The "Equal Health Care for All Act" seeks to eliminate discrimination and ensure equitable health care for all individuals, recognizing that health inequities persist, particularly for communities of color. The bill highlights that systemic inequalities and explicit or implicit bias contribute to poorer health outcomes based on factors like race, national origin, sex, disability, age, and religion. It emphasizes the importance of addressing these disparities, drawing parallels to efforts to eliminate bias in other societal sectors.

To address these issues, the legislation mandates that the Secretary of Health and Human Services require health care providers and facilities to disaggregate reported health outcomes data by demographic characteristics, including race, sex, disability, and age. This disaggregated data will be stored in a new, non-individually identifiable repository established by the Secretary within one year. This comprehensive data collection aims to identify patterns of inequitable health care provision.

The bill integrates equitable health care as a value measurement within Medicare's Hospital Value-Based Purchasing Program, effective fiscal year 2026. This requires the Secretary to adopt measures related to equitable care, accounting for social determinants of health to avoid penalizing hospitals for factors outside their control. Equitable health care is defined as the principle that high-quality care should be provided to all individuals without variation based on real or perceived race, national origin, sex (including sexual orientation and gender identity), disability, or age.

Furthermore, the bill establishes that a pattern of inequitable provision of health care can serve as a basis for permissive exclusion from Medicare and other federal health care programs. However, an exception is made if such exclusion would increase difficulty in accessing health care services for underserved or low-income communities. This provision aims to hold providers accountable while protecting vulnerable populations.

The legislation renames the Office for Civil Rights of the Department of Health and Human Services to the Office for Civil Rights and Health Equity, with its head, the Director for Civil Rights and Health Equity, appointed by the President. This enhanced office is central to enforcing the bill's provisions. It will oversee an administrative complaint and conciliation process for individuals alleging inequitable health care.

A core provision prohibits any health care provider from subjecting an individual to the inequitable provision of health care based on race, sex, disability, age, or religion. Aggrieved persons can file complaints with the Director, triggering investigations that may examine patterns of care and account for social determinants of health. The process includes conciliation, and failure to comply with agreements can lead to Attorney General enforcement.

Individuals can also pursue civil actions in court if administrative processes are exhausted or certified for immediate suit, seeking actual and punitive damages or injunctive relief. The Attorney General may also initiate civil actions for patterns or practices of inequitable care or cases of significant public importance. Penalties for violations can include punitive damages up to $1,000,000 for subsequent offenses.

The bill establishes a Federal Health Equity Commission to monitor and report on the implementation of this Act and progress toward health equity. This Commission, composed of appointed voting members and ex officio members, will submit annual reports to the President and Congress with recommendations. It is granted powers to hold hearings and issue subpoenas to fulfill its oversight duties.

Finally, the Act authorizes the Secretary of Health and Human Services to award grants to hospitals to promote equitable health care and reduce disparities. These grants can fund initiatives such as providing explicit and implicit bias training to staff, offering translation or interpretation services for patients, recruiting and training a diverse workforce, tracking data related to care and outcomes, and providing training on cultural sensitivity. Priority for these grants will be given to hospitals serving disproportionate shares of low-income patients.