I 

116TH CONGRESS 

2D SESSION H. R. 8436 

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

health care, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 29, 2020 

Mr. SCHIFF (for himself, Ms. BASS, Mr. GRIJALVA, Mr. COOPER, Mrs. 

HAYES, Mr. KHANNA, Ms. SCANLON, Ms. NORTON, and Ms. LEE of California) 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 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: 


SSpencer on DSK126QN23PROD with BILLS
2 

•HR 8436 IH

1 (1) In 1966, Martin Luther King, Jr., said, ‘‘Of 

2 all the forms of inequality, injustice in health care 

3 is the most shocking and inhuman because it often 

4 results in physical death.’’. 

5 (2) Inequality in health care remains a per6 sistent and devastating reality for many commu7 nities, but, in particular, communities of color. 

8 (3) Unequal health care has complex causes, 

9 many stemming from systemic inequality in access 

10 to health care, housing, nutrition, economic oppor11 tunity, education, and other factors. 

12 (4) Health care outcomes for African-American 

13 communities in particular lag far behind those of the 

14 population as a whole. 

15 (5) Dr. Anthony Fauci, director of the National 

16 Institute of Allergy and Infectious Diseases, said on 

17 April 7, 2020, the coronavirus outbreak is ‘‘shining 

18 a bright light’’ on ‘‘unacceptable’’ health disparities 

19 in the African-American community. 

20 (6) A contributing factor in health disparities is 

21 explicit and implicit bias in the delivery of health 

22 care, resulting in inferior care and poorer outcomes 

23 for some patients on the basis of race or ethnicity. 

24 (7) The Institute of Medicine issued a report in 

25 2002 titled ‘‘Unequal Treatment’’, finding that raVerDate Sep 11 2014 23:31 Nov 13, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8436.IH H8436

SSpencer on DSK126QN23PROD with BILLS
3 

•HR 8436 IH

1 cial and ethnic minorities receive lower-quality 

2 health care than Whites do, even when insurance 

3 status, income, age, and severity of condition is com4 parable. 

5 (8) Just as Congress has sought to eliminate 

6 bias, both explicit and implicit, in employment, hous7 ing, and other parts of our society, the elimination 

8 of bias and the legacy of structural racism in health 

9 care is of paramount importance. 

10 SEC. 3. DATA COLLECTION AND REPORTING. 

11 (a) REQUIRED REPORTING.— 

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

13 Human Services, in consultation with Director of the 

14 National Institutes of Health, the Director of the 

15 Centers for Medicare & Medicaid Services, the Di16 rector of the Agency for Healthcare Research and 

17 Quality, the Deputy Assistant Secretary for Minority 

18 Health, and the Director of the National Center for 

19 Health Statistics, shall by regulation require all 

20 health care providers and facilities that are required 

21 under other provisions of law to report data on 

22 health outcomes to the Department of Health and 

23 Human Services to disaggregate such data by demo24 graphic characteristics, including by race, ethnicity, 

25 sex, sexual orientation, disability status, gender 


SSpencer on DSK126QN23PROD with BILLS
4 

•HR 8436 IH

1 identity, age, and any other factor that the Sec2 retary determines would be useful for determining a 

3 pattern of inequitable health care. 

4 (2) PROPOSED REGULATIONS.—Not later than 

5 90 days after the date of enactment of this Act, the 

6 Secretary of Health and Human Services shall issue 

7 proposed regulations to carry out paragraph (1). 

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

9 Human Services shall— 

10 (1) not later than 1 year after the date of en11 actment of this Act, establish a repository of the 

12 disaggregated data reported pursuant to subsection 

13 (a); 

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

15 such repository publicly available; and 

16 (3) ensure that such repository does not contain 

17 any data that is individually identifiable. 

18 SEC. 4. REQUIRING EQUITABLE HEALTH CARE IN THE HOS19 PITAL VALUE-BASED PURCHASING PRO20 GRAM. 

21 (a) EQUITABLE HEALTH CARE AS VALUE MEASURE22 MENT.—Section 1886(b)(3)(B)(viii) of the Social Security 

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

24 adding at the end the following new subclause: 


SSpencer on DSK126QN23PROD with BILLS
5 

•HR 8436 IH

1 ‘‘(XIII)(aa) Effective for pay2 ments beginning with fiscal year 

3 2022, in expanding the number of 

4 measures under subclause (III), the 

5 Secretary shall adopt measures that 

6 relate to equitable health care fur7 nished by hospitals in inpatient set8 tings. 

9 ‘‘(bb) In carrying out this sub10 clause, the Secretary shall solicit 

11 input and recommendations from indi12 viduals and groups representing com13 munities of color and ensure measures 

14 adopted pursuant to this subclause ac15 count for social determinants of 

16 health care outcomes. 

17 ‘‘(cc) For purposes of this sub18 clause, the term ‘equitable health 

19 care’ refers to the principle that qual20 ity of care provided to an individual 

21 shall not vary on account of the real 

22 or perceived race, ethnicity, sex, sex23 ual orientation, disability status, gen24 der identity, or age of such indi25 vidual.’’. 


SSpencer on DSK126QN23PROD with BILLS
6 

•HR 8436 IH

1 (b) INCLUSION OF EQUITABLE HEALTH CARE MEAS2 URES.—Section 1886(o)(2)(B) of the Social Security Act 

3 (42 U.S.C. 1395ww(o)(2)(B)) is amended by adding at the 

4 end the following new clause: 

5 ‘‘(iv) INCLUSION OF EQUITABLE

6 HEALTH CARE MEASURES.—Beginning in 

7 fiscal year 2021, measures selected under 

8 subparagraph (A) shall include the equi9 table health care measures described under 

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

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

12 BASIS FOR PERMISSIVE EXCLUSION FROM 

13 MEDICARE AND STATE HEALTH CARE PRO14 GRAMS. 

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

16 1320a–7(b)) is amended by adding at the end the fol17 lowing new paragraph: 

18 ‘‘(18) PROVISION OF INEQUITABLE HEALTH

19 CARE.—Any individual or entity that the Secretary 

20 determines has engaged in a pattern of providing in21 equitable health care (as defined in section 7 of the 

22 Equality in Health Care for All Act) on the basis of 

23 race, ethnicity, sex, sexual orientation, disability sta24 tus, gender identity, age, or any other protected 

25 class.’’. 


SSpencer on DSK126QN23PROD with BILLS
7 

•HR 8436 IH

1 SEC. 6. OFFICE OF CIVIL RIGHTS AND HEALTH EQUITY OF 

2 THE DEPARTMENT OF HEALTH AND HUMAN 

3 SERVICES. 

4 (a) NAME OF OFFICE.—The Office for Civil Rights 

5 of the Department of Health and Human Services shall, 

6 beginning on the date of enactment of this Act, be known 

7 as the Office of Civil Rights and Health Equity. Any ref8 erence to the Office for Civil Rights in any law, regulation, 

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

10 States shall be deemed to be a reference to the Office of 

11 Civil Rights and Health Equity. 

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

13 Civil Rights and Health Equity shall be the Assistant Sec14 retary for Civil Rights and Health Equity, to be appointed 

15 by the President with advice and consent of the Senate. 

16 Any reference to the head of the Office for Civil Rights 

17 of the Department of Health and Human Services in any 

18 law, regulation, map, document, record, or other paper of 

19 the United States shall be deemed to be a reference to 

20 the Assistant Secretary for Civil Rights and Health Eq21 uity. 

22 SEC. 7. PROHIBITING DISCRIMINATION IN HEALTH CARE. 

23 (a) IN GENERAL.—No health care provider or entity 

24 providing health care may, on the basis of race, ethnicity, 

25 sex, sexual orientation, disability status, gender identity, 

26 age, subject another to inequitable health care. 


SSpencer on DSK126QN23PROD with BILLS
8 

•HR 8436 IH

1 (b) DEFINITION.—In this section, the term ‘‘inequi2 table health care’’ means any service provided by a health 

3 care provider or entity providing health care that— 

4 (1) is discriminatory in intent or effect; and 

5 (2) results in a disparate outcome for an indi6 vidual based at least in part on their membership in 

7 a protected class. 

8 SEC. 8. ADMINISTRATIVE COMPLAINT AND CONCILIATION 

9 PROCESS. 

10 (a) COMPLAINTS AND ANSWERS.— 

11 (1) IN GENERAL.—An aggrieved person may, 

12 not later than one year after an alleged violation of 

13 section 7 has occurred or terminated, file a com14 plaint with the Assistant Secretary alleging discrimi15 natory health care by a health care provider. 

16 (2) COMPLAINT.—A complaint submitted pur17 suant to paragraph (1) shall be in writing and shall 

18 contain such information and be in such form as the 

19 Assistant Secretary requires. 

20 (3) PROCEDURE.—Upon the filing of such a 

21 complaint— 

22 (A) the Assistant Secretary shall serve no23 tice upon the aggrieved person acknowledging 

24 receipt of such filing and advising the aggrieved 


SSpencer on DSK126QN23PROD with BILLS
9 

•HR 8436 IH

1 person of the time limits and procedures pro2 vided under this section and sections 9 and 10; 

3 (B) the Assistant Secretary shall, not later 

4 than 10 days after receipt of such filing serve 

5 on the respondent alleged to have provided dis6 criminatory care a notice of the complaint and 

7 advise the provider of the procedural rights and 

8 obligations of respondents under this section 

9 and sections 9 and 10, together with a copy of 

10 the original complaint; 

11 (C) a respondent may file, not later than 

12 30 days after receipt of notice from the Assist13 ant Secretary, an answer to such complaint; 

14 (D) the Assistant Secretary shall make an 

15 investigation of the alleged discriminatory 

16 health care practice and complete such inves17 tigation within 100 days after the filing of the 

18 complaint, unless it is impracticable to do so; 

19 and 

20 (E) the Assistant Secretary shall notify 

21 State licensing authorities with authority over 

22 the respondent of the complaint and provide a 

23 copy of the complaint and the final disposition 

24 of the complaint. 


SSpencer on DSK126QN23PROD with BILLS
10 

•HR 8436 IH

1 (4) INVESTIGATION.—If the Assistant Secretary 

2 is unable to complete the investigation within 100 

3 days after the filing of the complaint (or, when the 

4 Secretary takes further action under subsection 

5 (f)(2) with respect to a complaint, within 100 days 

6 after the commencement of such further action), the 

7 Assistant Secretary shall notify the complainant and 

8 respondent in writing of the reasons for not doing 

9 so. 

10 (5) OATH OR AFFIRMATION.—Complaints and 

11 answers shall be under oath or affirmation, and may 

12 be reasonably and fairly modified at any time. 

13 (6) PATTERN OF CARE.—In the course of inves14 tigating a complaint, the Assistant Secretary may 

15 seek records of care provided to patients other than 

16 the complainant if necessary to demonstrate or dis17 prove an allegation of inequitable health care. 

18 (7) ACCOUNTING FOR SOCIAL DETERMINANTS

19 OF HEALTH.—In investigating a complaint and 

20 reaching a determination, the Assistant Secretary 

21 shall account for social determinants of health and 

22 their effect on health care outcomes. 

23 (b) INVESTIGATIVE REPORT AND CONCILIATION.— 

24 (1) CONCILIATION.—During the period begin25 ning with the filing of such complaint and ending 


SSpencer on DSK126QN23PROD with BILLS
11 

•HR 8436 IH

1 with the resolution of a complaint or a dismissal by 

2 the Assistant Secretary, the Assistant Secretary 

3 shall, to the extent feasible, engage in conciliation 

4 with respect to such complaint. 

5 (2) CONCILIATION AGREEMENT.—A conciliation 

6 agreement arising out of such conciliation shall be 

7 an agreement between the respondent and the com8 plainant, and shall be subject to approval by the As9 sistant Secretary. 

10 (3) RIGHTS PROTECTED.—The Assistant Sec11 retary shall approve a conciliation agreement only if 

12 it protects the rights of the aggrieved person and 

13 other persons similarly situated. 

14 (4) PUBLICLY AVAILABLE.— 

15 (A) IN GENERAL.—Subject to subpara16 graph (B), a redacted copy of a conciliation 

17 agreement entered into pursuant to this section 

18 shall be made available to the public unless the 

19 complainant and respondent otherwise agree, 

20 and the Secretary determines, that disclosure is 

21 not required to further the purposes of this sec22 tion. 

23 (B) LIMITATION.—A conciliation agree24 ment that is made available to the public pursu25 ant to subparagraph (A) may not disclose perVerDate Sep 11 2014 23:31 Nov 13, 2020 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H8436.IH H8436

SSpencer on DSK126QN23PROD with BILLS
12 

•HR 8436 IH

1 sonally identifiable information or individually 

2 identifiable health information. 

3 (5) REPORT.— 

4 (A) FINAL REPORT.—At the end of each 

5 investigation under this section, the Assistant 

6 Secretary shall prepare a final investigative re7 port. 

8 (B) MODIFICATION OF REPORT.—A final 

9 report under this paragraph may be modified if 

10 additional evidence is later discovered. 

11 (c) FAILURE TO COMPLY WITH CONCILIATION

12 AGREEMENT.—Whenever the Assistant Secretary has rea13 sonable cause to believe that a health care provider has 

14 breached a conciliation agreement, the Assistant Secretary 

15 shall refer the matter to the Attorney General for consid16 eration of the filing of a civil action for the enforcement 

17 of such agreement. 

18 (d) PROHIBITIONS AND REQUIREMENTS WITH RE19 SPECT TO DISCLOSURE OF INFORMATION.— 

20 (1) WRITTEN CONSENT FOR DISCLOSURE.— 

21 Nothing said or done in the course of conciliation 

22 under this section may be made public or used as 

23 evidence in a subsequent proceeding under this sec24 tion or section 9 or 10 without the written consent 

25 of the persons concerned. 


SSpencer on DSK126QN23PROD with BILLS
13 

•HR 8436 IH

1 (2) INVESTIGATION DISCLOSURES.—Notwith2 standing paragraph (1), the Assistant Secretary 

3 shall make available to the aggrieved person and the 

4 respondent, at any time, upon request following 

5 completion of the Assistant Secretary’s investigation, 

6 information derived from an investigation and any 

7 final investigative report relating to that investiga8 tion. 

9 (e) PROMPT JUDICIAL ACTION.— 

10 (1) IN GENERAL.—If the Assistant Secretary 

11 concludes at any time following the filing of a com12 plaint that prompt judicial action is necessary to 

13 carry out the purposes of this section or section 9 

14 or 10, the Assistant Secretary may recommend that 

15 the Attorney General promptly commence an action. 

16 (2) IMMEDIATE SUIT.—If the Assistant Sec17 retary determines that the public interest would be 

18 served by allowing the complainant to bring a civil 

19 action in a State or Federal court immediately, the 

20 Assistant Secretary shall certify that the administra21 tive process has concluded and that the complainant 

22 may file such a suit immediately. 

23 (f) ANNUAL REPORT.—Not later than 1 year after 

24 the date of the enactment of this Act, and annually there25 after, the Assistant Secretary shall make publicly available 


SSpencer on DSK126QN23PROD with BILLS
14 

•HR 8436 IH

1 a report detailing the activities of the Office under this 

2 section, including— 

3 (1) the number of complaints filed and the 

4 basis on which they were filed; 

5 (2) the number of investigations undertaken as 

6 a result of such complaints; and 

7 (3) the disposition of all investigations. 

8 (g) DEFINITIONS.—In this section and sections 9 and 

9 10: 

10 (1) ASSISTANT SECRETARY.—The term ‘‘Assist11 ant Secretary’’ refers to the Assistant Secretary of 

12 Health and Human Services for Civil Rights and 

13 Health Equity. 

14 (2) AGGRIEVED PERSON.—The term ‘‘aggrieved 

15 person’’ means a person who believes that they were 

16 injured by a violation of section 7, or the personal 

17 representative or estate of the deceased person. 

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

19 means the attempted resolution of issues raised by 

20 a complaint, or by the investigation of such com21 plaint, through informal negotiations involving the 

22 aggrieved person, the respondent, and the Secretary. 

23 (4) CONCILIATION AGREEMENT.—The term 

24 ‘‘conciliation agreement’’ means a written agreement 


SSpencer on DSK126QN23PROD with BILLS
15 

•HR 8436 IH

1 setting forth the resolution of the issues in concilia2 tion. 

3 (5) INDIVIDUALLY IDENTIFIABLE HEALTH IN4 FORMATION.—The term ‘‘individually identifiable 

5 health information’’ means any information, includ6 ing demographic information collected from an indi7 vidual, that— 

8 (A) is created or received by a health care 

9 provider, health plan, employer, or health care 

10 clearinghouse; and 

11 (B) relates to the past, present, or future 

12 physical or mental health or condition of an in13 dividual, the provision of health care to an indi14 vidual, or the past, present, or future payment 

15 for the provision of health care to an individual, 

16 and— 

17 (i) identifies the individual; or 

18 (ii) with respect to which there is a 

19 reasonable basis to believe that the infor20 mation can be used to identify the indi21 vidual. 

22 (6) INEQUITABLE HEALTH CARE.—The term 

23 ‘‘inequitable health care’’ has the meaning given the 

24 term under section 7. 


SSpencer on DSK126QN23PROD with BILLS
16 

•HR 8436 IH

1 (7) PERSONALLY IDENTIFIABLE INFORMA2 TION.—The term ‘‘personally identifiable informa3 tion’’ has the meaning given such term under the 

4 regulations promulgated under section 264(c) of the 

5 Health Insurance Portability and Accountability Act 

6 of 1996. 

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

8 means the person or other entity accused in a com9 plaint of a violation of section 7. 

10 SEC. 9. ENFORCEMENT BY PRIVATE PERSONS. 

11 (a) IN GENERAL.— 

12 (1) CIVIL ACTION.— 

13 (A) IN SUIT.—An aggrieved person may 

14 commence a civil action to obtain appropriate 

15 relief with respect to an alleged violation of sec16 tion 7 or an enforcement action for breach of 

17 a conciliation agreement in an appropriate 

18 United States district court or State court— 

19 (i) not later than 2 years after the oc20 currence or termination of the alleged vio21 lation; and 

22 (ii) not sooner than the earlier of the 

23 conclusion of the administrative process 

24 and 180 days after the alleged violation. 


SSpencer on DSK126QN23PROD with BILLS
17 

•HR 8436 IH

1 (B) STATUTE OF LIMITATIONS.—The com2 putation of such 2-year period shall not include 

3 any time during which an administrative pro4 ceeding under section 8 was pending with re5 spect to a complaint under such section. 

6 (2) BARRING SUIT.—If the Assistant Secretary 

7 has obtained a conciliation agreement with the con8 sent of an aggrieved person, no action may be filed 

9 under this subsection by such aggrieved person with 

10 respect to the alleged violation of section 7 except 

11 for the purpose of enforcing the terms of such an 

12 agreement. 

13 (b) RELIEF WHICH MAY BE GRANTED.— 

14 (1) IN GENERAL.—In a civil action under sub15 section (a), if the court finds that a violation of sec16 tion 7 or breach of a conciliation agreement has oc17 curred, the court may award to the plaintiff actual 

18 and punitive damages, and may grant as relief, as 

19 the court deems appropriate, any permanent or tem20 porary injunction, temporary restraining order, or 

21 other order (including an order enjoining the defend22 ant from engaging in such practice or ordering such 

23 affirmative action as may be appropriate). 

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

25 subsection (a), the court, in its discretion, may allow 


SSpencer on DSK126QN23PROD with BILLS
18 

•HR 8436 IH

1 the prevailing party, other than the United States, 

2 a reasonable attorney’s fee and costs. The United 

3 States shall be liable for such fees and costs to the 

4 same extent as a private person. 

5 (c) INTERVENTION BY ATTORNEY GENERAL.—Upon 

6 timely application, the Attorney General may intervene in 

7 such civil action, if the Attorney General certifies that the 

8 case is of general public importance. 

9 SEC. 10. ENFORCEMENT BY THE ATTORNEY GENERAL. 

10 (a) PATTERN OR PRACTICE CASES.—Whenever the 

11 Attorney General has reasonable cause to believe that any 

12 person or entity is engaged in a pattern or practice that 

13 denies the rights specified in section 7 and such denial 

14 raises an issue of general public importance, the Attorney 

15 General may commence a civil action in any appropriate 

16 United States district court. 

17 (b) CONSULTATION.—The Assistant Secretary may 

18 determine, based on a pattern of complaints, a pattern of 

19 violations, a review of data reported by a health care pro20 vider, or any others mean, that there is reasonable cause 

21 to believe a health care provider is engaged in a pattern 

22 or practice that denies the rights specified in section 7. 

23 If the Assistant Secretary makes such a determination, 

24 they shall refer their findings to the Attorney General. 


SSpencer on DSK126QN23PROD with BILLS
19 

•HR 8436 IH

1 (c) ENFORCEMENT OF SUBPOENAS.—The Attorney 

2 General, on behalf of the Assistant Secretary, or other 

3 party at whose request a subpoena is issued, under this 

4 section, may enforce such subpoena in appropriate pro5 ceedings in the United States district court for the district 

6 in which the person to whom the subpoena was addressed 

7 resides, was served, or transacts business. 

8 (d) RELIEF WHICH MAY BE GRANTED IN CIVIL AC9 TIONS UNDER SUBSECTIONS (a) AND (b).— 

10 (1) IN GENERAL.—In a civil action under sub11 section (a) or (b), the court— 

12 (A) may award such preventive relief, in13 cluding a permanent or temporary injunction, 

14 restraining order, or other order against the 

15 person responsible for a violation of section 7 as 

16 is necessary to assure the full enjoyment of the 

17 rights granted by this section and sections 8 

18 and 9; 

19 (B) may award such other relief as the 

20 court deems appropriate, including monetary 

21 damages to persons aggrieved; and 

22 (C) may, to vindicate the public interest, 

23 assess a civil penalty against the respondent— 

24 (i) in an amount not exceeding 

25 $500,000, for a first violation; and 


SSpencer on DSK126QN23PROD with BILLS
20 

•HR 8436 IH

1 (ii) in an amount not exceeding 

2 $1,000,000, for any subsequent violation. 

3 (2) FEES AND COSTS.—In a civil action under 

4 this section, the court, in its discretion, may allow 

5 the prevailing party, other than the United States, 

6 a reasonable attorney’s fee and costs. The United 

7 States shall be liable for such fees and costs to the 

8 extent provided by section 2412 of title 28, United 

9 States Code. 

10 (e) INTERVENTION IN CIVIL ACTIONS.—Upon timely 

11 application, any person may intervene in a civil action 

12 commenced by the Attorney General under subsection (a) 

13 or (b) which involves an alleged violation of section 7 with 

14 respect to which such person is an aggrieved person or 

15 a conciliation agreement to which such person is a party. 

16 SEC. 11. FEDERAL HEALTH EQUITY COMMISSION. 

17 (a) ESTABLISHMENT OF COMMISSION.— 

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

19 Federal Health Equity Commission (hereinafter in 

20 this section referred to as the ‘‘Commission’’). 

21 (2) MEMBERSHIP.—The Commission shall be 

22 composed of 8 members. Not more than 4 of the 

23 members shall at any one time be of the same polit24 ical party. Members shall have recognized expertise 

25 in and personal experience with racial and ethnic 


SSpencer on DSK126QN23PROD with BILLS
21 

•HR 8436 IH

1 health disparities, health care needs of vulnerable 

2 and marginalized populations, and health equity as 

3 a vehicle for improving health status and health out4 comes. Members shall be appointed to the commis5 sion as follows: 

6 (A) Four members of the Commission shall 

7 be appointed by the President. 

8 (B) Two members of the Commission shall 

9 be appointed by the President pro tempore of 

10 the Senate, upon the recommendations of the 

11 majority leader and the minority leader of the 

12 Senate, and of the members appointed pursuant 

13 to this subparagraph not more than one shall 

14 be appointed from the same political party. 

15 (C) Two members of the Commission shall 

16 be appointed by the Speaker of the House of 

17 Representatives upon the recommendations of 

18 the majority leader and the minority leader of 

19 the House of Representatives, and of the mem20 bers appointed pursuant to this subparagraph 

21 not more than one shall be appointed from the 

22 same political party. 

23 (3) TERMS.—The term of office of each mem24 ber of the Commission shall be 6 years. 

25 (4) CHAIRPERSON; VICE CHAIRPERSON.— 


SSpencer on DSK126QN23PROD with BILLS
22 

•HR 8436 IH

1 (A) CHAIRPERSON.—The President shall, 

2 with the concurrence of a majority of the Com3 mission’s members, designate a Chairperson 

4 from among the Commission’s members. 

5 (B) VICE CHAIRPERSON.— 

6 (i) DESIGNATION.—The Speaker of 

7 the House of Representatives shall, in con8 sultation with the majority leader and the 

9 minority leader of the House of Represent10 atives and with the concurrence of a ma11 jority of the Commission’s members, des12 ignate a Vice Chairperson from among the 

13 Commission’s members. The Vice Chair14 person may not be a member of the same 

15 political party as the Chairperson. 

16 (ii) DUTY.—The Vice Chairperson 

17 shall act in place of the Chairperson in the 

18 absence of the Chairperson. 

19 (5) REMOVAL OF MEMBERS.—The President 

20 may remove a member of the Commission only for 

21 neglect of duty or malfeasance in office. 

22 (6) QUORUM.—Five members of the Commis23 sion constitute a quorum of the Commission. 

24 (7) EX-OFFICIO MEMBERS.—In addition to the 

25 members appointed under paragraph (2), the ComVerDate Sep 11 2014 23:31 Nov 13, 2020 Jkt 019200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H8436.IH H8436

SSpencer on DSK126QN23PROD with BILLS
23 

•HR 8436 IH

1 mission shall have the following nonvoting ex officio 

2 members: 

3 (A) The Assistant Secretary for Civil 

4 Rights and Health Equity of the Department of 

5 Health and Human Services. 

6 (B) The Deputy Assistant Secretary for 

7 Minority Health of the Department of Health 

8 and Human Services. 

9 (C) The Director of the National Institute 

10 for Minority Health and Health Disparities. 

11 (D) The Chairperson of the Advisory Com12 mittee on Minority Health established under 

13 section 1707 of the Public Health Service Act 

14 (42 U.S.C. 300u–6). 

15 (b) DUTIES OF THE COMMISSION.— 

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

17 (A) monitor and report on the implementa18 tion of the Equality in Health Care for All Act; 

19 and 

20 (B) investigate, monitor, and report on 

21 progress towards health equity and the elimi22 nation of health disparities. 

23 (2) ANNUAL REPORT.—The Commission 

24 shall— 


SSpencer on DSK126QN23PROD with BILLS
24 

•HR 8436 IH

1 (A) submit to the President and Congress 

2 at least one report annually on health equity 

3 and health disparities; and 

4 (B) include in such report— 

5 (i) a description of actions taken by 

6 the Department of Health and Human 

7 Services and any other Federal agency re8 lated to health equity or health disparities; 

9 and 

10 (ii) recommendations on ensuring 

11 equal health care and eliminating health 

12 disparities. 

13 (3) HEARINGS AND AUTHORITIES.— 

14 (A) POWER TO HOLD HEARINGS.—The 

15 Commission may, for the purpose of carrying 

16 out this section, hold such hearings as the Com17 mission deems advisable. Each member of the 

18 Commission shall have the power to administer 

19 oaths and affirmations in connection with the 

20 proceedings of the Commission. The Commis21 sion may hold a hearing only if the hearing is 

22 approved by a majority of the Commission, or 

23 by a majority of the members present at a 

24 meeting when a quorum is present. 


SSpencer on DSK126QN23PROD with BILLS
25 

•HR 8436 IH

1 (B) POWER TO ISSUE SUBPOENAS.—The 

2 Commission may issue subpoenas for the at3 tendance of witnesses and the production of 

4 written or other matter. 

5 (C) WITNESS FEES.—A witness attending 

6 any proceeding of the Commission shall be paid 

7 the same fees and mileage that are paid wit8 nesses in the courts of the United States. 

9 (D) DEPOSITIONS AND INTERROG10 ATORIES.—The Commission may use deposi11 tions and written interrogatories to obtain in12 formation and testimony about matters that are 

13 the subject of a Commission hearing or report. 

14 (c) ADMINISTRATIVE PROVISIONS.— 

15 (1) STAFF.— 

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

17 staff director for the Commission who shall— 

18 (i) serve as the administrative head of 

19 the Commission; and 

20 (ii) be appointed by the Chairperson 

21 with the concurrence of the Vice Chair22 person. 

23 (B) OTHER PERSONNEL.—The Commis24 sion may— 


SSpencer on DSK126QN23PROD with BILLS
26 

•HR 8436 IH

1 (i) appoint such other personnel as it 

2 deems advisable, subject to the provisions 

3 of title 5, United States Code, governing 

4 appointments in the competitive service, 

5 and the provisions of chapter 51 and sub6 chapter III of chapter 53 of that title re7 lating to classification and General Sched8 ule pay rates; and 

9 (ii) may procure temporary and inter10 mittent services under section 3109(b) of 

11 title 5, United States Code, at rates for in12 dividuals not in excess of the daily equiva13 lent paid for positions at the maximum 

14 rate for GS–15 of the General Schedule 

15 under section 5332 of title 5, United 

16 States Code. 

17 (2) COMPENSATION OF MEMBERS.— 

18 (A) IN GENERAL.—Each member of the 

19 Commission who is not otherwise in the service 

20 of the Government of the United States shall 

21 receive a sum equivalent to the compensation 

22 paid at level IV of the Executive Schedule 

23 under section 5315 of title 5, United States 

24 Code, prorated on a daily basis for time spent 

25 in the work of the Commission. 


SSpencer on DSK126QN23PROD with BILLS
27 

•HR 8436 IH

1 (B) PERSONS OTHERWISE IN GOVERN2 MENT SERVICE.—Each member of the Commis3 sion who is otherwise in the service of the Gov4 ernment of the United States shall serve with5 out compensation in addition to that received 

6 for such other service, but while engaged in the 

7 work of the Commission shall be paid actual 

8 travel expenses and per diem in lieu of subsist9 ence expenses when away from such member’s 

10 usual place of residence, under subchapter I of 

11 chapter 57 of title 5, United States Code. 

12 (3) RULES.—The Commission may make such 

13 rules as are necessary to carry out the purposes of 

14 this section. 

15 (4) COOPERATION.—All Federal agencies shall 

16 cooperate fully with the Commission to the end that 

17 it may effectively carry out its functions and duties. 

18 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

19 are authorized to be appropriated such sums as may be 

20 necessary to carry out the duties of the Commission for 

21 each of fiscal years 2021 through 2025. 

22 SEC. 12. GRANTS FOR HOSPITALS TO PROMOTE EQUITABLE 

23 HEALTH CARE AND OUTCOMES. 

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

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


SSpencer on DSK126QN23PROD with BILLS
28 

•HR 8436 IH

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

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

3 equitable health care and reduce disparities in care and 

4 outcomes. 

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

6 grants under this section and evaluating applications for 

7 such grants, the Secretary shall consult with the Assistant 

8 Secretary for Civil Rights and Health Equity of the De9 partment of Health and Human Services. 

10 (c) USE OF FUNDS.—A hospital shall use funds re11 ceived from a grant under this section to establish or ex12 pand programs to provide equal care to all patients and 

13 to ensure equitable health care outcomes. Such uses may 

14 include— 

15 (1) providing explicit and implicit bias training 

16 to medical providers and staff; 

17 (2) providing translation or interpretation serv18 ices for patients; 

19 (3) recruiting and training a diverse workforce; 

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

21 and 

22 (5) training on cultural sensitivity. 

23 (d) PRIORITY.—In awarding grants under this sec24 tion, the Secretary shall give priority to hospitals that 

25 have received disproportionate share hospital payments 


SSpencer on DSK126QN23PROD with BILLS
29 

•HR 8436 IH

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

2 U.S.C. 1395ww) or section 1925 of such Act (42 U.S.C. 

3 1396r–6) with respect to fiscal year 2020. 

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

5 under this section shall be used to supplement, not sup6 plant, any other Federal funds provided to a recipient. 

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

8 ‘‘equitable health care’’ has the meaning given the term 

9 in section 1886(b)(3)(B)(viii)(XIII)(cc) of the Social Secu10 rity Act (42 U.S.C. 1395ww(b)(3)(B)(viii)(XIII)(cc)), as 

11 amended by this Act. 

12 (g) AUTHORIZATION OF APPROPRIATIONS.—To carry 

13 out this section, there are authorized to be appropriated 

14 such sums as may be necessary for fiscal years 2021 

15 through 2026. 

Æ 


SSpencer on DSK126QN23PROD with BILLS