II 

118TH CONGRESS 

2D SESSION S. 4065 

To prohibit discrimination in health care and require the provision of equitable 

health care, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 22, 2024 

Mr. PADILLA (for himself and Mr. BOOKER) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To prohibit discrimination in health care and require the 

provision of equitable health care, 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 ‘‘Equal Health Care 

5 for All Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) In 1966, Dr. Martin Luther King, Jr., said 

9 ‘‘Of all the forms of inequality, injustice in health 


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1 care is the most shocking and inhuman because it 

2 often results in physical death.’’. 

3 (2) Inequity in health care remains a persistent 

4 and devastating reality for many communities, and, 

5 in particular, communities of color. 

6 (3) The inequitable provision of health care has 

7 complex causes, many stemming from systemic in8 equality in access to health care, housing, nutrition, 

9 economic opportunity, education, and other factors. 

10 (4) Health care outcomes for Black commu11 nities in particular lag far behind those of the popu12 lation as a whole. 

13 (5) Dr. Anthony Fauci, former Director of the 

14 National Institute of Allergy and Infectious Dis15 eases, said on April 7, 2020, the coronavirus out16 break is ‘‘shining a bright light’’ on ‘‘unacceptable’’ 

17 health disparities in the Black community. 

18 (6) A contributing factor in health disparities is 

19 explicit and implicit bias in the delivery of health 

20 care, resulting in inferior care and poorer outcomes 

21 for some patients on the basis of factors that include 

22 race, national origin, sex (including sexual orienta23 tion or gender identity), disability, age, and religion. 

24 (7) The National Academy of Medicine (for25 merly known as the ‘‘Institute of Medicine’’) issued 


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1 a report in 2002 titled ‘‘Unequal Treatment’’, find2 ing that racial and ethnic minorities receive lower3 quality health care than Whites do, even when insur4 ance status, income, age, and severity of condition is 

5 comparable. 

6 (8) Just as Congress has sought to eliminate 

7 bias, both explicit and implicit, in employment, hous8 ing, and other parts of our society, the elimination 

9 of bias and the legacy of structural racism in health 

10 care is of paramount importance. 

11 SEC. 3. DATA COLLECTION AND REPORTING. 

12 (a) REQUIRED REPORTING.— 

13 (1) IN GENERAL.—The Secretary of Health and 

14 Human Services (in this section referred to as the 

15 ‘‘Secretary’’), in consultation with the Director for 

16 Civil Rights and Health Equity, the Director of the 

17 National Institutes of Health, the Administrator of 

18 the Centers for Medicare & Medicaid Services, the 

19 Director of the Agency for Healthcare Research and 

20 Quality, the Deputy Assistant Secretary for Minority 

21 Health, and the Director of the Centers for Disease 

22 Control and Prevention, shall by regulation require 

23 all health care providers and facilities that are re24 quired under other provisions of law to report data 

25 on specific health outcomes to the Department of 


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1 Health and Human Services in aggregate form, to 

2 disaggregate such data by demographic characteris3 tics, including by race, national origin, sex (including 

4 sexual orientation and gender identity), disability, 

5 and age, as well as any other factor that the Sec6 retary determines would be useful for determining a 

7 pattern of inequitable provision of health care. 

8 (2) PROPOSED REGULATIONS.—Not later than 

9 90 days after the date of enactment of this Act, the 

10 Secretary shall issue proposed regulations to carry 

11 out paragraph (1). 

12 (b) REPOSITORY.—The Secretary shall— 

13 (1) not later than 1 year after the date of en14 actment of this Act, establish a repository of the 

15 disaggregated data reported pursuant to subsection 

16 (a); and 

17 (2) ensure that such repository does not contain 

18 any data that is individually identifiable. 

19 SEC. 4. REQUIRING EQUITABLE HEALTH CARE IN THE HOS20 PITAL VALUE-BASED PURCHASING PRO21 GRAM. 

22 (a) EQUITABLE HEALTH CARE AS VALUE MEASURE23 MENT.—Section 1886(b)(3)(B)(viii) of the Social Security 

24 Act (42 U.S.C. 1395ww(b)(3)(B)(viii)) is amended by 

25 adding at the end the following new subclause: 


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1 ‘‘(XIII)(aa) Effective for payments beginning with 

2 fiscal year 2025, in expanding the number of measures 

3 under subclause (III), the Secretary shall adopt measures 

4 that relate to equitable health care furnished by hospitals 

5 in inpatient settings. 

6 ‘‘(bb) In carrying out this subclause, the Secretary 

7 shall solicit input and recommendations from individuals 

8 and groups representing communities of color and other 

9 protected classes and ensure measures adopted pursuant 

10 to this subclause account for social determinants of health, 

11 as defined in section 7(e)(10) of the Equal Health Care 

12 for All Act, such that the social determinants of health 

13 do not adversely affect hospitals if the inequitable out14 comes are not caused by that hospital’s provision of care. 

15 ‘‘(cc) For purposes of this subclause, the term ‘equi16 table health care’ refers to the principle that high-quality 

17 care should be provided to all individuals and health care 

18 treatment and services should not vary on account of the 

19 real or perceived race, national origin, sex (including sex20 ual orientation and gender identity), disability, or age of 

21 an individual, as well as any other factor that the Sec22 retary determines would be useful for determining a pat23 tern of inequitable provision of health care.’’. 

24 (b) INCLUSION OF EQUITABLE HEALTH CARE MEAS25 URES.—Section 1886(o)(2)(B) of the Social Security Act 


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1 (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the 

2 end the following new clause: 

3 ‘‘(iv) INCLUSION OF EQUITABLE

4 HEALTH CARE MEASURES.—Beginning in 

5 fiscal year 2025, measures selected under 

6 subparagraph (A) shall include the equi7 table health care measures described in 

8 subsection (b)(3)(B)(viii)(XIII).’’. 

9 SEC. 5. INEQUITABLE PROVISION OF HEALTH CARE AS A 

10 BASIS FOR PERMISSIVE EXCLUSION FROM 

11 MEDICARE AND OTHER FEDERAL HEALTH 

12 CARE PROGRAMS. 

13 Section 1128(b) of the Social Security Act (42 U.S.C. 

14 1320a–7(b)) is amended by adding at the end the fol15 lowing new paragraph: 

16 ‘‘(18) INEQUITABLE PROVISION OF HEALTH

17 CARE.— 

18 ‘‘(A) IN GENERAL.—Subject to subpara19 graph (B), any health care provider that the 

20 Secretary determines, under section 7(b)(2) of 

21 the Equal Health Care for All Act, has engaged 

22 in a pattern of inequitable provision of health 

23 care (as defined in subsection (e)(7) of that 

24 Act) on the basis of race, national origin, sex 


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1 (including sexual orientation and gender iden2 tity), disability, or age of an individual. 

3 ‘‘(B) EXCEPTION.—For purposes of car4 rying out subparagraph (A), the Secretary shall 

5 not exclude any health care provider from par6 ticipation in the Medicare program under title 

7 XVIII of the Social Security Act or the Med8 icaid program under title XIX of such Act if 

9 the exclusion of such health care provider would 

10 result in increased difficulty in access to health 

11 care services for underserved or low-income 

12 communities.’’. 

13 SEC. 6. OFFICE FOR CIVIL RIGHTS AND HEALTH EQUITY OF 

14 THE DEPARTMENT OF HEALTH AND HUMAN 

15 SERVICES. 

16 (a) NAME OF OFFICE.—Beginning on the date of en17 actment of this Act, the Office for Civil Rights of the De18 partment of Health and Human Services shall be known 

19 as the ‘‘Office for Civil Rights and Health Equity’’ of the 

20 Department of Health and Human Services. Any ref21 erence to the Office for Civil Rights of the Department 

22 of Health and Human Services in any law, regulation, 

23 map, document, record, or other paper of the United 

24 States shall be deemed to be a reference to the Office for 

25 Civil Rights and Health Equity. 


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1 (b) HEAD OF OFFICE.—The head of the Office for 

2 Civil Rights and Health Equity shall be the Director for 

3 Civil Rights and Health Equity, to be appointed by the 

4 President. Any reference to the Director of the Office for 

5 Civil Rights of the Department of Health and Human 

6 Services in any law, regulation, map, document, record, 

7 or other paper of the United States shall be deemed to 

8 be a reference to the Director for Civil Rights and Health 

9 Equity. 

10 SEC. 7. PROHIBITING DISCRIMINATION IN HEALTH CARE. 

11 (a) PROHIBITING DISCRIMINATION.— 

12 (1) IN GENERAL.—No health care provider 

13 may, on the basis, in whole or in part, of race, sex 

14 (including sexual orientation and gender identity), 

15 disability, age, or religion, subject an individual to 

16 the inequitable provision of health care. 

17 (2) NOTICE OF PATIENT RIGHTS.—The Sec18 retary shall provide to each patient a notice of a pa19 tient’s rights under this section. 

20 (b) ADMINISTRATIVE COMPLAINT AND CONCILIATION

21 PROCESS.— 

22 (1) COMPLAINTS AND ANSWERS.— 

23 (A) IN GENERAL.—An aggrieved person 

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1 cluded, file a complaint with the Director alleg2 ing inequitable provision of health care by a 

3 provider described in subsection (a). 

4 (B) COMPLAINT.—A complaint submitted 

5 pursuant to subparagraph (A) shall be in writ6 ing and shall contain such information and be 

7 in such form as the Director requires. 

8 (C) OATH OR AFFIRMATION.—The com9 plaint and any answer made under this sub10 section shall be made under oath or affirmation, 

11 and may be reasonably and fairly modified at 

12 any time. 

13 (2) RESPONSE TO COMPLAINTS.— 

14 (A) IN GENERAL.—Upon the filing of a 

15 complaint under this subsection, the following 

16 procedures shall apply: 

17 (i) COMPLAINANT NOTICE.—The Di18 rector shall serve notice upon the com19 plainant acknowledging receipt of such fil20 ing and advising the complainant of the 

21 time limits and procedures provided under 

22 this section. 

23 (ii) RESPONDENT NOTICE.—The Di24 rector shall, not later than 30 days after 

25 receipt of such filing— 


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1 (I) serve on the respondent a no2 tice of the complaint, together with a 

3 copy of the original complaint; and 

4 (II) advise the respondent of the 

5 procedural rights and obligations of 

6 respondents under this section. 

7 (iii) ANSWER.—The respondent may 

8 file, not later than 60 days after receipt of 

9 the notice from the Director, an answer to 

10 such complaint. 

11 (iv) INVESTIGATIVE DUTIES.—The Di12 rector shall— 

13 (I) make an investigation of the 

14 alleged inequitable provision of health 

15 care; and 

16 (II) complete such investigation 

17 within 180 days (unless it is impracti18 cable to complete such investigation 

19 within 180 days) after the filing of 

20 the complaint. 

21 (B) INVESTIGATIONS.— 

22 (i) PATTERN OR PRACTICE.—In the 

23 course of investigating the complaint, the 

24 Director may seek records of care provided 

25 to patients other than the complainant if 


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1 necessary to demonstrate or disprove an 

2 allegation of inequitable provision of health 

3 care or to determine whether there is a 

4 pattern or practice of such care. 

5 (ii) ACCOUNTING FOR SOCIAL DETER6 MINANTS OF HEALTH.—In investigating 

7 the complaint and reaching a determina8 tion on the validity of the complaint, the 

9 Director shall account for social deter10 minants of health and the effect of such 

11 social determinants on health care out12 comes, so that the health care provider 

13 named in the complaint is not held ac14 countable for a factor outside of the con15 trol of the provider’s provision of health 

16 care. 

17 (iii) INABILITY TO COMPLETE INVES18 TIGATION.—If the Director is unable to 

19 complete (or finds it is impracticable to 

20 complete) the investigation within 180 

21 days after the filing of the complaint (or, 

22 if the Secretary takes further action under 

23 paragraph (6)(B) with respect to a com24 plaint, within 180 days after the com25 mencement of such further action), the DiVerDate Sep 11 2014 21:44 Apr 12, 2024 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S4065.IS S4065

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1 rector shall notify the complainant and re2 spondent in writing of the reasons in3 volved. 

4 (iv) REPORT TO STATE LICENSING

5 AUTHORITIES.—On concluding each inves6 tigation under this subparagraph, the Di7 rector shall provide to each State licensing 

8 authority that is responsible for the licens9 ing of the health care provider under inves10 tigation, information specifying the results 

11 of the investigation. 

12 (C) REPORT.— 

13 (i) FINAL REPORT.—On completing 

14 each investigation under this paragraph, 

15 the Director shall prepare a final investiga16 tive report. 

17 (ii) MODIFICATION OF REPORT.—A 

18 final report under this subparagraph may 

19 be modified if additional evidence is later 

20 discovered. 

21 (3) CONCILIATION.— 

22 (A) IN GENERAL.—During the period be23 ginning on the date on which a complaint is 

24 filed under this subsection and ending on the 

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1 cluding during an investigation under para2 graph (2)(B)), the Director shall, to the extent 

3 feasible, engage in conciliation with respect to 

4 such complaint. 

5 (B) CONCILIATION AGREEMENT.—A con6 ciliation agreement arising out of such concilia7 tion shall be an agreement between the re8 spondent and the complainant, and shall be 

9 subject to approval by the Director. 

10 (C) RIGHTS PROTECTED.—The Director 

11 shall approve a conciliation agreement only if 

12 the agreement protects the rights of the com13 plainant and other persons similarly situated. 

14 (D) REPORTING OF AGREEMENT.— 

15 (i) IN GENERAL.—Subject to clause 

16 (ii), the Secretary shall make available to 

17 the State licensing authority described in 

18 paragraph (2)(B)(iv) a copy of a concilia19 tion agreement entered into pursuant to 

20 this subsection unless the complainant and 

21 respondent otherwise agree, and the Sec22 retary determines, that disclosure is not re23 quired to further the purposes of this sub24 section. 


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1 (ii) LIMITATION.—A conciliation 

2 agreement that is made available to the 

3 State licensing authority pursuant to 

4 clause (i) may not disclose individually 

5 identifiable health information. 

6 (4) FAILURE TO COMPLY WITH CONCILIATION

7 AGREEMENT.—Whenever the Director has reason8 able cause to believe that a respondent has breached 

9 a conciliation agreement, the Director shall refer the 

10 matter to the Attorney General to consider filing a 

11 civil action to enforce such agreement. 

12 (5) WRITTEN CONSENT FOR DISCLOSURE OF

13 INFORMATION.—Nothing said or done in the course 

14 of conciliation under this subsection may be made 

15 public, or used as evidence in a subsequent pro16 ceeding under this subsection, without the written 

17 consent of the parties to the conciliation. 

18 (6) PROMPT JUDICIAL ACTION.— 

19 (A) IN GENERAL.—If the Director deter20 mines at any time following the filing of a com21 plaint under this subsection that prompt judi22 cial action is necessary to carry out the pur23 poses of this subsection, the Director may rec24 ommend that the Attorney General promptly 

25 commence a civil action under subsection (d). 


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1 (B) IMMEDIATE SUIT.—If the Director de2 termines at any time following the filing of a 

3 complaint under this subsection that the public 

4 interest would be served by allowing the com5 plainant to bring a civil action under subsection 

6 (c) in a State or Federal court immediately, the 

7 Director shall certify that the administrative 

8 process has concluded and that the complainant 

9 may file such a suit immediately. 

10 (7) ANNUAL REPORT.—Not later than 1 year 

11 after the date of enactment of this Act, and annually 

12 thereafter, the Director shall make publicly available 

13 a report detailing the activities of the Office for Civil 

14 Rights and Health Equity under this subsection, in15 cluding— 

16 (A) the number of complaints filed and the 

17 basis on which the complaints were filed; 

18 (B) the number of investigations under19 taken as a result of such complaints; and 

20 (C) the disposition of all such investiga21 tions. 

22 (c) ENFORCEMENT BY PRIVATE PERSONS.— 

23 (1) IN GENERAL.— 

24 (A) CIVIL ACTION.— 


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1 (i) IN SUIT.—A complainant under 

2 subsection (b) may commence a civil action 

3 to obtain appropriate relief with respect to 

4 an alleged violation of subsection (a), or 

5 for breach of a conciliation agreement 

6 under subsection (b), in an appropriate 

7 district court of the United States or State 

8 court— 

9 (I) not sooner than the earliest 

10 of— 

11 (aa) the date a conciliation 

12 agreement is reached under sub13 section (b); 

14 (bb) the date of a final dis15 position of a complaint under 

16 subsection (b); or 

17 (cc) 180 days after the first 

18 day of the alleged violation; and 

19 (II) not later than 2 years after 

20 the final day of the alleged violation. 

21 (ii) STATUTE OF LIMITATIONS.—The 

22 computation of such 2-year period shall 

23 not include any time during which an ad24 ministrative proceeding (including inves25 tigation or conciliation) under subsection 


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1 (b) was pending with respect to a com2 plaint under such subsection. 

3 (B) BARRING SUIT.—If the Director has 

4 obtained a conciliation agreement under sub5 section (b) regarding an alleged violation of 

6 subsection (a), no action may be filed under 

7 this paragraph by the complainant involved 

8 with respect to the alleged violation except for 

9 the purpose of enforcing the terms of such an 

10 agreement. 

11 (2) RELIEF WHICH MAY BE GRANTED.— 

12 (A) IN GENERAL.—In a civil action under 

13 paragraph (1), if the court finds that a viola14 tion of subsection (a) or breach of a conciliation 

15 agreement has occurred, the court may award 

16 to the plaintiff actual and punitive damages, 

17 and may grant as relief, as the court deter18 mines to be appropriate, any permanent or tem19 porary injunction, temporary restraining order, 

20 or other order (including an order enjoining the 

21 defendant from engaging in a practice violating 

22 subsection (a) or ordering such affirmative ac23 tion as may be appropriate). 

24 (B) FEES AND COSTS.—In a civil action 

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1 tion, may allow the prevailing party, other than 

2 the United States, a reasonable attorney’s fee 

3 and costs. The United States shall be liable for 

4 such fees and costs to the same extent as a pri5 vate person. 

6 (3) INTERVENTION BY ATTORNEY GENERAL.— 

7 Upon timely application, the Attorney General may 

8 intervene in a civil action under paragraph (1), if 

9 the Attorney General certifies that the case is of 

10 general public importance. 

11 (d) ENFORCEMENT BY THE ATTORNEY GENERAL.— 

12 (1) COMMENCEMENT OF ACTIONS.— 

13 (A) PATTERN OR PRACTICE CASES.—The 

14 Attorney General may commence a civil action 

15 in any appropriate district court of the United 

16 States if the Attorney General has reasonable 

17 cause to believe that any health care provider 

18 covered by subsection (a)— 

19 (i) is engaged in a pattern or practice 

20 that violates such subsection; or 

21 (ii) is engaged in a violation of such 

22 subsection that raises an issue of signifi23 cant public importance. 

24 (B) CASES BY REFERRAL.—The Director 

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1 plaints, a pattern of violations, a review of data 

2 reported by a health care provider covered by 

3 subsection (a), or any other means, that there 

4 is reasonable cause to believe a health care pro5 vider is engaged in a pattern or practice that 

6 violates subsection (a). If the Director makes 

7 such a determination, the Director shall refer 

8 the related findings to the Attorney General. If 

9 the Attorney General finds that such reasonable 

10 cause exists, the Attorney General may com11 mence a civil action in any appropriate district 

12 court of the United States. 

13 (2) ENFORCEMENT OF SUBPOENAS.—The At14 torney General, on behalf of the Director, or another 

15 party at whose request a subpoena is issued under 

16 this subsection, may enforce such subpoena in ap17 propriate proceedings in the district court of the 

18 United States for the district in which the person to 

19 whom the subpoena was addressed resides, was 

20 served, or transacts business. 

21 (3) RELIEF WHICH MAY BE GRANTED IN CIVIL

22 ACTIONS.— 

23 (A) IN GENERAL.—In a civil action under 

24 paragraph (1), the court— 


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1 (i) may award such preventive relief, 

2 including a permanent or temporary in3 junction, temporary restraining order, or 

4 other order against the person responsible 

5 for a violation of subsection (a) as is nec6 essary to assure the full enjoyment of the 

7 rights granted by this subsection; 

8 (ii) may award such other relief as the 

9 court determines to be appropriate, includ10 ing monetary damages, to aggrieved per11 sons; and 

12 (iii) may, to vindicate the public inter13 est, assess punitive damages against the 

14 respondent— 

15 (I) in an amount not exceeding 

16 $500,000, for a first violation; and 

17 (II) in an amount not exceeding 

18 $1,000,000, for any subsequent viola19 tion. 

20 (B) FEES AND COSTS.—In a civil action 

21 under this subsection, the court, in its discre22 tion, may allow the prevailing party, other than 

23 the United States, a reasonable attorney’s fee 

24 and costs. The United States shall be liable for 


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1 such fees and costs to the extent provided by 

2 section 2412 of title 28, United States Code. 

3 (4) INTERVENTION IN CIVIL ACTIONS.—Upon 

4 timely application, any person may intervene in a 

5 civil action commenced by the Attorney General 

6 under paragraphs (1) and (2) if the action involves 

7 an alleged violation of subsection (a) with respect to 

8 which such person is an aggrieved person (including 

9 a person who is a complainant under subsection (b)) 

10 or a conciliation agreement to which such person is 

11 a party. 

12 (e) DEFINITIONS.—In this section: 

13 (1) AGGRIEVED PERSON.—The term ‘‘aggrieved 

14 person’’ means— 

15 (A) a person who believes that the person 

16 was or will be injured in violation of subsection 

17 (a); or 

18 (B) the personal representative or estate of 

19 a deceased person who was injured in violation 

20 of subsection (a). 

21 (2) DIRECTOR.—The term ‘‘Director’’ means 

22 the Director for Civil Rights and Health Equity of 

23 the Department of Health and Human Services. 

24 (3) DISABILITY.—The term ‘‘disability’’ has the 

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1 cans with Disabilities Act of 1990 (42 U.S.C. 

2 12102). 

3 (4) CONCILIATION.—The term ‘‘conciliation’’ 

4 means the attempted resolution of issues raised by 

5 a complaint, or by the investigation of such com6 plaint, through informal negotiations involving the 

7 complainant, the respondent, and the Secretary. 

8 (5) CONCILIATION AGREEMENT.—The term 

9 ‘‘conciliation agreement’’ means a written agreement 

10 setting forth the resolution of the issues in concilia11 tion. 

12 (6) INDIVIDUALLY IDENTIFIABLE HEALTH IN13 FORMATION.—The term ‘‘individually identifiable 

14 health information’’ means any information, includ15 ing demographic information collected from an indi16 vidual— 

17 (A) that is created or received by a health 

18 care provider covered by subsection (a), health 

19 plan, employer, or health care clearinghouse; 

20 (B) that relates to the past, present, or fu21 ture physical or mental health or condition of, 

22 the provision of health care to, or the past, 

23 present, or future payment for the provision of 

24 health care to, the individual; and 

25 (C)(i) that identifies the individual; or 


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1 (ii) with respect to which there is a reason2 able basis to believe that the information can be 

3 used to identify the individual. 

4 (7) INEQUITABLE PROVISION OF HEALTH

5 CARE.—The term ‘‘inequitable provision of health 

6 care’’ means the provision of any health care service, 

7 by a health care provider in a manner that— 

8 (A) fails to meet a high-quality care stand9 ard, meaning the health care provider fails to— 

10 (i) avoid harm to patients as a result 

11 of the health services that are intended to 

12 help the patient; 

13 (ii) provide health services based on 

14 scientific knowledge to all and to all pa15 tients who benefit; 

16 (iii) refrain from providing services to 

17 patients not likely to benefit; 

18 (iv) provide care that is responsive to 

19 patient preferences, needs, and values; and 

20 (v) avoids waits or delays in care; and 

21 (B) is discriminatory in intent or effect 

22 based at least in part on a basis specified in 

23 subsection (a). 


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1 (8) RESPONDENT.—The term ‘‘respondent’’ 

2 means the person or other entity accused in a com3 plaint of a violation of subsection (a). 

4 (9) SECRETARY.—The term ‘‘Secretary’’ means 

5 the Secretary of Health and Human Services. 

6 (10) SOCIAL DETERMINANTS OF HEALTH.—The 

7 term ‘‘social determinants of health’’ means condi8 tions in the environments in which individuals live, 

9 work, attend school, and worship, that affect a wide 

10 range of health, functioning, and quality-of-life out11 comes and risks. 

12 (f) RULE OF CONSTRUCTION.—Nothing in this sec13 tion shall be construed as repealing or limiting the effect 

14 of title VI of the Civil Rights Act of 1964 (42 U.S.C. 

15 2000d et seq.), section 1557 of the Patient Protection and 

16 Affordable Care Act (42 U.S.C. 18116), section 504 of 

17 the Rehabilitation Act of 1973 (29 U.S.C. 794), or the 

18 Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.). 

19 SEC. 8. FEDERAL HEALTH EQUITY COMMISSION. 

20 (a) ESTABLISHMENT OF COMMISSION.— 

21 (1) IN GENERAL.—There is established the 

22 Federal Health Equity Commission (in this section 

23 referred to as the ‘‘Commission’’). 

24 (2) MEMBERSHIP.— 


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1 (A) IN GENERAL.—The Commission shall 

2 be composed of— 

3 (i) 8 voting members appointed under 

4 subparagraph (B); and 

5 (ii) the nonvoting, ex officio members 

6 described in subparagraph (C). 

7 (B) VOTING MEMBERS.—Not more than 4 

8 of the members described in subparagraph 

9 (A)(i) shall at any one time be of the same po10 litical party. Such members shall have recog11 nized expertise in and personal experience with 

12 racial and ethnic health inequities, health care 

13 needs of vulnerable and marginalized popu14 lations, and health equity as a vehicle for im15 proving health status and health outcomes. 

16 Such members shall be appointed to the Com17 mission as follows: 

18 (i) 4 members of the Commission 

19 shall be appointed by the President. 

20 (ii) 2 members of the Commission 

21 shall be appointed by the President pro 

22 tempore of the Senate, upon the rec23 ommendations of the majority leader and 

24 the minority leader of the Senate. Each 

25 member appointed to the Commission 


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1 under this clause shall be appointed from 

2 a different political party. 

3 (iii) 2 members of the Commission 

4 shall be appointed by the Speaker of the 

5 House of Representatives upon the rec6 ommendations of the majority leader and 

7 the minority leader of the House of Rep8 resentatives. Each member appointed to 

9 the Commission under this clause shall be 

10 appointed from a different political party. 

11 (C) EX OFFICIO MEMBER.—The Commis12 sion shall have the following nonvoting, ex offi13 cio members: 

14 (i) The Director for Civil Rights and 

15 Health Equity of the Department of 

16 Health and Human Services. 

17 (ii) The Deputy Assistant Secretary 

18 for Minority Health of the Department of 

19 Health and Human Services. 

20 (iii) The Director of the National In21 stitute on Minority Health and Health Dis22 parities. 

23 (iv) The Chairperson of the Advisory 

24 Committee on Minority Health established 


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1 under section 1707(c) of the Public Health 

2 Service Act (42 U.S.C. 300u–6(c)). 

3 (3) TERMS.—The term of office of each mem4 ber of the Commission appointed under paragraph 

5 (2)(B) shall be 6 years. 

6 (4) CHAIRPERSON; VICE CHAIRPERSON.— 

7 (A) CHAIRPERSON.—The President shall, 

8 with the concurrence of a majority of the mem9 bers of the Commission appointed under para10 graph (2)(B), designate a Chairperson from 

11 among the members of the Commission ap12 pointed under such paragraph. 

13 (B) VICE CHAIRPERSON.— 

14 (i) DESIGNATION.—The Speaker of 

15 the House of Representatives shall, in con16 sultation with the majority leaders and the 

17 minority leaders of the Senate and the 

18 House of Representatives and with the 

19 concurrence of a majority of the members 

20 of the Commission appointed under para21 graph (2)(B), designate a Vice Chairperson 

22 from among the members of the Commis23 sion appointed under such paragraph. The 

24 Vice Chairperson may not be a member of 


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1 the same political party as the Chair2 person. 

3 (ii) DUTY.—The Vice Chairperson 

4 shall act in place of the Chairperson in the 

5 absence of the Chairperson. 

6 (5) REMOVAL OF MEMBERS.—The President 

7 may remove a member of the Commission only for 

8 neglect of duty or malfeasance in office. 

9 (6) QUORUM.—A majority of members of the 

10 Commission appointed under paragraph (2)(B) shall 

11 constitute a quorum of the Commission, but a lesser 

12 number of members may hold hearings. 

13 (b) DUTIES OF THE COMMISSION.— 

14 (1) IN GENERAL.—The Commission shall— 

15 (A) monitor and report on the implementa16 tion of this Act; and 

17 (B) investigate, monitor, and report on 

18 progress towards health equity and the elimi19 nation of health disparities. 

20 (2) ANNUAL REPORT.—The Commission 

21 shall— 

22 (A) submit to the President and Congress 

23 at least one report annually on health equity 

24 and health disparities; and 

25 (B) include in such report— 


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1 (i) a description of actions taken by 

2 the Department of Health and Human 

3 Services and any other Federal agency re4 lated to health equity or health disparities; 

5 and 

6 (ii) recommendations on ensuring eq7 uitable health care and eliminating health 

8 disparities. 

9 (c) POWERS.— 

10 (1) HEARINGS.— 

11 (A) IN GENERAL.—The Commission or, at 

12 the direction of the Commission, any sub13 committee or member of the Commission, may, 

14 for the purpose of carrying out this section, as 

15 the Commission or the subcommittee or mem16 ber considers advisable— 

17 (i) hold such hearings, meet and act 

18 at such times and places, take such testi19 mony, receive such evidence, and admin20 ister such oaths; and 

21 (ii) require, by subpoena or otherwise, 

22 the attendance and testimony of such wit23 nesses and the production of such books, 

24 records, correspondence, memoranda, pa25 pers, documents, tapes, and materials. 


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1 (B) LIMITATION ON HEARINGS.—The 

2 Commission may hold a hearing under subpara3 graph (A)(i) only if the hearing is approved— 

4 (i) by a majority of the members of 

5 the Commission appointed under sub6 section (a)(2)(B); or 

7 (ii) by a majority of such members 

8 present at a meeting when a quorum is 

9 present. 

10 (2) ISSUANCE AND ENFORCEMENT OF SUB11 POENAS.— 

12 (A) ISSUANCE.—A subpoena issued under 

13 paragraph (1) shall— 

14 (i) bear the signature of the Chair15 person of the Commission; and 

16 (ii) be served by any person or class 

17 of persons designated by the Chairperson 

18 for that purpose. 

19 (B) ENFORCEMENT.—In the case of contu20 macy or failure to obey a subpoena issued 

21 under paragraph (1), the United States district 

22 court for the district in which the subpoenaed 

23 person resides, is served, or may be found may 

24 issue an order requiring the person to appear at 


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1 any designated place to testify or to produce 

2 documentary or other evidence. 

3 (C) NONCOMPLIANCE.—Any failure to 

4 obey the order of the court may be punished by 

5 the court as a contempt of court. 

6 (3) WITNESS ALLOWANCES AND FEES.— 

7 (A) IN GENERAL.—Section 1821 of title 

8 28, United States Code, shall apply to a witness 

9 requested or subpoenaed to appear at a hearing 

10 of the Commission. 

11 (B) EXPENSES.—The per diem and mile12 age allowances for a witness shall be paid from 

13 funds available to pay the expenses of the Com14 mission. 

15 (4) POSTAL SERVICES.—The Commission may 

16 use the United States mails in the same manner and 

17 under the same conditions as other agencies of the 

18 Federal Government. 

19 (5) GIFTS.—The Commission may accept, use, 

20 and dispose of gifts or donations of services or prop21 erty. 

22 (d) ADMINISTRATIVE PROVISIONS.— 

23 (1) STAFF.— 

24 (A) DIRECTOR.—There shall be a full-time 

25 staff director for the Commission who shall— 


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1 (i) serve as the administrative head of 

2 the Commission; and 

3 (ii) be appointed by the Chairperson 

4 with the concurrence of the Vice Chair5 person. 

6 (B) OTHER PERSONNEL.—The Commis7 sion may— 

8 (i) appoint such other personnel as it 

9 considers advisable, subject to the provi10 sions of title 5, United States Code, gov11 erning appointments in the competitive 

12 service, and the provisions of chapter 51 

13 and subchapter III of chapter 53 of that 

14 title relating to classification and General 

15 Schedule pay rates; and 

16 (ii) may procure temporary and inter17 mittent services under section 3109(b) of 

18 title 5, United States Code, at rates for in19 dividuals not in excess of the daily equiva20 lent paid for positions at the maximum 

21 rate for GS–15 of the General Schedule 

22 under section 5332 of title 5, United 

23 States Code. 

24 (2) COMPENSATION OF MEMBERS.— 


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1 (A) NON-FEDERAL EMPLOYEES.—Each 

2 member of the Commission who is not an offi3 cer or employee of the Federal Government 

4 shall be compensated at a rate equal to the 

5 daily equivalent of the annual rate of basic pay 

6 prescribed for level IV of the Executive Sched7 ule under section 5315 of title 5, United States 

8 Code, for each day (including travel time) dur9 ing which the member is engaged in the per10 formance of the duties of the Commission. 

11 (B) FEDERAL EMPLOYEES.—Each member 

12 of the Commission who is an officer or em13 ployee of the Federal Government shall serve 

14 without compensation in addition to the com15 pensation received for the services of the mem16 ber as an office or employee of the Federal 

17 Government. 

18 (C) TRAVEL EXPENSES.—A member of the 

19 Commission shall be allowed travel expenses, in20 cluding per diem in lieu of subsistence, at rates 

21 authorized for an employee of an agency under 

22 subchapter I of chapter 57 of title 5, United 

23 States Code, while away from the home or reg24 ular place of business of the member in the per25 formance of the duties of the Commission. 


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1 (3) COOPERATION.—The Commission may se2 cure directly from any Federal department or agency 

3 such information as the Commission considers nec4 essary to carry out this Act. Upon request of the 

5 Chairman of the Commission, the head of such de6 partment or agency shall furnish such information to 

7 the Commission. 

8 (e) PERMANENT COMMISSION.—Section 1013 of title 

9 5, United States Code, shall not apply to the Commission. 

10 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

11 are authorized to be appropriated for fiscal year 2025 and 

12 each fiscal year thereafter such sums as may be necessary 

13 to carry out the duties of the Commission. 

14 SEC. 9. GRANTS FOR HOSPITALS TO PROMOTE EQUITABLE 

15 HEALTH CARE AND OUTCOMES. 

16 (a) IN GENERAL.—Not later than 180 days after the 

17 date of the enactment of this Act, the Secretary of Health 

18 and Human Services (in this section referred to as the 

19 ‘‘Secretary’’) shall award grants to hospitals to promote 

20 equitable health care treatment and services, and reduce 

21 disparities in care and outcomes. 

22 (b) CONSULTATION.—In establishing the criteria for 

23 grants under this section and evaluating applications for 

24 such grants, the Secretary shall consult with the Director 


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1 for Civil Rights and Health Equity of the Department of 

2 Health and Human Services. 

3 (c) USE OF FUNDS.—A hospital shall use funds re4 ceived from a grant under this section to establish or ex5 pand programs to provide equitable health care to all pa6 tients and to ensure equitable health care outcomes. Such 

7 uses may include— 

8 (1) providing explicit and implicit bias training 

9 to medical providers and staff; 

10 (2) providing translation or interpretation serv11 ices for patients; 

12 (3) recruiting and training a diverse workforce; 

13 (4) tracking data related to care and outcomes; 

14 and 

15 (5) training on cultural sensitivity. 

16 (d) PRIORITY.—In awarding grants under this sec17 tion, the Secretary shall give priority to hospitals that 

18 have received disproportionate share hospital payments 

19 under section 1886(r) of the Social Security Act (42 

20 U.S.C. 1395ww(r)) or section 1923 of such Act (42 U.S.C. 

21 1396r–4) with respect to fiscal year 2021. 

22 (e) SUPPLEMENT, NOT SUPPLANT.—Grants awarded 

23 under this section shall be used to supplement, not sup24 plant, any nongovernment efforts, or other Federal, State, 

25 or local funds provided to a recipient. 


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1 (f) EQUITABLE HEALTH CARE DEFINED.—The term 

2 ‘‘equitable health care’’ has the meaning given such term 

3 in section 1886(b)(3)(B)(viii)(XIII)(cc) of the Social Secu4 rity Act (42 U.S.C. 1395ww(b)(3)(B)(viii)(XIII)(cc)), as 

5 added by section 4(a). 

Æ 


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