Representatives Lee, Chu and Senator Hirono Reintroduce Legislation to Create a More Equitable Health Care System

July 25, 2024

Representatives Lee, Chu and Senator Hirono Reintroduce Legislation to Create a More Equitable Health Care System

~ Ahead of introduction, the lawmakers hosted a press conference with leaders from national health advocacy organizations. Photos can be downloaded here. Video can be downloaded here ~

WASHINGTON, DC - Today, Representative Barbara Lee (D-CA), Representative Judy Chu (D-CA), Chair of the Congressional Asian Pacific American Caucus (CAPAC), and U.S. Senator Mazie K. Hirono (D-HI) introduced the Health Equity and Accountability Act (HEAA) of 2024, legislation that would address health disparities among racial and ethnic minorities as well as women, the LGBTQ+ community, rural populations, and socioeconomically disadvantaged communities across the United States. HEAA has been introduced in every Congress since 2003, with support from CAPAC, the Congressional Black Caucus (CBC), and the Congressional Hispanic Caucus (CHC), also known as the Congressional Tri-Caucus.

"As a co-Chair of the Congressional Asian Pacific American Caucus healthcare taskforce, and a member of the Congressional Black Caucus, I am proud to lead the re-introduction of the Health Equity and Accountability Act (HEAA). HEAA is a bold, comprehensive vision for addressing racial health disparities and improving health outcomes in communities of color and the underserved. It's the only legislation that directly addresses the intersections of health inequities and race and ethnicity," said Congresswoman Lee. "We need to pass HEAA to address the underlying challenges that prevent communities of color and underserved communities from gaining coverage and accessing high-quality, affordable health care. With the help of our advocates and partners, I know Congress can act to create a truly just health care system for all."

"Higher uninsured rates, language and cultural barriers to care, social determinants, and greater exposure to pollution are just a few of the factors that threaten and hurt the health of Americans of color," said CAPAC Chair Rep. Chu. "The Health Equity and Accountability Act would create a healthcare system that works for all Americans - no matter their race, ethnicity, gender, or language ability - by advancing culturally and linguistically appropriate health care, improving data reporting, addressing diseases that disproportionately harm certain communities, and so much more. This legislation is a necessary step to take for health equity to be a reality for all, and I am honored to once again join Congressmember Lee and Senator Hirono to lead the introduction of this bold, legislative vision on behalf of the Tri-Caucus this Congress."

"Everyone deserves access to high-quality, affordable health care, but health disparities prevent many marginalized and underserved communities from accessing these essential resources and services," said Senator Hirono. "The Health Equity and Accountability Act will help to dismantle these barriers by implementing comprehensive provisions to address inequities, including strengthening data collection, increasing access to health services and resources, and diversifying the health care workforce. I am proud to lead this effort and will continue working to ensure that communities across Hawaii and throughout the country have access to the affordable and equitable health care they deserve."

"For generations, Black Americans have faced persistent disparities in health outcomes and access to quality, affordable health care in our nation. The Tri-Caucus is committed to removing barriers and expanding access to health care in our communities," said CBC Chairman Steven Horsford. "The CBC is proud to join our Tri-Caucus partners in cosponsoring the Health Equity and Accountability Act which will take significant steps towards removing systemic barriers, improving outcomes, and making our communities healthier."

"As Chair of the Congressional Hispanic Caucus, I'm proud to join the Tri-Caucus Chairs and leading Congressional Members in introducing the Health Equity and Accountability Act (HEAA) of 2024," said CHC Chair Nanette Barragán. "HEAA is a bold, comprehensive vision to address persistent ethnic and racial health disparities to improve health outcomes for people of color, including millions of Latino families. Data shows Latinos, like many minority populations and underserved communities, face uphill challenges in accessing affordable and high-quality healthcare. This legislation is a critical step toward a fairer healthcare system that prioritizes health equity for all."

"Everyone deserves affordable, high-quality healthcare - no matter the color of their skin, their zip code, sex or gender," said Congresswoman Robin Kelly, Chair of the CBC Health Brain Trust. "The Health Equity and Accountability Act will address disparities in maternal health, mental health, improve research, and support culturally competent care. Throughout the years, we have been able to pass pieces of this bill and slowly close the gaps in healthcare inequities. But it's not enough. We must continue to build on our progress and improve healthcare outcomes for every American."

"Everyone deserves access to affordable, culturally competent health care," said Senator Padilla. "Yet persistent structural inequities too often prevent historically marginalized groups from receiving essential care, despite the disproportionate risks they face to their physical and mental health. Our bill takes critical steps to address the unique health needs of these communities, including by expanding access to equitable reproductive care, combating high-impact minority diseases, and diversifying our health care workforce."

"Every individual, regardless of their race, ethnicity or socioeconomic background, has a right to high-quality and affordable health care," said Senator Booker. "This legislation is designed to dismantle the systemic barriers that prevent many Americans from receiving the dignified, equitable care they deserve. By enhancing data collection, expanding service access, and promoting a diverse health care workforce, we can better address disparities in our health care system and improve the experiences of underserved communities."

HEAA builds upon policies enacted under landmark health care legislation, such as the Affordable Care Act (ACA) and Inflation Reduction Act, and lays out additional investments and policy changes to improve the health and well-being of underserved communities, address systemic health inequities, and ensure access to high-quality and affordable health care for all. HEAA's comprehensive policy changes are laid out across 10 titles as detailed below:

1. Data Collection and Reporting - Strengthens collection of data to better identify health disparities and inform policies and standards to prevent continued bias and inequities.
2. Culturally and Linguistically Appropriate Health and Health Care - Improves access to and quality of culturally and linguistically appropriate care for non-English speakers.
3. Health Workforce Diversity - Directs funding to diversify the health care workforce and better supports workforce development for underrepresented minority health professionals.
4. Improving Health Care Access and Quality - Addresses systemic barriers to quality care for disparity-impacted communities through expanding coverage, improving access, innovating in delivery, and creating health empowerment zones.
5. Improving Health Outcomes for Women, Gender-Diverse People, Children, and Families - Addresses reproductive and sexual health needs, aiming to dismantle barriers to access to health coverage and services, information, and other vital resources.
6. Mental Health and Substance Use Disorders - Strengthens protective factors, expands access to services and resources for mental health and substance use disorders, and reduces the structural barriers that contribute to behavioral health inequities.
7. Addressing High-Impact Minority Diseases - Addresses high-impact minority diseases by increasing services and resources including screenings, research, treatments, and coverage.
8. Health Information Technology - Expands and invests in health information technology infrastructure to reduce impact of health disparities on racial and ethnic minority communities.
9. Accountability and Evaluation - Ensures the federal government is held accountable for efforts to reduce health disparities and requires further transparency.
10. Addressing Social Determinants and Improving Environmental Justice - Defines social determinants of health, as well as the role they play in health inequities, and contains proposals to address these root causes for health disparities, including provisions to address environmental hazards, gun violence and hunger for seniors, children, and families.

In addition to Representatives Lee and Chu, the bill is cosponsored in the House by Representatives Nanette Barragán (D-CA), Steven Horsford (D-NV), Robin Kelly (D-IL), Jill Tokuda (D-HI), Ayanna Pressley (D-MA), Sylvia Garcia (D-TX), Valerie Foushee (D-NC), Mark Takano (D-CA), Raja Krishnamoorthi (D-IL), Shri Thanedar (D-MI), Bonnie Watson Coleman (D-NJ), Sheila Cherfilus-McCormick (D-FL), Suzanne Bonamici (D-OR), Nydia M. Velazquez (D-NY), Terri Sewell (D-AL), Raul M. Grijalva (D-AZ), Doris Matsui (D-CA), Frederica S. Wilson (D-FL), Grace Napolitano (D-CA), Jahana Hayes (D-CT), Delia C. Ramirez (D-IL), Daniel Goldman (D-NY), Jimmy Gomez (D-CA), Jesus Garcia (D-IL), Grace Meng (D-NY), Lisa Blunt Rochester (D-DE), Yvette Clarke (D-NY), Gwen Moore (D-WI), Eleanor Norton (D-DC), Shontel Brown (D-OH), Antonio Cardenas (D-CA), Marilyn Strickland (D-WA), Darren Soto (D-FL), and Adam Schiff (D-CA).

In addition to Senator Hirono, the bill is cosponsored in the Senate by Senators Alex Padilla (D-CA), Cory Booker (D-NJ), Tammy Duckworth (D-IL), Elizabeth Warren (D-MA), Raphael Warnock (D-GA), Ben Cardin (D-MD), Peter Welch (D-VT), and Richard Blumenthal (D-CT).

HEAA is endorsed by over 70 organizations, including Asian & Pacific Islander American Health Forum, Association of Asian Pacific Community Health Organizations, National Immigration Law Center, National Health Law Program, American Kidney Fund, National Minority Quality Forum, Center for Law and Social Policy, and National Network for Arab American Communities. The full list of endorsing organizations can be found here.

"As our nation's demographics change, so do our health needs," said Juliet K. Choi, President & CEO of the Asian & Pacific Islander American Health Forum. "Underserved and underrepresented communities face substantial barriers to obtaining quality health care and equitable health outcomes. APIAHF is proud to lead the 118th Congress's reintroduction of HEAA, with AAPCHO, to tackle these health disparities head on. HEAA invests in culturally and linguistically appropriate health care and health services, creates a pipeline for an inclusive workforce, and deploys innovative strategies to reach communities regardless of region, immigration status, gender, ethnicity, age, or disability. Achieving health equity requires a multi-faceted approach, and HEAA provides a blueprint to do exactly that."

"Every person should have high quality and affordable health care regardless of where they live, language they speak, or ability to pay," said Jeffrey B. Caballero, MPH, Executive Director of the Association of Asian Pacific Community Health Organizations (AAPCHO). "HEAA is visionary legislation to address the vast inequities facing Asian American, Native Hawaiian, Pacific Islander, and all communities who are underserved in every sector of our health care system, including vulnerable populations getting care at community health centers. AAPCHO is proud to join Senator Hirono, Congresswoman Lee, Congresswoman Chu, and the Congressional Tri Caucus in introducing HEAA in the 118th Congress. We appreciate our partnership with APIAHF and the broad coalition of patient, provider, disease, and civil rights groups who contributed to this bill. We look forward to Congress advancing HEAA's vision of a health care system that truly meets the needs of our nation's diverse communities."

"All of us living in the U.S., no matter where we were born or how much money we have, should have quality affordable health care," said Kica Matos, President of the National Immigration Law Center. "HEAA addresses unfair obstacles so that more people can access care, including ensuring immigration status and language barriers don't stand between families and the care they need. We are grateful to Senator Mazie Hirono, Representative Barbara Lee, and the Congressional Tri-Caucus, for leading this important effort to eliminate health disparities."

"The Health Equity and Accountability Act of 2024 (HEAA) represents a crucial opportunity to comprehensively fight the vast racial health inequities that mark the U.S., as well as their intersections with xenophobia, sexism, ableism, ageism, and classism," said Madeline T. Morcelle, Senior Attorney at the National Health Law Program (NHeLP). "HEAA builds upon the Affordable Care Act's achievements through groundbreaking reforms such as closing Medicaid's immigrant and post-pregnancy coverage gaps; establishing Medicaid doula payment models among other payment and service delivery innovations that center racial health equity; and strengthening data collection and access to culturally and linguistically appropriate health care. HEAA also recognizes that we cannot achieve racial health equity without a federal right to abortion that includes Medicaid coverage. The National Health Law Program urges Congress to pass this vital legislation."

"Kidney failure has a profound and disproportionate impact on people of color, and we are urgently in need of a national action plan to promote kidney health for all," said LaVarne A. Burton, President and CEO of the American Kidney Fund. "The Health Equity and Accountability Act (HEAA) takes concrete steps to address the striking health disparities: Black people in the U.S. are four times more likely than their white counterparts to develop kidney failure, the prevalence of kidney failure among Hispanic/Latino Americans and Native Americans is more than twice the prevalence in the white, non-Hispanic population, and Asian Americans are 1.4 times more likely to develop kidney failure. The American Kidney Fund applauds the introduction of this important bill, which includes critical action steps to meaningfully reduce inequities in our health system. Through our Kidney Health for All initiative and our recently launched Rare Kidney Disease Action Network, with its initial focus on IgA nephropathy-which disproportionately affects Asian Americans-AKF has been fighting on all fronts on efforts to help eliminate disparities in kidney care access and outcomes."

"We are proud to be a leading partner with Congresswoman Barbara Lee, Senator Mazie Hirono, and the Congressional TriCaucus in their steadfast leadership, bold vision, and unwavering commitment to creating a nation in which health equity is a reality," said Gary A. Puckrein, PhD, President and CEO of the National Minority Quality Forum (NMQF). "NMQF is particularly proud of our continuing work on Title IX - Accountability and Evaluation, which ensures the federal government is responsive to, and held accountable for, efforts to reduce health inequities and disparities by expanding civil rights protections for anyone operating with Federal financial assistance, ensuring populations in correctional facilities receive care, and requiring reporting regarding how those protections are enforced. The National Minority Quality Forum stands ready to help ensure that HEAA advances in Congress and becomes law."

"As an antipoverty organization, the Center for Law and Social Policy knows that health equity is strongly tied to economic justice," said Isha Weerasinghe, Associate Director of Mental Health and Well-being at the Center for Law and Social Policy (CLASP). "The Health Equity and Accountability Act includes critical language around data equity, culturally and linguistically sensitive health care, restoring federal health benefits for immigrants, improving maternal health care, and ensuring mental health services are available. CLASP supports HEAA as a critical step in ensuring everyone has access to quality health care."

"The Health Equity and Accountability Act (HEAA) is a critical initiative of the broader movement for health equity," said Adam Beddawi, Policy Manager at the National Network for Arab American Communities (NNAAC). "In every Congress, HEAA outlines an agenda for equitable policymaking in the health sector. These goals are only as achievable as we are willing to challenge our own limitations. On behalf of the racially, ethnically, culturally, and linguistically diverse communities represented in the National Network for Arab American Communities (NNAAC), we were honored to participate in the development of HEAA in this Congress. Title I in particular outlines how the recent revision to the federal standards for data on race and ethnicity can be leveraged to improve the quality of health disparities analysis in the federal government. By passing this and other key provisions of HEAA, Congress can take an important step toward the development of a more equitable and evidence-based system of healthcare service provision."

The full text of the bill is available here. A one-pager is available here.

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