2 such time, in such manner, and containing such in3 formation as the Secretary may require. 

4 (e) PRIORITIZATION; GEOGRAPHICAL DIVERSITY.— 

5 In awarding grants under this section, the Secretary 

6 shall— 

7 (1) give priority to eligible entities seeking to 

8 use a grant to improve, as described in subsection 

9 (b), the health of populations that— 

10 (A) are target populations described in 

11 subsection (b)(3); and 

12 (B) have significant health inequities 

13 throughout the populations; and 

14 (2) seek to ensure geographical diversity among 

15 grantees. 

16 (f) REPORTS BY GRANTEES.—As a condition on re17 ceipt of a grant under this section, the Secretary shall re18 quire grantees— 

19 (1) to provide a report to the Secretary upon 

20 completion of the Health in All Policies Demonstra21 tion Project; and 

22 (2) to include in such report the extent to which 

23 the approach implemented achieved the goals listed 

24 in paragraphs (1) through (6) of subsection (c). 

25 (g) REPORT TO CONGRESS.— 


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1 (1) SUBMISSION.—The Secretary shall submit 

2 to the Congress— 

3 (A) not later than one year after the date 

4 of enactment of this Act, an initial report on 

5 the Health in All Policies Demonstration 

6 Project; and 

7 (B) not later than one year after the com8 pletion of the Demonstration Project, a final re9 port on the Demonstration Project. 

10 (2) CONTENTS OF INITIAL REPORT.—The re11 port under paragraph (1)(A) shall include— 

12 (A) evaluation of the success of soliciting 

13 applications; 

14 (B) identification of the number of applica15 tions received; 

16 (C) specification of the timeline for award17 ing funding; and 

18 (D) identification of barriers to imple19 menting the Health in All Policies Demonstra20 tion Project, if any. 

21 (3) CONTENTS OF FINAL REPORT.—The report 

22 under paragraph (1)(B) shall each include the fol23 lowing: 

24 (A) An assessment of the Health in All 

25 Policies Demonstration Project, including an 


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1 evaluation of the effectiveness of the Dem2 onstration Project. 

3 (B) Recommendations for Federal legisla4 tive actions— 

5 (i) to integrate, based on such assess6 ment, a collaborative and interdisciplinary 

7 approach to improve the health of all com8 munities; and 

9 (ii) to support eligible entities in pur10 suing a comparable integration of such an 

11 approach across State programs. 

12 (h) DEFINITIONS.—In this section: 

13 (1) The term ‘‘Medicare beneficiaries’’ means 

14 individuals entitled to part A of XVIII of the Social 

15 Security Act and enrolled under part B of such title. 

16 (2) The term ‘‘Medicare-Medicaid dual eligi17 bles’’ means individuals who are dually eligible for 

18 benefits under title XVIII of the Social Security Act 

19 and title XIX of such Act. 

20 (i) AUTHORIZATION OF APPROPRIATIONS.—To carry 

21 out this section, there is authorized to be appropriated 

22 $2,000,000 for the period of fiscal years 2021 through 

23 2024. 


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1 SEC. 3. NATIONAL ACADEMIES OF SCIENCES, ENGINEER2 ING, AND MEDICINE REPORT. 

3 (a) IN GENERAL.—The Secretary of Health and 

4 Human Services shall seek to enter into an arrangement, 

5 not later than 60 days after the date of enactment of this 

6 Act, with the National Academies of Sciences, Engineer7 ing, and Medicine (or if the Academies decline to enter 

8 into such arrangement, another appropriate entity) under 

9 which the Academies (or other appropriate entity) agrees 

10 to prepare a report on eliminating health disparities to im11 prove health equity. 

12 (b) REPORT.— 

13 (1) CONTENTS.—The report prepared pursuant 

14 to subsection (a) shall— 

15 (A) review evidence on how social deter16 minants of health affect health outcomes among 

17 middle-income Medicare beneficiaries and Medi18 care-Medicaid dual eligibles; 

19 (B) examine successful interventions, in20 cluding with respect to health outcomes, that 

21 address social determinants of health (including 

22 transportation, meals, housing, access to health 

23 care, personal care assistance, and access to 

24 long-term services and supports), reduce health 

25 disparities, and improve health equity; 

26 (C) make conclusions regarding— 


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1 (i) the effectiveness of existing pro2 grams and policies of the Centers for 

3 Medicare & Medicaid Services intended to 

4 reduce health disparities; 

5 (ii) best practices and successful 

6 strategies that reduce health disparities; 

7 and 

8 (iii) efforts needed to address health 

9 disparities related to health care workforce 

10 shortages; and 

11 (D) make recommendations regarding— 

12 (i) priorities for health disparities 

13 interventions within Federal health care 

14 programs; and 

15 (ii) potential opportunities for expan16 sion or replication of successful interven17 tions and payment models to reduce health 

18 disparities and improve health equity. 

19 (2) SUBMISSION.—The arrangement under sub20 section (a) shall require the National Academies of 

21 Sciences, Engineering, and Medicine (or other ap22 propriate entity), not later than 18 months after en23 tering into such arrangement, to finalize the report 

24 prepared pursuant to such arrangement and submit 

25 such report to the Committees on Energy and ComVerDate Sep 11 2014 04:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5246.IH H5246

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1 merce and Ways and Means of the House of Rep2 resentatives and the Committees on Finance and 

3 Health, Education, Labor, and Pensions of the Sen4 ate. 

5 (c) DEFINITIONS.—In this section: 

6 (1) The term ‘‘health equity’’ means a state 

7 where all people are able to attain their full health 

8 potential and no one is hindered from achieving this 

9 potential due to social position or another socially 

10 determined circumstance. 

11 (2) The term ‘‘middle-income Medicare bene12 ficiaries’’ means individuals entitled to part A of 

13 XVIII of the Social Security Act and enrolled under 

14 part B of such title who have an income that is not 

15 below 125 percent of the poverty line applicable to 

16 a family of the size involved, but not more than 400 

17 percent of the poverty line so applicable. 

18 (3) The term ‘‘Medicare-Medicaid dual eligi19 bles’’ means individuals who are dually eligible for 

20 benefits under title XVIII of the Social Security Act 

21 and title XIX of such Act. 

22 (4) The term ‘‘social determinants of health’’ 

23 refers to the conditions in the environments in which 

24 people live, learn, work, play, worship, and age that 


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1 affect a wide range of health, functioning, and qual2 ity-of-life outcomes and risks. 

Æ 


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