Health Equity and Accountability Act of 2026

(a) In general.— No person in the United States shall, on the basis of sex (including sexual orientation, gender identity, and pregnancy, including termination of pregnancy), race, color, national origin, marital status, familial status, sexual orientation, gender identity, or disability status, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under—

(1) any health program or activity, including any health research program or activity, receiving Federal financial assistance, including credits, subsidies, or contracts of insurance; or

(2) any health program or activity that is administered by an executive agency.

(b) Definition.— In this section, the term familial status means, with respect to one or more individuals—

(1) being domiciled with any individual related by blood or affinity whose close association with the individual is the equivalent of a family relationship;

(2) being in the process of securing legal custody of any individual; or

(3) being pregnant.

For the purposes of title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), a payment made under part A, B, C, or D of title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) to a provider of services, physician, or other supplier (including a payment made to a subcontractor of the provider of services, physician, or other supplier) shall be deemed a grant, not a contract of insurance or guaranty.

Title XXXIV of the Public Health Service Act, as amended by titles I, II, III, and IV of this Act, is further amended by inserting after subtitle D the following:

“(a) In general.—

(1) Name of Office.— Beginning on the date of enactment of this subtitle, 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.

(2) 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.

(b) Purpose.— The Director for Civil Rights and Health Equity shall ensure that the health programs, activities, policies, projects, procedures, and operations of health entities that receive Federal financial assistance are in compliance with title VI of the Civil Rights Act of 1964, including through the following activities:

(1) The development and implementation of an action plan to address racial and ethnic health care disparities. Such plan shall—

(A) address concerns relating to the Office for Civil Rights and Health Equity as released by the United States Commission on Civil Rights in the report entitled “Health Care Challenge: Acknowledging Disparity, Confronting Discrimination, and Ensuring Equity” (September 1999), in conjunction with existing and future reports of the National Academy of Medicine (formerly known as the Institute of Medicine) including the reports titled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care”, “Crossing the Quality Chasm: A New Health System for the 21st Century”, “In the Nation’s Compelling Interest: Ensuring Diversity in the Health Care Workforce”, “The National Partnership for Action to End Health Disparities”, and “The Health of Lesbian, Gay, Bisexual, and Transgender People”, and other related reports of the National Academies of Sciences, Engineering, and Medicine;

(B) be issued in proposed form for public review and comment; and

(C) be finalized taking into consideration any comments or concerns that are received by the Office.

(2) Investigative and enforcement actions against intentional or in effect discrimination and policies and practices that have a disparate impact on racial and ethnic minority groups and communities of color pursuant to section 9007 of the Health Equity and Accountability Act of 2026.

(3) The review of racial, ethnic, gender identity, sexual orientation, sex, disability status, socioeconomic status, and primary language health data collected by Federal health agencies to assess health care disparities related to intentional discrimination and policies and practices that have a disparate impact on minorities. Such review shall include an assessment of health disparities in communities with a combination of these classes.

(4) Outreach and education activities relating to compliance with title VI of the Civil Rights Act of 1964, including the process of filing a complaint in accordance with section 9007 of the Health Equity and Accountability Act of 2026.

(5) The provision of technical assistance for health entities to facilitate compliance with title VI of the Civil Rights Act of 1964.

(6) Coordination and oversight of activities of the civil rights compliance offices established under section 3452.

(7) Ensuring—

(A) at a minimum, compliance with the most recent version of the Office of Management and Budget statistical policy directive entitled “Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity”; and

(B) consideration of available data and language standards such as—

(i) the standards for collecting, monitoring, and reporting data under section 3101; and

(ii) the National Standards on Culturally and Linguistically Appropriate Services of the Office of Minority Health.

(c) Funding and staff.— The Secretary shall ensure the effectiveness of the Office for Civil Rights and Health Equity by ensuring that the Office is provided with—

(1) adequate funding to enable the Office to carry out its duties under this section; and

(2) staff with expertise in—

(A) epidemiology;

(B) statistics;

(C) health quality assurance;

(D) minority health and health disparities;

(E) health equity;

(F) cultural and linguistic competency;

(G) civil rights; and

(H) social, political, mental, behavioral, economic, and related determinants of health, including education access and quality, health care access and quality, neighborhood and built environment, and social and community context.

(d) Advisory board.—

(1) Establishment.— The Secretary, in collaboration with the Director Civil Rights and Health Equity and the Deputy Assistant Secretary for Minority Health, shall establish an advisory board (in this subsection referred to as the “advisory board”) to report in accordance with paragraph (2).

(2) Reports to Congress.— Not later than December 31, 2027, and annually thereafter, the advisory board shall publish and submit to the Office, other Federal agencies, and the Congress a report that includes—

(A) the number of complaints filed in accordance with section 9007 of the Health Equity and Accountability Act of 2026 during the reporting period under title VI of the Civil Rights Act of 1964, broken down by category;

(B) the number of such complaints investigated and closed by the Office;

(C) the outcomes of such complaints investigated;

(D) the staffing levels of the Office, including staff credentials;

(E) the number of such complaints that are pending (including backlogged complaints) in which civil rights inequities can be demonstrated and an explanation of why such complaints remain pending; and

(F) trends among filed complaints and other systemic patterns or themes, including an analysis from the Department of Justice about litigation concerning such complaints.

(3) Composition.— The members of the advisory board shall include—

(A) representatives of stakeholders; and

(B) subject matter- and disciplinary-appropriate experts.

(e) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2027 through 2030.

(a) In general.— The Secretary shall establish civil rights compliance offices in each agency within the Department of Health and Human Services that administers health programs.

(b) Purpose of offices.— Each office established under subsection (a) shall ensure that recipients of Federal financial assistance under Federal health programs administer programs, and determine and implement policies, services, and activities, in a manner that—

(1) does not discriminate, either intentionally or in effect, on the basis of race, color, national origin, language, ethnicity, sex, age, disability status, sexual orientation, or gender identity; and

(2) promotes the reduction and elimination of disparities in health and health care based on race, color, national origin, language, ethnicity, sex, age, disability status, sexual orientation, or gender identity.

(c) Powers and duties.— The offices established in subsection (a) shall, with respect to the applicable agency, have the following powers and duties:

(1) The establishment of compliance and program participation standards for recipients of Federal financial assistance under each program administered by the agency, including the establishment of disparity reduction standards to encompass disparities in health and health care related to race, color, national origin, language, ethnicity, sex, age, disability, sexual orientation, or gender identity.

(2) The development and implementation of policies, procedures, and program-specific guidelines that interpret and apply Department of Health and Human Services guidance under title VI of the Civil Rights Act of 1964 and section 1557 of the Patient Protection and Affordable Care Act to each Federal health program administered by the agency.

(3) The development of a disparity-reduction impact analysis methodology that shall—

(A) be applied to every rule issued by the agency and published as part of the formal rulemaking process under sections 555, 556, and 557 of title 5, United States Code; and

(B) include an analysis of the intersecting forms of discrimination.

(4) Oversight of data collection, reporting, analysis, and publication requirements for all recipients of Federal financial assistance under each Federal health program administered by the agency, compliance with, at a minimum, the most recent version of the Office of Management and Budget statistical policy directive entitled “Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity”, and consideration of available data and language standards such as—

(A) the standards for collecting and reporting data under section 3101;

(B) the National Standards on Culturally and Linguistically Appropriate Services of the Office of Minority Health; and

(C) the disaggregation of all health and health care data by racial and ethnic minority group.

(5) The conduct of publicly available studies regarding discrimination within Federal health programs administered by the agency as well as disparity reduction initiatives by recipients of Federal financial assistance under Federal health programs.

(6) Annual reports to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives on the progress in reducing disparities in health and health care through the Federal programs administered by the agency.

(d) Relationship to Office for Civil Rights in the Department of Justice.—

(1) Department of Health and Human Services.— The Office for Civil Rights of the Department of Health and Human Services shall provide standard-setting and compliance review investigation support services to each civil rights compliance office established under subsection (a), subject to paragraph (2).

(2) Department of Justice.— The Office for Civil Rights of the Department of Justice may, as appropriate, institute formal proceedings when a civil rights compliance office established under subsection (a) determines that a recipient of Federal financial assistance is not in compliance with the disparity reduction standards of the applicable agency.

(e) Definition.— In this section, the term Federal health programs mean programs—

(1) under the Social Security Act that pay for health care and services; and

(2) under this Act that—

(A) provide Federal financial assistance for health care, biomedical research, or health services research; or

(B) are designed to improve the public’s health, including health service programs.”.

(a) Coordination within Department of Justice of activities regarding Health disparities.— Section 3(a) of the Civil Rights Commission Act of 1983 (42 U.S.C. 1975a(a)) is amended—

(1) in paragraph (1), by striking “and” at the end;

(2) in paragraph (2), by striking the period at the end and inserting “; and”; and

(3) by adding at the end the following:

“(3) shall, with respect to activities carried out in health care and correctional facilities, toward the goal of eliminating health disparities between the general population and members of minority groups based on race or color, promote coordination of such activities of—

(A) the Office of Justice Programs of the Department of Justice, including the Office for Civil Rights within that Office;

(B) the Office for Civil Rights within the Department of Health and Human Services; and

(C) the Office of Minority Health within the Department of Health and Human Services.”.

(b) Authorization of appropriations.— Section 5 of the Civil Rights Commission Act of 1983 (42 U.S.C. 1975c) is amended by striking the first sentence and inserting the following: “For the purpose of carrying out this Act, there are authorized to be appropriated $30,000,000 for fiscal year 2027, and such sums as may be necessary for each of the fiscal years 2028 through 2032.”.

It is the sense of the Congress that—

(1) health disparities negatively impact outcomes for health and human security of the Nation;

(2) reducing racial, ethnic, age, sexual, and gender disparities in prevention and treatment are unique civil and human rights challenges and, as such, Federal agencies and health care entities and systems receiving Federal funds should be accountable for their role in causing disparities and inequity;

(3) funding for the National Institute on Minority Health and Health Disparities, the Office of Civil Rights in the Department of Health and Human Services, the National Institute of Nursing Research, and the Office of Minority Health should be doubled by fiscal year 2027, to effectively address racial and ethnic disparities elimination in health and health care as a matter of health and national security;

(4) adequate funding by fiscal year 2027, and subsequent funding increases, should be provided for health and human service professions training programs, the Racial and Ethnic Approaches to Community Health Initiative at the Centers for Disease Control and Prevention, the Minority HIV/AIDS Initiative, the Excellence Centers to Eliminate Ethnic/Racial Disparities Program at the Agency for Healthcare Research and Quality, and the National Health Service Corps Scholarship Program initiatives, programs, policies, projects, and activities that are the backbone of the Nation’s agenda to eliminate racial and ethnic health disparities and inequities;

(5) adequate funding for fiscal year 2027 and increased funding for future years should be provided for the Racial and Ethnic Approaches to Community Health Initiative’s United States Risk Factor Survey to ensure adequate data collection to track health disparities, and there should be appropriate avenues provided to disseminate findings to the general public;

(6) current and newly created health disparity elimination incentives, programs, agencies, and departments under this Act (and the amendments made by this Act) should receive adequate staffing and funding by fiscal year 2027; and

(7) stewardship and accountability should be provided to the Congress and the President for measurable and sustainable progress toward health disparity elimination under programs under this Act, including increased data collection and reporting, capacity building for impacted communities, technical assistance, training programs, and avenues to disseminate program details and successes to the public and to policymakers.

(a) GAO report on NIH grant racial and ethnic diversity.—

(1) In general.— The Comptroller General of the United States shall conduct a study on the racial and ethnic diversity among the following groups:

(A) All applicants for grants, contracts, and cooperative agreements awarded by the National Institutes of Health during the period beginning on January 1, 2027, and ending December 31, 2035.

(B) All recipients of such grants, contracts, and cooperative agreements during such period.

(C) All members of the peer review panels of such applicants and recipients, respectively.

(2) Report.— Not later than 6 months after the date of enactment of this Act, the Comptroller General shall complete the study under paragraph (1) and submit to Congress a report containing the results of such study.

(b) NIH report on certain authority of National Institute on Minority Health and Health Disparities.— Not later than 6 months after the date of enactment of this Act, and biennially thereafter, the Director of the National Institutes of Health, in collaboration with the Director of the National Institute on Minority Health and Health Disparities, shall submit to Congress a report that details and evaluates—

(1) the steps taken during the applicable report period by the Director of the National Institutes of Health to plan, coordinate, review, and evaluate all minority health and health disparity research that is conducted or supported by the institutes and centers at the National Institutes of Health; and

(2) the outcomes of such steps.

(c) GAO report related to recipients of PPACA funding.— Not later than one year after the date of enactment of this Act and biennially thereafter, the Comptroller General of the United States shall submit to Congress a report that identifies—

(1) the racial and ethnic diversity of community-based organizations that applied for Federal enrollment funding provided pursuant to the Patient Protection and Affordable Care Act (Public Law 111–148) (including the amendments made by such Act);

(2) the percentage of such organizations that were awarded such funding; and

(3) the impact of such community-based organizations’ enrollment efforts on the insurance status of their communities.

(d) Annual report on activities of National Institute on Minority Health and Health Disparities.— The Director of the National Institute on Minority Health and Health Disparities shall prepare an annual report on the activities carried out or to be carried out by such institute, and shall submit each such report to the Committee on Health, Education, Labor, and Pensions of the Senate, the Committee on Energy and Commerce of the House of Representatives, the Secretary of Health and Human Services, and the Director of the National Institutes of Health. With respect to the fiscal year involved, the report shall—

(1) describe and evaluate the progress made in health disparities research conducted or supported by institutes and centers of the National Institutes of Health;

(2) summarize and analyze expenditures made for activities with respect to health disparities research conducted or supported by the National Institutes of Health;

(3) include a separate statement applying the requirements of paragraphs (1) and (2) specifically to minority health disparities research; and

(4) contain such recommendations as the Director of the Institute considers appropriate.

(a) In general.— In carrying out the investigative and enforcement actions of section 3451(b)(2) of the Public Health Service Act, as added by section 9003 of this Act, the Director for Civil Rights and Health Equity (referred to in this section as the “Director”) shall pursue such investigative and enforcement actions pursuant to 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.

(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.

(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) Publicly available agreement.—

(i) In general.— Subject to clause (ii), the Secretary shall make available to the public 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 public 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.

(a) Establishment of Commission.—

(1) In general.— There is established the Federal Health Equity Commission (hereinafter 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 listed 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) Four members of the Commission shall be appointed by the President.

(ii) Two 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) Two 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 appointed under paragraph (2)(B) of the Commission 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 14 of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Commission.

(f) Authorization of appropriations.— There are authorized to be appropriated for fiscal year 2027 and each fiscal year thereafter such sums as may be necessary to carry out the duties of the Commission.