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Adds a new paragraph (18) to authorize permissive exclusion of health care providers who the Secretary determines have engaged in a pattern of inequitable provision of health care on the basis of race, national origin, sex (including sexual orientation and gender identity), disability, or age, and establishes an exception preventing exclusion if it would increase difficulty in access to health care services for underserved or low-income communities.
Adds a new subclause (XIII) to subsection (b)(3)(B)(viii) to establish an equitable health care measure as a value measurement.
Adds a new clause (iv) to require that measures selected under subparagraph (A) include the equitable health care measures described in subsection (b)(3)(B)(viii)(XIII), beginning in fiscal year 2026.
Section 1013 of title 5, United States Code, shall not apply to the Commission (the Commission is exempted from application of 5 U.S.C. 1013).
Requires HHS to collect and publish non‑identifiable, demographically disaggregated health‑outcome data, adds equity measures to Medicare hospital payment programs, creates new civil‑rights enforcement against inequitable care, renames and elevates the HHS civil‑rights office, establishes a Federal Health Equity Commission, and funds grants to hospitals to reduce disparities. The bill also authorizes the Secretary to exclude providers from Federal health programs for patterns of inequitable care while directing safeguards so exclusions do not worsen access for underserved communities.
In 1966, Dr. Martin Luther King, Jr. said that injustice in health care is one of the most shocking and inhuman forms of inequality because it often leads to physical death.
Inequity in health care remains a persistent and devastating reality for many communities, particularly communities of color.
The unequal provision of health care has complex causes that often come from systemic inequality in access to health care, housing, nutrition, economic opportunity, education, and other factors.
Health care outcomes for Black communities in particular lag far behind those of the population as a whole.
A contributing factor in health disparities is explicit and implicit bias in delivering health care, which results in worse care and poorer outcomes for some patients based on race, national origin, sex (including sexual orientation or gender identity), disability, age, and religion.
Who is affected and how:
Hospitals and health systems: Must expand data collection and reporting, incorporate equity measures into quality and value programs, apply for and administer grants, and may face increased oversight. Hospitals receiving grant priority (disproportionate share hospitals) may gain funds to improve services.
Health‑care providers and clinicians: Face new civil‑rights requirements prohibiting lower‑quality care based on protected characteristics. Providers may be investigated and, in patterns of inequitable care, could be excluded from Medicare/Medicaid; however, exclusions must not reduce access for underserved areas.
Patients and communities, especially communities of color and historically underserved groups: Stand to benefit from improved measurement of disparities, targeted hospital programs, stronger enforcement against discriminatory care, and increased transparency. Annual public reporting and a federal commission could raise visibility of systemic problems.
Department of Health and Human Services and the renamed Office for Civil Rights and Health Equity: Will take on substantial new rulemaking, data‑management, investigatory, reporting, and grant‑administration responsibilities and will gain an elevated leadership role (President‑appointed Director).
Federal payers (CMS/Medicare/Medicaid): Must adjust value‑based purchasing measures and implement equity measures in payment programs, which may shift hospital payments or incentives.
Legal system and civil‑rights enforcement actors (AG and private litigants): Increased civil‑rights claims and potential DOJ enforcement actions against systemic patterns of inequitable care.
Data privacy and research stakeholders: De‑identified data repository will expand analytic capacity but will require technical and legal safeguards to protect individually identifiable information.
Net effects:
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (Sponsor introductory remarks on measure: CR S4458: 3)
Introduced July 17, 2025 by Alejandro Padilla · Last progress July 17, 2025
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Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (Sponsor introductory remarks on measure: CR S4458: 3)
Introduced in Senate