119-s2347

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2347 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 2347

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

 July 17, 2025

 Mr. Padilla (for himself, Mr. Booker, Mr. Schiff, and Mr. Gallego) 
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.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Equal Health Care for All Act''.

SEC. 2. FINDINGS.

 Congress finds the following:

    (1) In 1966, Dr. Martin Luther King, Jr. said ``Of all the 
 forms of inequality, injustice in health care is the most 
 shocking and inhuman because it often results in physical 
 death.''.

    (2) Inequity in health care remains a persistent and 
 devastating reality for many communities, and, in particular, 
 communities of color.

    (3) The inequitable provision of health care has complex 
 causes, many stemming from systemic inequality in access to 
 health care, housing, nutrition, economic opportunity, 
 education, and other factors.

    (4) Health care outcomes for Black communities in 
 particular lag far behind those of the population as a whole.

    (5) A contributing factor in health disparities is explicit 
 and implicit bias in the delivery of health care, resulting in 
 inferior care and poorer outcomes for some patients on the 
 basis of factors that include race, national origin, sex 
 (including sexual orientation or gender identity), disability, 
 age, and religion.

    (6) The National Academy of Medicine (formerly known as the 
 ``Institute of Medicine'') issued a report in 2002 titled 
 ``Unequal Treatment'', finding that racial and ethnic 
 minorities receive lower-quality health care than White 
 individuals do, even when insurance status, income, age, and 
 severity of condition is comparable.

    (7) Just as Congress has sought to eliminate bias, both 
 explicit and implicit, in employment, housing, and other parts 
 of our society, the elimination of bias and the legacy of 
 structural racism in health care is of paramount importance.

SEC. 3. DATA COLLECTION AND REPORTING.

    (a) Required Reporting.--

    (1) In general.--The Secretary of Health and Human Services 
 (in this section referred to as the ``Secretary''), in 
 consultation with the Director for Civil Rights and Health 
 Equity, the Director of the National Institutes of Health, the 
 Administrator of the Centers for Medicare & Medicaid Services, 
 the Director of the Agency for Healthcare Research and Quality, 
 the Deputy Assistant Secretary for Minority Health, and the 
 Director of the Centers for Disease Control and Prevention, 
 shall by regulation require all health care providers and 
 facilities that are required under other provisions of law to 
 report data on specific health outcomes to the Department of 
 Health and Human Services in aggregate form, to disaggregate 
 such data by demographic characteristics, including by race, 
 national origin, sex (including sexual orientation and gender 
 identity), disability, and age, as well as any other factor 
 that the Secretary determines would be useful for determining a 
 pattern of inequitable provision of health care.

    (2) Proposed regulations.--Not later than 90 days after the 
 date of enactment of this Act, the Secretary shall issue 
 proposed regulations to carry out paragraph

    (1) .

    (b) Repository.--The Secretary shall--

    (1) not later than 1 year after the date of enactment of 
 this Act, establish a repository of the disaggregated data 
 reported pursuant to subsection

    (a) ; and

    (2) ensure that such repository does not contain any data 
 that is individually identifiable.

SEC. 4. REQUIRING EQUITABLE HEALTH CARE IN THE HOSPITAL VALUE-BASED 
 PURCHASING PROGRAM.

    (a) Equitable Health Care as Value Measurement.--

Section 1886

    (b)

    (3)
        (B)
            (viii) of the Social Security Act (42 U.S.C. 
1395ww

    (b)

    (3)
        (B)
            (viii) ) is amended by adding at the end the following 
new subclause:
 ``
            (XIII) (aa) Effective for payments beginning with fiscal year 
2026, in expanding the number of measures under subclause
            (III) , the 
Secretary shall adopt measures that relate to equitable health care 
furnished by hospitals in inpatient settings.
 ``

    (bb) In carrying out this subclause, the Secretary shall solicit 
input and recommendations from individuals and groups representing 
communities of color and other protected classes and ensure measures 
adopted pursuant to this subclause account for social determinants of 
health, as defined in 

section 7

    (e)

    (10) of the Equal Health Care for All 
Act, such that the social determinants of health do not adversely 
affect hospitals if any inequitable outcomes are not caused by that 
hospital's provision of care.
 ``
            (cc) For purposes of this subclause, the term `equitable health 
care' refers to the principle that high-quality care should be provided 
to all individuals and health care treatment and services should not 
vary on account of the real or perceived race, national origin, sex 
(including sexual orientation and gender identity), disability, or age 
of an individual, as well as any other factor that the Secretary 
determines would be useful for determining a pattern of inequitable 
provision of health care.''.

    (b) Inclusion of Equitable Health Care Measures.--

Section 1886

    (o)

    (2)
        (B) of the Social Security Act (42 U.S.C. 1395ww

    (o)

    (2)
        (B) ) is 
amended by adding at the end the following new clause:
 ``
            (iv) Inclusion of equitable health care 
 measures.--Beginning in fiscal year 2026, 
 measures selected under subparagraph
        (A) shall 
 include the equitable health care measures 
 described in subsection

    (b)

    (3)
        (B)
            (viii) 
            (XIII) .''.

SEC. 5. INEQUITABLE PROVISION OF HEALTH CARE AS A BASIS FOR PERMISSIVE 
 EXCLUSION FROM MEDICARE AND OTHER FEDERAL HEALTH CARE 
 PROGRAMS.

 

Section 1128

    (b) of the Social Security Act (42 U.S.C. 1320a-7

    (b) ) 
is amended by adding at the end the following new paragraph:
 ``

    (18) Inequitable provision of health care.--
 ``
        (A) In general.--Subject to subparagraph
        (B) , any 
 health care provider that the Secretary determines, 
 under 

section 7

    (b)

    (2) of the Equal Health Care for All 
 Act, has engaged in a pattern of inequitable provision 
 of health care (as defined in subsection

    (e)

    (7) of such 
 Act) on the basis of race, national origin, sex 
 (including sexual orientation and gender identity), 
 disability, or age of an individual.
 ``
        (B) Exception.--For purposes of carrying out 
 subparagraph
        (A) , the Secretary shall not exclude any 
 health care provider from participation in the Medicare 
 program under title XVIII or the Medicaid program under 
 title XIX if the exclusion of such health care provider 
 would result in increased difficulty in access to 
 health care services for underserved or low-income 
 communities.''.

SEC. 6. OFFICE FOR CIVIL RIGHTS AND HEALTH EQUITY OF THE DEPARTMENT OF 
 HEALTH AND HUMAN SERVICES.

    (a) Name of Office.--Beginning on the date of enactment of this 
Act, the Office for Civil Rights of the Department of Health and Human 
Services shall be known as the ``Office for Civil Rights and Health 
Equity'' of the Department of Health and Human Services. Any reference 
to the Office for Civil Rights of the Department of Health and Human 
Services in any law, regulation, map, document, record, or other paper 
of the United States shall be deemed to be a reference to the Office 
for Civil Rights and Health Equity.

    (b) Head of Office.--The head of the Office for Civil Rights and 
Health Equity shall be the Director for Civil Rights and Health Equity, 
to be appointed by the President. Any reference to the Director of the 
Office for Civil Rights of the Department of Health and Human Services 
in any law, regulation, map, document, record, or other paper of the 
United States shall be deemed to be a reference to the Director for 
Civil Rights and Health Equity.

SEC. 7. PROHIBITING DISCRIMINATION IN HEALTH CARE.

    (a) Prohibiting Discrimination.--

    (1) In general.--No health care provider may, on the basis, 
 in whole or in part, of race, sex (including sexual orientation 
 and gender identity), disability, age, or religion, subject an 
 individual to the inequitable provision of health care.

    (2) Notice of patient rights.--The Secretary shall provide 
 to each patient a notice of a patient's rights under this 
 section.

    (b) Administrative Complaint and Conciliation Process.--

    (1) Complaints and answers.--
        (A) In general.--An aggrieved person may, not later 
 than 1 year after an alleged violation of subsection

    (a) has occurred or concluded, file a complaint with 
 the Director alleging inequitable provision of health 
 care by a provider described in subsection

    (a) .
        (B) Complaint.--A complaint submitted pursuant to 
 subparagraph
        (A) shall be in writing and shall contain 
 such information and be in such form as the Director 
 requires.
            (C) Oath or affirmation.--The complaint and any 
 answer made under this subsection shall be made under 
 oath or affirmation, and may be reasonably and fairly 
 modified at any time.

    (2) Response to complaints.--
        (A) In general.--Upon the filing of a complaint 
 under this subsection, the following procedures shall 
 apply:
            (i) Complainant notice.--The Director shall 
 serve notice upon the complainant acknowledging 
 receipt of such filing and advising the 
 complainant of the time limits and procedures 
 provided under this section.
            (ii) Respondent notice.--The Director 
 shall, not later than 30 days after receipt of 
 such filing--
            (I) serve on the respondent a 
 notice of the complaint, together with 
 a copy of the original complaint; and
            (II) advise the respondent of the 
 procedural rights and obligations of 
 respondents under this section.
            (iii) Answer.--The respondent may file, not 
 later than 60 days after receipt of the notice 
 from the Director, an answer to such complaint.
            (iv) Investigative duties.--The Director 
 shall--
            (I) make an investigation of the 
 alleged inequitable provision of health 
 care; and
            (II) complete such investigation 
 within 180 days (unless it is 
 impracticable to complete such 
 investigation within 180 days) after 
 the filing of the complaint.
        (B) Investigations.--
            (i) Pattern or practice.--In the course of 
 investigating the complaint, the Director may 
 seek records of care provided to patients other 
 than the complainant if necessary to 
 demonstrate or disprove an allegation of 
 inequitable provision of health care or to 
 determine whether there is a pattern or 
 practice of such care.
            (ii) Accounting for social determinants of 
 health.--In investigating the complaint and 
 reaching a determination on the validity of the 
 complaint, the Director shall account for 
 social determinants of health and the effect of 
 such social determinants on health care 
 outcomes, so that the health care provider 
 named in the complaint is not held accountable 
 for a factor outside of the control of the 
 provider's provision of health care.
            (iii) Inability to complete 
 investigation.--If the Director is unable to 
 complete (or finds it is impracticable to 
 complete) the investigation within 180 days 
 after the filing of the complaint (or, if the 
 Secretary takes further action under paragraph

    (6)
        (B) with respect to a complaint, within 180 
 days after the commencement of such further 
 action), the Director shall notify the 
 complainant and respondent in writing of the 
 reasons involved.
            (iv) Report to state licensing 
 authorities.--On concluding each investigation 
 under this subparagraph, the Director shall 
 provide to each State licensing authority that 
 is responsible for the licensing of the health 
 care provider under investigation, information 
 specifying the results of the investigation.
            (C) Report.--
            (i) Final report.--On completing each 
 investigation under this paragraph, the 
 Director shall prepare a final investigative 
 report.
            (ii) Modification of report.--A final 
 report under this subparagraph may be modified 
 if additional evidence is later discovered.

    (3) Conciliation.--
        (A) In general.--During the period beginning on the 
 date on which a complaint is filed under this 
 subsection and ending on the date of final disposition 
 of such complaint (including during an investigation 
 under paragraph

    (2)
        (B) ), the Director shall, to the 
 extent feasible, engage in conciliation with respect to 
 such complaint.
        (B) Conciliation agreement.--A conciliation 
 agreement arising out of such conciliation shall be an 
 agreement between the respondent and the complainant, 
 and shall be subject to approval by the Director.
            (C) Rights protected.--The Director shall approve a 
 conciliation agreement only if the agreement protects 
 the rights of the complainant and other persons 
 similarly situated.
            (D) Reporting of agreement.--
            (i) In general.--Subject to clause
            (ii) , 
 the Secretary shall make available to the State 
 licensing authority described in paragraph

    (2)
        (B)
            (iv) a copy of a conciliation agreement 
 entered into pursuant to this subsection unless 
 the complainant and respondent otherwise agree, 
 and the Secretary determines, that disclosure 
 is not required to further the purposes of this 
 subsection.
            (ii) Limitation.--A conciliation agreement 
 that is made available to the State licensing 
 authority pursuant to clause
            (i) may not 
 disclose individually identifiable health 
 information.

    (4) Failure to comply with conciliation agreement.--
 Whenever the Director has reasonable cause to believe that a 
 respondent has breached a conciliation agreement, the Director 
 shall refer the matter to the Attorney General to consider 
 filing a civil action to enforce such agreement.

    (5) Written consent for disclosure of information.--Nothing 
 said or done in the course of conciliation under this 
 subsection may be made public, or used as evidence in a 
 subsequent proceeding under this subsection, without the 
 written consent of the parties to the conciliation.

    (6) Prompt judicial action.--
        (A) In general.--If the Director determines at any 
 time following the filing of a complaint under this 
 subsection that prompt judicial action is necessary to 
 carry out the purposes of this subsection, the Director 
 may recommend that the Attorney General promptly 
 commence a civil action under subsection
            (d) .
        (B) Immediate suit.--If the Director determines at 
 any time following the filing of a complaint under this 
 subsection that the public interest would be served by 
 allowing the complainant to bring a civil action under 
 subsection
            (c) in a State or Federal court immediately, 
 the Director shall certify that the administrative 
 process has concluded and that the complainant may file 
 such a suit immediately.

    (7) Annual report.--Not later than 1 year after the date of 
 enactment of this Act, and annually thereafter, the Director 
 shall make publicly available a report detailing the activities 
 of the Office for Civil Rights and Health Equity under this 
 subsection, including--
        (A) the number of complaints filed and the basis on 
 which the complaints were filed;
        (B) the number of investigations undertaken as a 
 result of such complaints; and
            (C) the disposition of all such investigations.
            (c) Enforcement by Private Persons.--

    (1) In general.--
        (A) Civil action.--
            (i) In suit.--A complainant under 
 subsection

    (b) may commence a civil action to 
 obtain appropriate relief with respect to an 
 alleged violation of subsection

    (a) , or for 
 breach of a conciliation agreement under 
 subsection

    (b) , in an appropriate district 
 court of the United States or State court--
            (I) not sooner than the earliest 
 of--

    (aa) the date a 
 conciliation agreement is 
 reached under subsection

    (b) ;

    (bb) the date of a final 
 disposition of a complaint 
 under subsection

    (b) ; or
            (cc) 180 days after the 
 first day of the alleged 
 violation; and
            (II) not later than 2 years after 
 the final day of the alleged violation.
            (ii) Statute of limitations.--The 
 computation of such 2-year period shall not 
 include any time during which an administrative 
 proceeding (including investigation or 
 conciliation) under subsection

    (b) was pending 
 with respect to a complaint under such 
 subsection.
        (B) Barring suit.--If the Director has obtained a 
 conciliation agreement under subsection

    (b) regarding 
 an alleged violation of subsection

    (a) , no action may 
 be filed under this paragraph by the complainant 
 involved with respect to the alleged violation except 
 for the purpose of enforcing the terms of such an 
 agreement.

    (2) Relief which may be granted.--
        (A) In general.--In a civil action under paragraph

    (1) , if the court finds that a violation of subsection

    (a) or breach of a conciliation agreement has occurred, 
 the court may award to the plaintiff actual and 
 punitive damages, and may grant as relief, as the court 
 determines to be appropriate, any permanent or 
 temporary injunction, temporary restraining order, or 
 other order (including an order enjoining the defendant 
 from engaging in a practice violating subsection

    (a) or 
 ordering such affirmative action as may be 
 appropriate).
        (B) Fees and costs.--In a civil action under 
 paragraph

    (1) , the court, in its discretion, may allow 
 the prevailing party, other than the United States, a 
 reasonable attorney's fee and costs. The United States 
 shall be liable for such fees and costs to the same 
 extent as a private person.

    (3) Intervention by attorney general.--Upon timely 
 application, the Attorney General may intervene in a civil 
 action under paragraph

    (1) , if the Attorney General certifies 
 that the case is of general public importance.
            (d) Enforcement by the Attorney General.--

    (1) Commencement of actions.--
        (A) Pattern or practice cases.--The Attorney 
 General may commence a civil action in any appropriate 
 district court of the United States if the Attorney 
 General has reasonable cause to believe that any health 
 care provider covered by subsection

    (a) --
            (i) is engaged in a pattern or practice 
 that violates such subsection; or
            (ii) is engaged in a violation of such 
 subsection that raises an issue of significant 
 public importance.
        (B) Cases by referral.--The Director may determine, 
 based on a pattern of complaints, a pattern of 
 violations, a review of data reported by a health care 
 provider covered by subsection

    (a) , or any other means, 
 that there is reasonable cause to believe a health care 
 provider is engaged in a pattern or practice that 
 violates subsection

    (a) . If the Director makes such a 
 determination, the Director shall refer the related 
 findings to the Attorney General. If the Attorney 
 General finds that such reasonable cause exists, the 
 Attorney General may commence a civil action in any 
 appropriate district court of the United States.

    (2) Enforcement of subpoenas.--The Attorney General, on 
 behalf of the Director, or another party at whose request a 
 subpoena is issued under this subsection, may enforce such 
 subpoena in appropriate proceedings in the district court of 
 the United States for the district in which the person to whom 
 the subpoena was addressed resides, was served, or transacts 
 business.

    (3) Relief which may be granted in civil actions.--
        (A) In general.--In a civil action under paragraph

    (1) , the court--
            (i) may award such preventive relief, 
 including a permanent or temporary injunction, 
 temporary restraining order, or other order 
 against the person responsible for a violation 
 of subsection

    (a) as is necessary to assure the 
 full enjoyment of the rights granted by this 
 subsection;
            (ii) may award such other relief as the 
 court determines to be appropriate, including 
 monetary damages, to aggrieved persons; and
            (iii) may, to vindicate the public 
 interest, assess punitive damages against the 
 respondent--
            (I) in an amount not exceeding 
 $500,000, for a first violation; and
            (II) in an amount not exceeding 
 $1,000,000, for any subsequent 
 violation.
        (B) Fees and costs.--In a civil action under this 
 subsection, the court, in its discretion, may allow the 
 prevailing party, other than the United States, a 
 reasonable attorney's fee and costs. The United States 
 shall be liable for such fees and costs to the extent 
 provided by 

section 2412 of title 28, United States 
 Code.

    (4) Intervention in civil actions.--Upon timely 
 application, any person may intervene in a civil action 
 commenced by the Attorney General under paragraphs

    (1) and

    (2) if the action involves an alleged violation of subsection

    (a) with respect to which such person is an aggrieved person 
 (including a person who is a complainant under subsection

    (b) ) 
 or a conciliation agreement to which such person is a party.

    (e) 

=== Definitions. ===
-In this section:

    (1) Aggrieved person.--The term ``aggrieved person'' 
 means--
        (A) a person who believes that the person was or 
 will be injured in violation of subsection

    (a) ; or
        (B) the personal representative or estate of a 
 deceased person who was injured in violation of 
 subsection

    (a) .

    (2) Director.--The term ``Director'' means the Director for 
 Civil Rights and Health Equity of the Department of Health and 
 Human Services.

    (3) Disability.--The term ``disability'' has the meaning 
 given such term in 

section 3 of the Americans with Disabilities 
 Act of 1990 (42 U.S.C. 12102).

    (4) Conciliation.--The term ``conciliation'' means the 
 attempted resolution of issues raised by a complaint, or by the 
 investigation of such complaint, through informal negotiations 
 involving the complainant, the respondent, and the Secretary.

    (5) Conciliation agreement.--The term ``conciliation 
 agreement'' means a written agreement setting forth the 
 resolution of the issues in conciliation.

    (6) Individually identifiable health information.--The term 
 ``individually identifiable health information'' means any 
 information, including demographic information collected from 
 an individual--
        (A) that is created or received by a health care 
 provider covered by subsection

    (a) , health plan, 
 employer, or health care clearinghouse;
        (B) that relates to the past, present, or future 
 physical or mental health or condition of, the 
 provision of health care to, or the past, present, or 
 future payment for the provision of health care to, the 
 individual; and
            (C) 
            (i) that identifies the individual; or
            (ii) with respect to which there is a reasonable 
 basis to believe that the information can be used to 
 identify the individual.

    (7) Inequitable provision of health care.--The term 
 ``inequitable provision of health care'' means the provision of 
 any health care service, by a health care provider in a manner 
 that--
        (A) fails to meet a high-quality care standard, 
 meaning the health care provider fails to--
            (i) avoid harm to patients as a result of 
 the health services that are intended to help 
 the patient;
            (ii) provide health services based on 
 scientific knowledge to all patients who 
 benefit;
            (iii) refrain from providing services to 
 patients not likely to benefit;
            (iv) provide care that is responsive to 
 patient preferences, needs, and values; and
            (v) avoids waits or delays in care; and
        (B) is discriminatory in intent or effect based at 
 least in part on a basis specified in subsection

    (a) .

    (8) Respondent.--The term ``respondent'' means the person 
 or other entity accused in a complaint of a violation of 
 subsection

    (a) .

    (9) Secretary.--The term ``Secretary'' means the Secretary 
 of Health and Human Services.

    (10) Social determinants of health.--The term ``social 
 determinants of health'' means conditions in the environments 
 in which individuals live, work, attend school, and worship, 
 that affect a wide range of health, functioning, and quality-
 of-life outcomes and risks.

    (f) Rule of Construction.--Nothing in this section shall be 
construed as repealing or limiting the effect of title VI of the Civil 
Rights Act of 1964 (42 U.S.C. 2000d et seq.), 

section 1557 of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18116), 

section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), or the Age 
Discrimination Act of 1975 (42 U.S.C. 6101 et seq.).

SEC. 8. FEDERAL HEALTH EQUITY COMMISSION.

    (a) Establishment of Commission.--

    (1) In general.--There is established the Federal Health 
 Equity Commission (in this section referred to as the 
 ``Commission'').

    (2) Membership.--
        (A) In general.--The Commission shall be composed 
 of--
            (i) 8 voting members appointed under 
 subparagraph
        (B) ; and
            (ii) the nonvoting, ex officio members 
 described in subparagraph
            (C) .
        (B) Voting members.--Not more than 4 of the members 
 described in subparagraph
        (A)
            (i) shall at any one time 
 be of the same political party. Such members shall have 
 recognized expertise in and personal experience with 
 racial and ethnic health inequities, health care needs 
 of vulnerable and marginalized populations, and health 
 equity as a vehicle for improving health status and 
 health outcomes. Such members shall be appointed to the 
 Commission as follows:
            (i) 4 members of the Commission shall be 
 appointed by the President.
            (ii) 2 members of the Commission shall be 
 appointed by the President pro tempore of the 
 Senate, upon the recommendations of the 
 majority leader and the minority leader of the 
 Senate. Each member appointed to the Commission 
 under this clause shall be appointed from a 
 different political party.
            (iii) 2 members of the Commission shall be 
 appointed by the Speaker of the House of 
 Representatives upon the recommendations of the 
 majority leader and the minority leader of the 
 House of Representatives. Each member appointed 
 to the Commission under this clause shall be 
 appointed from a different political party.
            (C) Ex officio member.--The Commission shall have 
 the following nonvoting, ex officio members:
            (i) The Director for Civil Rights and 
 Health Equity of the Department of Health and 
 Human Services.
            (ii) The Deputy Assistant Secretary for 
 Minority Health of the Department of Health and 
 Human Services.
            (iii) The Director of the National 
 Institute on Minority Health and Health 
 Disparities.
            (iv) The Chairperson of the Advisory 
 Committee on Minority Health established under 
 

section 1707
            (c) of the Public Health Service 
 Act (42 U.S.C. 300u-6
            (c) ).

    (3) Terms.--The term of office of each member of the 
 Commission appointed under paragraph

    (2)
        (B) shall be 6 years.

    (4) Chairperson; vice chairperson.--
        (A) Chairperson.--The President shall, with the 
 concurrence of a majority of the members of the 
 Commission appointed under paragraph

    (2)
        (B) , designate 
 a Chairperson from among the members of the Commission 
 appointed under such paragraph.
        (B) Vice chairperson.--
            (i) Designation.--The Speaker of the House 
 of Representatives shall, in consultation with 
 the majority leaders and the minority leaders 
 of the Senate and the House of Representatives 
 and with the concurrence of a majority of the 
 members of the Commission appointed under 
 paragraph

    (2)
        (B) , designate a Vice Chairperson 
 from among the members of the Commission 
 appointed under such paragraph. The Vice 
 Chairperson may not be a member of the same 
 political party as the Chairperson.
            (ii) Duty.--The Vice Chairperson shall act 
 in place of the Chairperson in the absence of 
 the Chairperson.

    (5) Removal of members.--The President may remove a member 
 of the Commission only for neglect of duty or malfeasance in 
 office.

    (6) Quorum.--A majority of members of the Commission 
 appointed under paragraph

    (2)
        (B) shall constitute a quorum of 
 the Commission, but a lesser number of members may hold 
 hearings.

    (b) Duties of the Commission.--

    (1) In general.--The Commission shall--
        (A) monitor and report on the implementation of 
 this Act; and
        (B) investigate, monitor, and report on progress 
 towards health equity and the elimination of health 
 disparities.

    (2) Annual report.--The Commission shall--
        (A) submit to the President and Congress at least 
 one report annually on health equity and health 
 disparities; and
        (B) include in such report--
            (i) a description of actions taken by the 
 Department of Health and Human Services and any 
 other Federal agency related to health equity 
 or health disparities; and
            (ii) recommendations on ensuring equitable 
 health care and eliminating health disparities.
            (c) Powers.--

    (1) Hearings.--
        (A) In general.--The Commission or, at the 
 direction of the Commission, any subcommittee or member 
 of the Commission, may, for the purpose of carrying out 
 this section, as the Commission or the subcommittee or 
 member considers advisable--
            (i) hold such hearings, meet and act at 
 such times and places, take such testimony, 
 receive such evidence, and administer such 
 oaths; and
            (ii) require, by subpoena or otherwise, the 
 attendance and testimony of such witnesses and 
 the production of such books, records, 
 correspondence, memoranda, papers, documents, 
 tapes, and materials.
        (B) Limitation on hearings.--The Commission may 
 hold a hearing under subparagraph
        (A)
            (i) only if the 
 hearing is approved--
            (i) by a majority of the members of the 
 Commission appointed under subsection

    (a)

    (2)
        (B) ; or
            (ii) by a majority of such members present 
 at a meeting when a quorum is present.

    (2) Issuance and enforcement of subpoenas.--
        (A) Issuance.--A subpoena issued under paragraph

    (1) shall--
            (i) bear the signature of the Chairperson 
 of the Commission; and
            (ii) be served by any person or class of 
 persons designated by the Chairperson for that 
 purpose.
        (B) Enforcement.--In the case of contumacy or 
 failure to obey a subpoena issued under paragraph

    (1) , 
 the United States district court for the district in 
 which the subpoenaed person resides, is served, or may 
 be found may issue an order requiring the person to 
 appear at any designated place to testify or to produce 
 documentary or other evidence.
            (C) Noncompliance.--Any failure to obey the order 
 of the court may be punished by the court as a contempt 
 of court.

    (3) Witness allowances and fees.--
        (A) In general.--

Section 1821 of title 28, United 
 States Code, shall apply to a witness requested or 
 subpoenaed to appear at a hearing of the Commission.
        (B) Expenses.--The per diem and mileage allowances 
 for a witness shall be paid from funds available to pay 
 the expenses of the Commission.

    (4) Postal services.--The Commission may use the United 
 States mails in the same manner and under the same conditions 
 as other agencies of the Federal Government.

    (5) Gifts.--The Commission may accept, use, and dispose of 
 gifts or donations of services or property.
            (d) Administrative Provisions.--

    (1) Staff.--
        (A) Director.--There shall be a full-time staff 
 director for the Commission who shall--
            (i) serve as the administrative head of the 
 Commission; and
            (ii) be appointed by the Chairperson with 
 the concurrence of the Vice Chairperson.
        (B) Other personnel.--The Commission may--
            (i) appoint such other personnel as it 
 considers advisable, subject to the provisions 
 of title 5, United States Code, governing 
 appointments in the competitive service, and 
 the provisions of chapter 51 and subchapter III 
 of chapter 53 of that title relating to 
 classification and General Schedule pay rates; 
 and
            (ii) may procure temporary and intermittent 
 services under 

section 3109

    (b) of title 5, 
 United States Code, at rates for individuals 
 not in excess of the daily equivalent paid for 
 positions at the maximum rate for GS-15 of the 
 General Schedule under 

section 5332 of title 5, 
 United States Code.

    (2) Compensation of members.--
        (A) Non-federal employees.--Each member of the 
 Commission who is not an officer or employee of the 
 Federal Government shall be compensated at a rate equal 
 to the daily equivalent of the annual rate of basic pay 
 prescribed for level IV of the Executive Schedule under 
 

section 5315 of title 5, United States Code, for each 
 day (including travel time) during which the member is 
 engaged in the performance of the duties of the 
 Commission.
        (B) Federal employees.--Each member of the 
 Commission who is an officer or employee of the Federal 
 Government shall serve without compensation in addition 
 to the compensation received for the services of the 
 member as an office or employee of the Federal 
 Government.
            (C) Travel expenses.--A member of the Commission 
 shall be allowed travel expenses, including per diem in 
 lieu of subsistence, at rates authorized for an 
 employee of an agency under subchapter I of chapter 57 
 of title 5, United States Code, while away from the 
 home or regular place of business of the member in the 
 performance of the duties of the Commission.

    (3) Cooperation.--The Commission may secure directly from 
 any Federal department or agency such information as the 
 Commission considers necessary to carry out this Act. Upon 
 request of the Chairman of the Commission, the head of such 
 department or agency shall furnish such information to the 
 Commission.

    (e) Permanent Commission.--

Section 1013 of title 5, United States 
Code, shall not apply to the Commission.

    (f) Authorization of Appropriations.--There are authorized to be 
appropriated for fiscal year 2025 and each fiscal year thereafter such 
sums as may be necessary to carry out the duties of the Commission.

SEC. 9. GRANTS FOR HOSPITALS TO PROMOTE EQUITABLE HEALTH CARE AND 
 OUTCOMES.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall award grants to 
hospitals to promote equitable health care treatment and services, and 
reduce disparities in care and outcomes.

    (b) Consultation.--In establishing the criteria for grants under 
this section and evaluating applications for such grants, the Secretary 
shall consult with the Director for Civil Rights and Health Equity of 
the Department of Health and Human Services.
            (c) Use of Funds.--A hospital shall use funds received from a grant 
under this section to establish or expand programs to provide equitable 
health care to all patients and to ensure equitable health care 
outcomes. Such uses may include--

    (1) providing explicit and implicit bias training to 
 medical providers and staff;

    (2) providing translation or interpretation services for 
 patients;

    (3) recruiting and training a diverse workforce;

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

    (5) training on cultural sensitivity.
            (d) Priority.--In awarding grants under this section, the Secretary 
shall give priority to hospitals that have received disproportionate 
share hospital payments under 

section 1886

    (r) of the Social Security 
Act (42 U.S.C. 1395ww

    (r) ) or 

section 1923 of such Act (42 U.S.C. 1396r-
4) with respect to fiscal year 2025.

    (e) Supplement, Not Supplant.--Grants awarded under this section 
shall be used to supplement, not supplant, any nongovernment efforts, 
or other Federal, State, or local funds provided to a recipient.

    (f) Equitable Health Care Defined.--The term ``equitable health 
care'' has the meaning given such term in subclause
            (VIII) 
            (cc) of 

section 1886

    (b)

    (3)
        (B)
            (viii) of the Social Security Act (42 U.S.C. 
1395ww

    (b)

    (3)
        (B)
            (viii) ), as added by 

section 4

    (a) .
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