Sponsor
Josh Harder
Representative · D-CA
Representative · D-CA
The bill focuses federal attention and sustained funding on improving access and workforce in underserved areas through targeted Zones and multiple financial incentives, but does so with significant fiscal cost, administrative complexity, and risk that better-resourced communities will benefit more than the most under-resourced ones.
Residents in designated Health Investment Zones (especially low-income, rural, Medicare/Medicaid beneficiaries, and people with chronic conditions) gain improved local access to primary, behavioral, dental, and preventive care through targeted funding for clinics, mobile units, transportation, and provider payment incentives.
Healthcare workers and employers receive stronger financial incentives (employer hiring tax credits, student loan repayment payments that count toward forgiveness, and other hiring supports), making it easier to recruit and retain clinicians in underserved Zones.
Local governments and community nonprofits receive grant funding, subgrants, and language-access and workforce-pipeline support to implement coordinated plans, modernize facilities/equipment, and build long-term local capacity to address health disparities.
The package creates substantial fiscal exposure—through employer tax credits, Medicare Part B add-ons, loan repayment payments, and open-ended appropriations—which could increase federal spending, reduce revenue, and pressure the federal budget or the Medicare Trust Fund.
Selection and award processes risk privileging communities and organizations with grant-writing and matching capacity, and awards may favor larger institutions, potentially leaving the most under-resourced communities and small nonprofits behind.
Application, certification, reporting, and payment-coordination requirements add administrative complexity and workload for community groups, state/local agencies, and federal administrators, which can slow implementation and divert staff time from direct services.
Based on analysis of 9 sections of legislative text.
Designates federal Health Investment Zones and provides grants, loan repayment, Medicare add‑ons, and employer tax credits to expand care and reduce health disparities in eligible areas.
Creates a federal program to designate “Health Investment Zones” (HIZs) in geographic areas with measurable health disadvantages and directs HHS to solicit applications, select zones, and publish designations. The bill pairs designation with incentives: federal grants for community health projects, loan repayment for eligible practitioners, new Medicare Part B add‑ons for services in HIZs, and employer tax credits and Work Opportunity Credit eligibility for wages paid to workers serving in HIZs. Establishes eligibility criteria and application requirements for local coalitions, funds a range of allowable activities (mobile clinics, equipment, language access, transportation, etc.), requires program evaluation after 10 years, and authorizes appropriations for the 10‑year program period beginning with the first zone designation.
Official title: To provide for the designation of areas as Health Investment Zones to reduce health disparities and improve health outcomes in such areas, and for other purposes.
Introduced February 11, 2026 by Josh Harder · Last progress February 11, 2026