II 

117TH CONGRESS 

1ST SESSION S. 3073 

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 

OCTOBER 26, 2021 

Mr. PADILLA 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 provision of inequitable 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, Director of the Na14 tional Institute of Allergy and Infectious Diseases, 

15 said on April 7, 2020, the coronavirus outbreak is 

16 ‘‘shining a bright light’’ on ‘‘unacceptable’’ health 

17 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 consultation with the Director 

15 for Civil Rights and Health Equity, the Director of 

16 the National Institutes of Health, the Administrator 

17 of the Centers for Medicare & Medicaid Services, the 

18 Director of the Agency for Healthcare Research and 

19 Quality, the Deputy Assistant Secretary for Minority 

20 Health, and the Director of the Centers for Disease 

21 Control and Prevention, shall by regulation require 

22 all health care providers and facilities that are re23 quired under other provisions of law to report data 

24 on specific health outcomes to the Department of 

25 Health and Human Services in aggregate form, to 


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1 disaggregate such data by demographic characteris2 tics, including by race, national origin, sex (including 

3 sexual orientation and gender identity), disability, 

4 and age, as well as any other factor that the Sec5 retary of Health and Human Services determines 

6 would be useful for determining a pattern of provi7 sion of inequitable health care. 

8 (2) PROPOSED REGULATIONS.—Not later than 

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

10 Secretary of Health and Human Services shall issue 

11 proposed regulations to carry out paragraph (1). 

12 (b) REPOSITORY.—The Secretary of Health and 

13 Human Services shall— 

14 (1) not later than 1 year after the date of en15 actment of this Act, establish a repository of the 

16 disaggregated data reported pursuant to subsection 

17 (a); 

18 (2) subject to paragraph (3), make the data in 

19 such repository publicly available; and 

20 (3) ensure that such repository does not contain 

21 any data that is individually identifiable. 


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1 SEC. 4. REQUIRING EQUITABLE HEALTH CARE IN THE HOS2 PITAL VALUE-BASED PURCHASING PRO3 GRAM. 

4 (a) EQUITABLE HEALTH CARE AS VALUE MEASURE5 MENT.—Section 1886(b)(3)(B)(viii) of the Social Security 

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

7 adding at the end the following new subclause: 

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

9 fiscal year 2024, in expanding the number of measures 

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

11 that relate to equitable health care furnished by hospitals 

12 in inpatient settings. 

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

14 shall solicit input and recommendations from individuals 

15 and groups representing communities of color and other 

16 protected classes and ensure measures adopted pursuant 

17 to this subclause account for social determinants of health, 

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

19 for All Act. 

20 ‘‘(cc) For purposes of this subclause, the term ‘equi21 table health care’ refers to the principle that high-quality 

22 care should be provided to all individuals and health care 

23 treatment and services should not vary on account of the 

24 real or perceived race, national origin, sex (including sex25 ual orientation and gender identity), disability, or age of 

26 an individual, as well as any other factor that the SecVerDate Sep 11 2014 00:24 Oct 30, 2021 Jkt 029200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3073.IS S3073

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1 retary determines would be useful for determining a pat2 tern of provision of inequitable health care.’’. 

3 (b) INCLUSION OF EQUITABLE HEALTH CARE MEAS4 URES.—Section 1886(o)(2)(B) of the Social Security Act 

5 (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the 

6 end the following new clause: 

7 ‘‘(iv) INCLUSION OF EQUITABLE

8 HEALTH CARE MEASURES.—Beginning in 

9 fiscal year 2024, measures selected under 

10 subparagraph (A) shall include the equi11 table health care measures described in 

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

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

14 BASIS FOR PERMISSIVE EXCLUSION FROM 

15 MEDICARE AND STATE HEALTH CARE PRO16 GRAMS. 

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

18 1320a–7(b)) is amended by adding at the end the fol19 lowing new paragraph: 

20 ‘‘(18) PROVISION OF INEQUITABLE HEALTH

21 CARE.— 

22 ‘‘(A) IN GENERAL.—Subject to subpara23 graph (B), any health care provider that the 

24 Secretary determines has engaged in a pattern 

25 of providing inequitable health care (as defined 


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1 in section 7(e)(7) of the Equal Health Care for 

2 All Act) on the basis of race, national origin, 

3 sex (including sexual orientation and gender 

4 identity), disability, or age of an individual. 

5 ‘‘(B) EXCEPTION.—For purposes of car6 rying out subparagraph (A), the Secretary shall 

7 not exclude any health care provider from par8 ticipation in the Medicare program under title 

9 XVIII of the Social Security Act or the Med10 icaid program under title XIX of such Act if 

11 the exclusion of such health care provider would 

12 result in increased difficulty in access to health 

13 care services for underserved or low-income 

14 communities.’’. 

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

16 THE DEPARTMENT OF HEALTH AND HUMAN 

17 SERVICES. 

18 (a) NAME OF OFFICE.—Beginning on the date of en19 actment of this Act, the Office for Civil Rights of the De20 partment of Health and Human Services shall be known 

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

22 Department of Health and Human Services. Any ref23 erence to the Office for Civil Rights of the Department 

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

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


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

2 Civil Rights and Health Equity. 

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

4 Civil Rights and Health Equity shall be the Director for 

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

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

7 Civil Rights of the Department of Health and Human 

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

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

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

11 Equity. 

12 SEC. 7. PROHIBITING DISCRIMINATION IN HEALTH CARE. 

13 (a) PROHIBITING DISCRIMINATION.— 

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

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

16 (including sexual orientation and gender identity), 

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

18 the provision of inequitable health care. 

19 (2) NOTICE OF PATIENT RIGHTS.—The Sec20 retary shall provide to each patient a notice of a pa21 tient’s rights under this section. 

22 (b) ADMINISTRATIVE COMPLAINT AND CONCILIATION

23 PROCESS.— 

24 (1) COMPLAINTS AND ANSWERS.— 


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1 (A) IN GENERAL.—An aggrieved person 

2 may, not later than 1 year after an alleged vio3 lation of subsection (a) has occurred or con4 cluded, file a complaint with the Director alleg5 ing inequitable provision of health care by a 

6 provider described in subsection (a). 

7 (B) COMPLAINT.—A complaint submitted 

8 pursuant to subparagraph (A) shall be in writ9 ing and shall contain such information and be 

10 in such form as the Director requires. 

11 (C) OATH OR AFFIRMATION.—The com12 plaint and any answer made under this sub13 section shall be made under oath or affirmation, 

14 and may be reasonably and fairly modified at 

15 any time. 

16 (2) RESPONSE TO COMPLAINTS.— 

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

18 complaint under this subsection, the following 

19 procedures shall apply: 

20 (i) COMPLAINANT NOTICE.—The Di21 rector shall serve notice upon the com22 plainant acknowledging receipt of such fil23 ing and advising the complainant of the 

24 time limits and procedures provided under 

25 this section. 


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1 (ii) RESPONDENT NOTICE.—The Di2 rector shall, not later than 30 days after 

3 receipt of such filing— 

4 (I) serve on the respondent a no5 tice of the complaint, together with a 

6 copy of the original complaint; and 

7 (II) advise the respondent of the 

8 procedural rights and obligations of 

9 respondents under this section. 

10 (iii) ANSWER.—The respondent may 

11 file, not later than 60 days after receipt of 

12 the notice from the Director, an answer to 

13 such complaint. 

14 (iv) INVESTIGATIVE DUTIES.—The Di15 rector shall— 

16 (I) make an investigation of the 

17 alleged inequitable provision of health 

18 care; and 

19 (II) complete such investigation 

20 within 180 days (unless it is impracti21 cable to complete such investigation 

22 within 180 days) after the filing of 

23 the complaint. 

24 (B) INVESTIGATIONS.— 


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1 (i) PATTERN OR PRACTICE.—In the 

2 course of investigating the complaint, the 

3 Director may seek records of care provided 

4 to patients other than the complainant if 

5 necessary to demonstrate or disprove an 

6 allegation of inequitable provision of health 

7 care or to determine whether there is a 

8 pattern or practice of such care. 

9 (ii) ACCOUNTING FOR SOCIAL DETER10 MINANTS OF HEALTH.—In investigating 

11 the complaint and reaching a determina12 tion on the validity of the complaint, the 

13 Director shall account for social deter14 minants of health and the effect of such 

15 social determinants on health care out16 comes. 

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 00:24 Oct 30, 2021 Jkt 029200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3073.IS S3073

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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 the State licensing 

8 authorities that were notified under sub9 paragraph (A), information specifying the 

10 results of the investigation. 

11 (C) REPORT.— 

12 (i) FINAL REPORT.—On completing 

13 each investigation under this paragraph, 

14 the Director shall prepare a final investiga15 tive report. 

16 (ii) MODIFICATION OF REPORT.—A 

17 final report under this subparagraph may 

18 be modified if additional evidence is later 

19 discovered. 

20 (3) CONCILIATION.— 

21 (A) IN GENERAL.—During the period be22 ginning on the date on which a complaint is 

23 filed under this subsection and ending on the 

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1 graph (2)(B)), the Director shall, to the extent 

2 feasible, engage in conciliation with respect to 

3 such complaint. 

4 (B) CONCILIATION AGREEMENT.—A con5 ciliation agreement arising out of such concilia6 tion shall be an agreement between the re7 spondent and the complainant, and shall be 

8 subject to approval by the Director. 

9 (C) RIGHTS PROTECTED.—The Director 

10 shall approve a conciliation agreement only if 

11 the agreement protects the rights of the com12 plainant and other persons similarly situated. 

13 (D) PUBLICLY AVAILABLE AGREEMENT.— 

14 (i) IN GENERAL.—Subject to clause 

15 (ii), the Secretary shall make available to 

16 the public a copy of a conciliation agree17 ment entered into pursuant to this sub18 section unless the complainant and re19 spondent otherwise agree, and the Sec20 retary determines, that disclosure is not re21 quired to further the purposes of this sub22 section. 

23 (ii) LIMITATION.—A conciliation 

24 agreement that is made available to the 

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1 close individually identifiable health infor2 mation. 

3 (4) FAILURE TO COMPLY WITH CONCILIATION

4 AGREEMENT.—Whenever the Director has reason5 able cause to believe that a respondent has breached 

6 a conciliation agreement, the Director shall refer the 

7 matter to the Attorney General to consider filing a 

8 civil action to enforce such agreement. 

9 (5) WRITTEN CONSENT FOR DISCLOSURE OF

10 INFORMATION.—Nothing said or done in the course 

11 of conciliation under this subsection may be made 

12 public, or used as evidence in a subsequent pro13 ceeding under this subsection, without the written 

14 consent of the parties to the conciliation. 

15 (6) PROMPT JUDICIAL ACTION.— 

16 (A) IN GENERAL.—If the Director deter17 mines at any time following the filing of a com18 plaint under this subsection that prompt judi19 cial action is necessary to carry out the pur20 poses of this subsection, the Director may rec21 ommend that the Attorney General promptly 

22 commence a civil action under subsection (d). 

23 (B) IMMEDIATE SUIT.—If the Director de24 termines at any time following the filing of a 

25 complaint under this subsection that the public 


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1 interest would be served by allowing the com2 plainant to bring a civil action under subsection 

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

4 Director shall certify that the administrative 

5 process has concluded and that the complainant 

6 may file such a suit immediately. 

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

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

9 thereafter, the Director shall make publicly available 

10 a report detailing the activities of the Office for Civil 

11 Rights and Health Equity under this subsection, in12 cluding— 

13 (A) the number of complaints filed and the 

14 basis on which the complaints were filed; 

15 (B) the number of investigations under16 taken as a result of such complaints; and 

17 (C) the disposition of all such investiga18 tions. 

19 (c) ENFORCEMENT BY PRIVATE PERSONS.— 

20 (1) IN GENERAL.— 

21 (A) CIVIL ACTION.— 

22 (i) IN SUIT.—A complainant under 

23 subsection (b) may commence a civil action 

24 to obtain appropriate relief with respect to 

25 an alleged violation of subsection (a), or 


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1 for breach of a conciliation agreement 

2 under subsection (b), in an appropriate 

3 district court of the United States or State 

4 court— 

5 (I) not sooner than the earliest 

6 of— 

7 (aa) the date a conciliation 

8 agreement is reached under sub9 section (b); 

10 (bb) the date of a final dis11 position of a complaint under 

12 subsection (b); or 

13 (cc) 180 days after the first 

14 day of the alleged violation; and 

15 (II) not later than 2 years after 

16 the final day of the alleged violation. 

17 (ii) STATUTE OF LIMITATIONS.—The 

18 computation of such 2-year period shall 

19 not include any time during which an ad20 ministrative proceeding (including inves21 tigation or conciliation) under subsection 

22 (b) was pending with respect to a com23 plaint under such subsection. 

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

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1 section (b) regarding an alleged violation of 

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

3 this paragraph by the complainant involved 

4 with respect to the alleged violation except for 

5 the purpose of enforcing the terms of such an 

6 agreement. 

7 (2) RELIEF WHICH MAY BE GRANTED.— 

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

9 paragraph (1), if the court finds that a viola10 tion of subsection (a) or breach of a conciliation 

11 agreement has occurred, the court may award 

12 to the plaintiff actual and punitive damages, 

13 and may grant as relief, as the court deter14 mines to be appropriate, any permanent or tem15 porary injunction, temporary restraining order, 

16 or other order (including an order enjoining the 

17 defendant from engaging in a practice violating 

18 subsection (a) or ordering such affirmative ac19 tion as may be appropriate). 

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

21 under paragraph (1), 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 same extent as a pri2 vate person. 

3 (3) INTERVENTION BY ATTORNEY GENERAL.— 

4 Upon timely application, the Attorney General may 

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

6 the Attorney General certifies that the case is of 

7 general public importance. 

8 (d) ENFORCEMENT BY THE ATTORNEY GENERAL.— 

9 (1) COMMENCEMENT OF ACTIONS.— 

10 (A) PATTERN OR PRACTICE CASES.—The 

11 Attorney General may commence a civil action 

12 in any appropriate district court of the United 

13 States if the Attorney General has reasonable 

14 cause to believe that any health care provider 

15 covered by subsection (a)— 

16 (i) is engaged in a pattern or practice 

17 that violates such subsection; or 

18 (ii) is engaged in a violation of such 

19 subsection that raises an issue of signifi20 cant public importance. 

21 (B) CASES BY REFERRAL.—The Director 

22 may determine, based on a pattern of com23 plaints, a pattern of violations, a review of data 

24 reported by a health care provider covered by 

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


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1 is reasonable cause to believe a health care pro2 vider is engaged in a pattern or practice that 

3 violates subsection (a). If the Director makes 

4 such a determination, the Director shall refer 

5 the related findings to the Attorney General. If 

6 the Attorney General finds that such reasonable 

7 cause exists, the Attorney General may com8 mence a civil action in any appropriate district 

9 court of the United States. 

10 (2) ENFORCEMENT OF SUBPOENAS.—The At11 torney General, on behalf of the Director, or another 

12 party at whose request a subpoena is issued under 

13 this subsection, may enforce such subpoena in ap14 propriate proceedings in the district court of the 

15 United States for the district in which the person to 

16 whom the subpoena was addressed resides, was 

17 served, or transacts business. 

18 (3) RELIEF WHICH MAY BE GRANTED IN CIVIL

19 ACTIONS.— 

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

21 paragraph (1), the court— 

22 (i) may award such preventive relief, 

23 including a permanent or temporary in24 junction, temporary restraining order, or 

25 other order against the person responsible 


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1 for a violation of subsection (a) as is nec2 essary to assure the full enjoyment of the 

3 rights granted by this subsection; 

4 (ii) may award such other relief as the 

5 court determines to be appropriate, includ6 ing monetary damages, to aggrieved per7 sons; and 

8 (iii) may, to vindicate the public inter9 est, assess punitive damages against the 

10 respondent— 

11 (I) in an amount not exceeding 

12 $500,000, for a first violation; and 

13 (II) in an amount not exceeding 

14 $1,000,000, for any subsequent viola15 tion. 

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

17 under this subsection, the court, in its discre18 tion, may allow the prevailing party, other than 

19 the United States, a reasonable attorney’s fee 

20 and costs. The United States shall be liable for 

21 such fees and costs to the extent provided by 

22 section 2412 of title 28, United States Code. 

23 (4) INTERVENTION IN CIVIL ACTIONS.—Upon 

24 timely application, any person may intervene in a 

25 civil action commenced by the Attorney General 


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

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

3 which such person is an aggrieved person (including 

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

5 or a conciliation agreement to which such person is 

6 a party. 

7 (e) DEFINITIONS.—In this section: 

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

9 person’’ means— 

10 (A) a person who believes that the person 

11 was or will be injured in violation of subsection 

12 (a); or 

13 (B) the personal representative or estate of 

14 a deceased person who was injured in violation 

15 of subsection (a). 

16 (2) DIRECTOR.—The term ‘‘Director’’ refers to 

17 the Director for Civil Rights and Health Equity of 

18 the Department of Health and Human Services. 

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

20 meaning given such term in section 3 of the Ameri21 cans with Disabilities Act of 1990 (42 U.S.C. 

22 12102). 

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

24 means the attempted resolution of issues raised by 

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1 plaint, through informal negotiations involving the 

2 complainant, the respondent, and the Secretary. 

3 (5) CONCILIATION AGREEMENT.—The term 

4 ‘‘conciliation agreement’’ means a written agreement 

5 setting forth the resolution of the issues in concilia6 tion. 

7 (6) INDIVIDUALLY IDENTIFIABLE HEALTH IN8 FORMATION.—The term ‘‘individually identifiable 

9 health information’’ means any information, includ10 ing demographic information collected from an indi11 vidual— 

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

13 care provider covered by subsection (a), health 

14 plan, employer, or health care clearinghouse; 

15 (B) that relates to the past, present, or fu16 ture physical or mental health or condition of, 

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

18 present, or future payment for the provision of 

19 health care to, the individual; and 

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

21 (ii) with respect to which there is a reason22 able basis to believe that the information can be 

23 used to identify the individual. 

24 (7) PROVISION OF INEQUITABLE HEALTH

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


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

2 by a health care provider in a manner that— 

3 (A) fails to meet a high-quality care stand4 ard, meaning the health care provider fails to— 

5 (i) avoid harm to patients as a result 

6 of the health services that are intended to 

7 help the patient; 

8 (ii) provide health services based on 

9 scientific knowledge to all and to all pa10 tients who benefit; 

11 (iii) refrain from providing services to 

12 patients not likely to benefit; 

13 (iv) provide care that is responsive to 

14 patient preferences, needs, and values; and 

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

16 (B) is discriminatory in intent or effect 

17 based at least in part on a basis specified in 

18 subsection (a). 

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

20 means the person or other entity accused in a com21 plaint of a violation of subsection (a). 

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

23 the Secretary of Health and Human Services. 

24 (10) SOCIAL DETERMINANTS OF HEALTH.—The 

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1 tions in the environments in which individuals live, 

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

3 range of health, functioning, and quality-of-life out4 comes and risks. 

5 (f) RULE OF CONSTRUCTION.—Nothing in this sec6 tion shall be construed as repealing or limiting the effect 

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

8 2000b et seq.), section 1557 of the Patient Protection and 

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

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

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

12 SEC. 8. FEDERAL HEALTH EQUITY COMMISSION. 

13 (a) ESTABLISHMENT OF COMMISSION.— 

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

15 Federal Health Equity Commission (in this section 

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

17 (2) MEMBERSHIP.— 

18 (A) IN GENERAL.—The Commission shall 

19 be composed of— 

20 (i) 8 voting members appointed under 

21 subparagraph (B); and 

22 (ii) the nonvoting, ex officio members 

23 listed in subparagraph (C). 

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

25 of the members described in subparagraph 


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1 (A)(i) shall at any one time be of the same po2 litical party. Such members shall have recog3 nized expertise in and personal experience with 

4 racial and ethnic health inequities, health care 

5 needs of vulnerable and marginalized popu6 lations, and health equity as a vehicle for im7 proving health status and health outcomes. 

8 Such members shall be appointed to the Com9 mission as follows: 

10 (i) 4 members of the Commission 

11 shall be appointed by the President. 

12 (ii) 2 members of the Commission 

13 shall be appointed by the President pro 

14 tempore of the Senate, upon the rec15 ommendations of the majority leader and 

16 the minority leader of the Senate. Each 

17 member appointed to the Commission 

18 under this clause shall be appointed from 

19 a different political party. 

20 (iii) 2 members of the Commission 

21 shall be appointed by the Speaker of the 

22 House of Representatives upon the rec23 ommendations of the majority leader and 

24 the minority leader of the House of Rep25 resentatives. Each member appointed to 


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1 the Commission under this clause shall be 

2 appointed from a different political party. 

3 (C) EX OFFICIO MEMBER.—The Commis4 sion shall have the following nonvoting, ex offi5 cio members: 

6 (i) The Director for Civil Rights and 

7 Health Equity of the Department of 

8 Health and Human Services. 

9 (ii) The Deputy Assistant Secretary 

10 for Minority Health of the Department of 

11 Health and Human Services. 

12 (iii) The Director of the National In13 stitute on Minority Health and Health Dis14 parities. 

15 (iv) The Chairperson of the Advisory 

16 Committee on Minority Health established 

17 under section 1707(c) of the Public Health 

18 Service Act (42 U.S.C. 300u–6(c)). 

19 (3) TERMS.—The term of office of each mem20 ber appointed under paragraph (2)(B) of the Com21 mission shall be 6 years. 

22 (4) CHAIRPERSON; VICE CHAIRPERSON.— 

23 (A) CHAIRPERSON.—The President shall, 

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1 graph (2)(B), designate a Chairperson from 

2 among the members of the Commission ap3 pointed under such paragraph. 

4 (B) VICE CHAIRPERSON.— 

5 (i) DESIGNATION.—The Speaker of 

6 the House of Representatives shall, in con7 sultation with the majority leaders and the 

8 minority leaders of the Senate and the 

9 House of Representatives and with the 

10 concurrence of a majority of the members 

11 of the Commission appointed under para12 graph (2)(B), designate a Vice Chairperson 

13 from among the members of the Commis14 sion appointed under such paragraph. The 

15 Vice Chairperson may not be a member of 

16 the same political party as the Chair17 person. 

18 (ii) DUTY.—The Vice Chairperson 

19 shall act in place of the Chairperson in the 

20 absence of the Chairperson. 

21 (5) REMOVAL OF MEMBERS.—The President 

22 may remove a member of the Commission only for 

23 neglect of duty or malfeasance in office. 

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

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


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1 constitute a quorum of the Commission, but a lesser 

2 number of members may hold hearings. 

3 (b) DUTIES OF THE COMMISSION.— 

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

5 (A) monitor and report on the implementa6 tion of this Act; and 

7 (B) investigate, monitor, and report on 

8 progress towards health equity and the elimi9 nation of health disparities. 

10 (2) ANNUAL REPORT.—The Commission 

11 shall— 

12 (A) submit to the President and Congress 

13 at least one report annually on health equity 

14 and health disparities; and 

15 (B) include in such report— 

16 (i) a description of actions taken by 

17 the Department of Health and Human 

18 Services and any other Federal agency re19 lated to health equity or health disparities; 

20 and 

21 (ii) recommendations on ensuring eq22 uitable health care and eliminating health 

23 disparities. 

24 (c) POWERS.— 

25 (1) HEARINGS.— 


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

2 the direction of the Commission, any sub3 committee or member of the Commission, may, 

4 for the purpose of carrying out this section, as 

5 the Commission or the subcommittee or mem6 ber considers advisable— 

7 (i) hold such hearings, meet and act 

8 at such times and places, take such testi9 mony, receive such evidence, and admin10 ister such oaths; and 

11 (ii) require, by subpoena or otherwise, 

12 the attendance and testimony of such wit13 nesses and the production of such books, 

14 records, correspondence, memoranda, pa15 pers, documents, tapes, and materials. 

16 (B) LIMITATION ON HEARINGS.—The 

17 Commission may hold a hearing under subpara18 graph (A)(i) only if the hearing is approved— 

19 (i) by a majority of the members of 

20 the Commission appointed under sub21 section (a)(2)(B); or 

22 (ii) by a majority of such members 

23 present at a meeting when a quorum is 

24 present. 


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1 (2) ISSUANCE AND ENFORCEMENT OF SUB2 POENAS.— 

3 (A) ISSUANCE.—A subpoena issued under 

4 paragraph (1) shall— 

5 (i) bear the signature of the Chair6 person of the Commission; and 

7 (ii) be served by any person or class 

8 of persons designated by the Chairperson 

9 for that purpose. 

10 (B) ENFORCEMENT.—In the case of contu11 macy or failure to obey a subpoena issued 

12 under paragraph (1), the United States district 

13 court for the district in which the subpoenaed 

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

15 issue an order requiring the person to appear at 

16 any designated place to testify or to produce 

17 documentary or other evidence. 

18 (C) NONCOMPLIANCE.—Any failure to 

19 obey the order of the court may be punished by 

20 the court as a contempt of court. 

21 (3) WITNESS ALLOWANCES AND FEES.— 

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

23 28, United States Code, shall apply to a witness 

24 requested or subpoenaed to appear at a hearing 

25 of the Commission. 


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1 (B) EXPENSES.—The per diem and mile2 age allowances for a witness shall be paid from 

3 funds available to pay the expenses of the Com4 mission. 

5 (4) POSTAL SERVICES.—The Commission may 

6 use the United States mails in the same manner and 

7 under the same conditions as other agencies of the 

8 Federal Government. 

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

10 and dispose of gifts or donations of services or prop11 erty. 

12 (d) ADMINISTRATIVE PROVISIONS.— 

13 (1) STAFF.— 

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

15 staff director for the Commission who shall— 

16 (i) serve as the administrative head of 

17 the Commission; and 

18 (ii) be appointed by the Chairperson 

19 with the concurrence of the Vice Chair20 person. 

21 (B) OTHER PERSONNEL.—The Commis22 sion may— 

23 (i) appoint such other personnel as it 

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1 erning appointments in the competitive 

2 service, and the provisions of chapter 51 

3 and subchapter III of chapter 53 of that 

4 title relating to classification and General 

5 Schedule pay rates; and 

6 (ii) may procure temporary and inter7 mittent services under section 3109(b) of 

8 title 5, United States Code, at rates for in9 dividuals not in excess of the daily equiva10 lent paid for positions at the maximum 

11 rate for GS–15 of the General Schedule 

12 under section 5332 of title 5, United 

13 States Code. 

14 (2) COMPENSATION OF MEMBERS.— 

15 (A) NON-FEDERAL EMPLOYEES.—Each 

16 member of the Commission who is not an offi17 cer or employee of the Federal Government 

18 shall be compensated at a rate equal to the 

19 daily equivalent of the annual rate of basic pay 

20 prescribed for level IV of the Executive Sched21 ule under section 5315 of title 5, United States 

22 Code, for each day (including travel time) dur23 ing which the member is engaged in the per24 formance of the duties of the Commission. 


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1 (B) FEDERAL EMPLOYEES.—Each member 

2 of the Commission who is an officer or em3 ployee of the Federal Government shall serve 

4 without compensation in addition to the com5 pensation received for the services of the mem6 ber as an office or employee of the Federal 

7 Government. 

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

9 Commission shall be allowed travel expenses, in10 cluding per diem in lieu of subsistence, at rates 

11 authorized for an employee of an agency under 

12 subchapter I of chapter 57 of title 5, United 

13 States Code, while away from the home or reg14 ular place of business of the member in the per15 formance of the duties of the Commission. 

16 (3) COOPERATION.—The Commission may se17 cure directly from any Federal department or agency 

18 such information as the Commission considers nec19 essary to carry out this Act. Upon request of the 

20 Chairman of the Commission, the head of such de21 partment or agency shall furnish such information to 

22 the Commission. 

23 (e) PERMANENT COMMISSION.—Section 14 of the 

24 Federal Advisory Committee Act (5 U.S.C. App.) shall not 

25 apply to the Commission. 


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1 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated for fiscal year 2022 and 

3 each fiscal year thereafter such sums as may be necessary 

4 to carry out the duties of the Commission. 

5 SEC. 9. GRANTS FOR HOSPITALS TO PROMOTE EQUITABLE 

6 HEALTH CARE AND OUTCOMES. 

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

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

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

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

11 equitable health care treatment and services, and reduce 

12 disparities in care and outcomes. 

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

14 grants under this section and evaluating applications for 

15 such grants, the Secretary shall consult with the Director 

16 for Civil Rights and Health Equity of the Department of 

17 Health and Human Services. 

18 (c) USE OF FUNDS.—A hospital shall use funds re19 ceived from a grant under this section to establish or ex20 pand programs to provide equitable health care to all pa21 tients and to ensure equitable health care outcomes. Such 

22 uses may include— 

23 (1) providing explicit and implicit bias training 

24 to medical providers and staff; 


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1 (2) providing translation or interpretation serv2 ices for patients; 

3 (3) recruiting and training a diverse workforce; 

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

5 and 

6 (5) training on cultural sensitivity. 

7 (d) PRIORITY.—In awarding grants under this sec8 tion, the Secretary shall give priority to hospitals that 

9 have received disproportionate share hospital payments 

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

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

12 1396r–4) with respect to fiscal year 2021. 

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

14 under this section shall be used to supplement, not sup15 plant, any nongovernment efforts, or other Federal, State, 

16 or local funds provided to a recipient. 

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

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

19 in section 1886(b)(3)(B)(viii)(XIII)(cc) of the Social Secu20 rity Act (42 U.S.C. 1395ww(b)(3)(B)(viii)(XIII)(cc)), as 

21 added by section 4(a). 

22 (g) AUTHORIZATION OF APPROPRIATIONS.—To carry 

23 out this section, there are authorized to be appropriated 


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1 such sums as may be necessary for each of fiscal years 

2 2022 through 2027. 

Æ 


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