22 Sep Health Equity Legislative and Regulatory Round-Up
The many root causes of health disparities in the US require systemic changes to mitigate income inequality and provide evidence-based education and access to resources in an equitable manner. Such causes require cross functional collaboration from policy makers, state and local government, and grassroots-organizations, catalyzing policy change from a top-down approach.
The Health Equity Collaborative endorses the following list of pro-equity legislation introduced/reintroduced by the 117th Congress and recent regulatory initiatives championed by the Biden Administration as concrete steps towards developing a more equitable healthcare ecosystem for all patients:
- Air Carrier Access Amendments Act of 2021 (H.R. 1696/S. 642):
Introduced by Rep. Langevin (D-RI) and Sen. Balwin (D-HI), this Bill would improve the overall safety of air travel and remove access barriers for passengers with disabilities by implementing new measures to enforce ACAA rules, including fines on airlines that violate them, defined mandatory accessibility standards, and removal of physical barriers to access on airplanes.
- Allied Workforce Diversity Act of 2021 (H.R. 3320/S.1679):
Introduced by Rep. Rush (D-IL) and Sen. Casey Jr. (D-PA), this Bill would provide grants to allow allied health professional programs to attract and retain diverse students in order to improve health outcomes for all Americans. Specifically, amending the Public Health Service Act to authorize assistance for increasing workforce diversity in the professions of physical therapy, occupational therapy, respiratory therapy, audiology, and speech-language pathology.
- ASAP Act of 2021 (H.R. 3317/S.1680):
Introduced by Rep. Newman (D-IL) and Sen. Duckworth (D-IL), this Bill would establish a discretionary grant program that supports local transit authority and commuter rail efforts to increase the number of existing accessible stations or facilities that meet or exceed accessibility design standards under the ADA for rapid rail and commuter rail systems. The program would appropriate $10 billion over 10 years – at least $1 billion annually – for this grant program.
- Asuncion Valdivia Heat Illness and Fatalities Prevent Act of 2021 (H.R. 2193/S.1068):
Introduced by Rep. Chu (D-CA) and Sen. Brown (D-OH), this Bill would require the Occupational Safety and Health Administration (OSHA) to establish an enforceable federal standard to protect workers from heat stress. This Department of Labor-led initiative will begin this process by: 1. Noticing a new rule-making process for indoor/outdoor heat standards for workers, implementation of unannounced inspections of workplaces when the heat goes over 80 degrees, creation of a National Emphasis Program on heat, and establish a Heat Work Group within the National Advisory Board on Labor.
- Better Care Better Jobs Act (H.R. 4131/S.2210):
Introduced by Rep. Dingell (D-MI) and Sen. Casey (D-PA) along with 39 Democratic cosponsors, this Bill would invest $400 Billion in funding towards Medicaid home and community-based services (HCBS) focused on access (expanding financial eligibility criteria for HCBS to federal limits) and strengthening the HCBS workforce.
- Black Maternal Health Momnibus Act of 2021 (H.R. 959/S.346):
Introduced by Rep. Underwood (D-IL) and Sen. Booker (D-NJ), this legislative package comprised of 12 bills addressed the social determinants of the Black maternal mortality crisis through a multifaceted approach of increased grant funding, enhanced data collection and improving community programs including improving access to housing, transportation and nutrition services.
- Communities Act (H.R. 4285):
Introduced by Rep. Rush (D-IL), this Bill would enact 100% loan forgiveness for primary care doctors who serve in medically underserved communities for five years. Specifically, for each year of service, the Department of Health and Human Services shall pay one-fifth of the total amount owed on a participating provider’s qualifying student loans. Current law caps the maximum amount of student loan repayment that a provider may receive in exchange for such service.
- Comprehensive Care for Alzheimer’s Act (H.R. 2517/S. 1125):
Introduced by Rep. Higgins (D-NY) and Sen. Stabenow (D-MI), this Bill would ask CMMI to test a different payment structure where providers are reimbursed through an annual per-patient payment so that providers can afford the upfront costs associated with developing and implementing a dementia care management program.
- DIVERSE Trials Act (H.R. 5030/S.2706):
Introduced by Rep. Ruiz (D-CA) and Sen. Menendez (D-NJ), this Bill would encourage diversity in clinical trials by requiring HHS to issue guidance on how to conduct decentralized clinical trials; exempting free digital health technology that enables trial participation from the Anti-Kickback statute; allow HHS to issue grants to community health centers and community-based organizations to support clinical trial diversity education.
- End FDA REMS Restrictions/Ban on Telehealth Delivery of Mifepristone (Press Release):
Since April 12, 2021 the FDA temporarily allowed mifepristone to be dispensed by mail for the duration of the COVID-19 public health emergency. Many consumer and women’s rights groups are calling on the FDA to permanently lift the to allow patients the ability to obtain a safe and effective abortion pill through a telemedicine consult, without risking exposure to COVID-19 with an in-person visit.
- Environmental Justice Act of 2021 (H.R. 2434/S.2630):
Introduced by Rep. Ruiz (D-CA) and Sen. Booker (D-NJ), this Bill would require agencies to address and mitigate the disproportionate impact of environmental and human health hazards on communities of color, indigenous communities, and low-income communities resulting from agencies’ programs and policies. The bill also requires agencies to address cumulative impacts of pollution in permitting decisions and expands the types of legal actions available to individuals regarding charges of federal discriminatory practices. Specifically, the bill provides statutory authority for a variety of existing programs, executive orders, federal guidance, and committees concerning environmental justice.
- Establish Universal Paid Family and Medical Leave (S. Con. Res. 14, Subtitle A):
Subtitle A within the Build Back Better Act would provide up to 12 weeks of universal paid family and medical leave for all U.S. workers.
- GLOBE Act of 2021 (H.R. 3800/S.1996):
Introduced by Rep. Titus (D-NV) and Sen. Markey (D-MA), this Bill would establish equality and justice as key components of U.S. foreign policy; affirm that discrimination, hatred, and violence against LGBTQI persons will not be tolerated by the United States; and assert that the United States government will treat LGBTQI rights as human rights throughout its foreign policy, development assistance, and immigration programs. The bill would also establish a permanent Special Envoy for the Human Rights of LGBTQI Persons at the State Department.
- Helping Adults Protect Immunity Act (H.R. 2170/S.581):
Introduced by Rep. Soto (D-FL) and Sen. Brown (D-OH), this Bill would require state Medicaid programs to cover, without cost-sharing, vaccines for adults that are recommended by the Advisory Committee on Immunization Practices.
- HOPE Act of 2021 (H.R. 2336/S.1181):
Introduced by Rep. Morelle (D-NY) and Sen. Gillibrand (D-NY), this Bill would authorize the establishment of HOPE Account Pilot Projects, HOPE Action Plans Pilot Projects, and competitive grants for pilot projects focused on combatting food insecurity and homelessness facing America’s most vulnerable populations.
- Helping Experts Accelerate Rare Treatments Act of 2021 (H.R. 1184):
Introduced by Rep. Tonko (D-NY), this Bill addresses rare diseases, including by requiring the Food and Drug Administration to ensure the inclusion of rare disease experts and staff members in various parts of the drug review process. The bill also requires certain reports to address issues related to rare diseases and drugs for treating such diseases (sometimes referred to as orphan drugs if the rarity of the disease makes it difficult for the drug to be profitable).
- Improving Access to Nutrition Act of 2021 (H.R. 1753):
Introduced by Rep. Lee (D-CA), this Bill repeals certain work requirements for the Supplemental Nutrition Assistance Program (SNAP, formerly known as the food stamp program). The requirements apply to able-bodied adults who are ages 18-49 and have no dependent children. Individuals who do not meet certain work requirements are generally prohibited from receiving more than 3 months of SNAP benefits over a 36-month period.
- Improving Health Insurance Affordability Act of 2021 (S. 499):
Introduced by Sen. Shaheen (D-NH), this Bill expands the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increases cost-sharing subsidies under the Patient Protection and Affordable Care Act.
- Medicare Medically Necessary Dental Care Act of 2021 (H.R. 5110):
Introduced by Rep. Cohen (D-TN), this Bill would provide coverage under Medicare part B for medically necessary dental procedures in conjunction with treatment of patients requiring prosthetic heart valve replacement and organ transplantation or the diagnoses of cancer of the head or neck, lymphoma, and leukemia.
- Menstrual Equity For All Act of 2021 (H.R. 3614):
Introduced by Rep. Meng (D-CA), this Bill would comprehensive initiative that seeks to help different populations of women and girls afford and access needed menstrual products, including tampons, pads and many other items. Specifically, The bill contains numerous components that include giving states the option to use federal grant funds to provide students with free menstrual products in schools, incentivizing colleges and universities to implement pilot programs that provide free menstrual products to students, ensuring that incarcerated individuals and detainees in federal, state, and local facilitates have access to free menstrual products, allowing homeless assistance providers to use grant funds that cover shelter necessities to also use that money to purchase menstrual products, requiring Medicaid to cover the cost of menstrual products, and directing large employers to provide free menstrual products for their employees in the workplace.
- Patient Access to Medical Foods Act (H.R. 56):
Introduced by Rep. Biggs (R-AZ), this Bill provides for coverage of medical foods under Medicare, Medicaid, the Children’s Health Insurance Program, and TRICARE. The bill also requires private health insurance providers to cover medical foods.
- Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 2759/S.1362):
Introduced by Rep. Butterfield (D-ND) an Sen. Grassley (R-IA), This bill provides for Medicare coverage and payment with respect to certain pharmacist services that (1) are furnished by a pharmacist in a health-professional shortage area, and (2) would otherwise be covered under Medicare if furnished by a physician.
- Protecting Seniors through Immunizations Act of 2021 (H.R. 1978/S. 912):
Introduced by Rep. Kuster (D-NH) and Sen. Hirono (D-HI), this Bill would expand access to immunizations for seniors by eliminating cost sharing for all vaccines recommended by the CDC and covered under Medicare Part D.
- PSA Screening for HIM Act (H.R. 1176):
Introduced by Rep. Rush (D-IL), this Bill would ensure at the highest risk of developing Prostate Cancer have access to screenings without facing financial barriers. Specifically amending the Public Health Service Act to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for prostate cancer screenings without the imposition of cost-sharing requirements.
- Pursuing Equity in Mental Health Act (H.R. 1475/S.1795):
Introduced by Rep. Watson Coleman (D-NJ) and Sen. Menendez (D-NJ), this Bill (which has passed the House) would authorize $805 million in grants and other funding to support research, improving the pipeline of culturally competent providers, build outreach programs that reduce stigma, and develop a training program for providers to effectively manage disparities.
- Reduced Costs and Continued Cures Act (H.R. 5260):
Introduced by Rep. Peters (D-CA), this Bill establishes a cap on seniors’ out-of-pocket drug costs, includes a “smoothing” mechanism that minimizes the impact of prescription drug costs on seniors, and establishes a $50 per month out-of-pocket maximum for insulin. Additionally, the Bill aims to address loopholes in the health care system by requiring transparency and increasing insurer responsibility for the high cost of drugs while promoting more low-cost options for patients by bolstering competition in the marketplace, and curbing gaming of the system by drug companies.
- REPEAL HIV Discrimination Act of 2021 (H.R. 1305):
Introduced by Rep. Lee (D-CA), this Bill directs the Department of Justice (DOJ), the Department of Health and Human Services (HHS), and the Department of Defense (DOD) to initiate a national review of federal (including military) and state laws, policies, regulations, and judicial precedents and decisions regarding criminal and related civil commitment cases involving people living with HIV. DOJ must transmit to Congress and make publicly available the results of such review with related recommendations.
- Reproductive Rights are Human Rights Act of 2021 (H.R. 3576/S.1864):
Introduced by Rep. Clark (D-MA) and Sen. Menendez (D-NJ), this Bill would permanently require the State Department to report on the status of reproductive rights in its annual human rights reports thereby empowering lawmakers to take action against bad actors, enact policy, and advocate for the fair treatment of all people.
- Rural STEM Education Research Act (H.R. 210/S.1374):
Introduced by Rep. Lucas (D-OK) and Sen. Wicker (R-MS), this Bill (which has passed the House) would direct the National Science Foundation (NSF) to support research regarding STEM (science, technology, engineering, and mathematics, including computer science) education in rural schools.
- South Asian Heart Health Awareness and Research Act of 2021 (H.R. 3771):
Introduced by Rep. Jayapal (D-WA), this Bill establishes, or authorizes to be established, programs that support heart-disease research and awareness among communities disproportionately affected by heart disease, including the South Asian population of the United States. Specifically, the Centers for Disease Control and Prevention must award grants to states for awareness initiatives, educational materials, and research catalogs regarding the prevalence of heart disease, including the association of type 2 diabetes, with respect to the South Asian population and other at-risk populations.
- WELL Seniors Act of 2021 (S.2174):
Introduced by Sen. King (I-ME), this Bill would include balance screenings and services to address certain social determinants of health (e.g., food and housing security) as elements that may be covered in annual wellness visits under Medicare. The bill also provides incentive payments for visits that cover such elements.