Social Determinants and Health Disparities Legislation

Aligning for Health has been active in advocating for key legislative solutions to address social determinants, including through the introduction of the Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509/H.R. 6072) and the reintroduction of the Social Determinants Accelerator Act of 2021 (H.R. 2503/S. 3039).

Aligning for Health is proud to support the Social Determinants Accelerator Act of 2021, a bipartisan bill introduced in the House (H.R. 2503) by Reps. Bustos (D-IL), Cole (R-OK), McGovern (D-MA), and Mullin (R-OK) and in the Senate (S. 3039) by Senators Young (R-IN) and Stabenow (D-MI).
The Social Determinants Accelerator Act of 2021 will help states and communities devise strategies to better leverage existing programs and authorities to improve the health and well-being of those participating in Medicaid by creating an inter-agency social determinants council and providing planning grants and technical assistance to state, local and Tribal governments to help them devise innovative, evidence-based approaches to coordinate services and improve outcomes and cost-effectiveness.

Aligning for Health is proud to support the Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act, which was introduced in the Senate (S.509) by Senators Dan Sullivan (R-AK) and Chris Murphy (D-CT) and in the House (H.R. 6072) by Representatives Dan Kildee (D-MI), Jackie Walorski (R-IN), Lisa Blunt Rochester (D-DE), and Richard Hudson (R-NC).

The LINC to Address Social Needs Act would assist States in establishing statewide or regional public-private partnerships to better coordinate health care and social services, leveraging local expertise and technology to overcome longstanding challenges in linking people to health, food, housing, child development, job training, and transportation supports and services.

Senate Finance Committee Response on Health Disparities

  • On July 8th, 2020, Aligning for Health sent a letter to Senate Finance Committee Chair Grassley (R-IA) in response to a request for input on steps the Committee can take to address health disparities.
  • AFH strongly supports the Committee’s efforts to assess and discuss what actionable steps Congress can take to improve access to, and the coordination of, public health, health care, and social services both during and after the public health emergency subsides.
  • AFH noted that the Social Determinants Accelerator Act (S. 2986/H.R. 4004) is a bipartisan, bicameral proposal that has been referred for consideration by the Senate Finance Committee and if passed, would take important steps toward improving the health of families on Medicaid by helping to address their social needs.

Senate HELP Response on Preparing for the Next Pandemic

  • On June 26th 2020, Aligning for Health sent a letter to Senate HELP Committee Chair Alexander (R-TN) in response to a request for information on  recommendations for creating a system of health care resiliency and preparing for the next pandemic.
  • AFH recommended strengthening medical and social care alignment, noting that social service networks are generally not connected to the health care system in a sustainable way.  Congress should take advantage of this moment to catalyze a large-scale effort to build community-based infrastructure that will efficiently allow health and social providers to collaborate while maintaining accountability among entities for better health outcomes.
  • AFH recommended that Congress take up consideration of a proposal to help states develop community integration networks. AFH described the need to provide seed funding to states to develop and launch community integration networks built around a lead entity and which connect payers, providers, community based organizations, and state agencies.

Senate Finance Committee Response on Maternal Health

  • On March 20, 2020, Aligning for Health sent a letter to the Senate Finance Committee in response to a request for information on solutions to improve maternal health.
  • In its letter, AFH noted that the Social Determinants Accelerator Act (S. 2986/H.R. 4004) would provide funding for states and localities to design and tailor approaches and strategies that meet their residents’ needs, which could be focused on efforts to improve maternal health.

Ways and Means Response on Rural and Underserved Communities Health Task Force

  • On November 27, 2019, Aligning for Health sent a letter to the Ways and Means Rural and Underserved Communities Health Task Force in response to a request for information on November 15, 2019. In response to the RFI, AFH described barriers that impede coordination between health and social service programs, and the lack of comprehensive evidence around interventions focused on the social determinants of health, which limits the replicability or scaling of successful interventions.

Care That’s Fair Act of 2021 Letter of Support

Aligning for Health is proud to endorse the Care That’s Fair Act of 2021 (H.R. 4554), introduced by Reps. Butterfield (D-NC) and Joyce (R-OH). This bill would provide grants for support for States to identify and act on racial disparities, and seeks to empower states to utilize medical claims, clinical, and social data to address racial disparities, social determinants of health, and maternal and infant mortality.

The Improving Social Determinants of Health Act of 2020 Letter of Support

Aligning for Health is proud to endorse the Improving Social Determinants of Health Act of 2020 introduced by Rep. Barragan (D-CA), which would authorize the CDC to create a program to improve health outcomes and reduce health inequities by coordinating CDC social determinants of health activities and improve the capacity of public health agencies and community organizations to address social determinants of health.

CARING Act Letter of Support

Aligning for Health thanks Representatives Blunt Rochester (D-NY) and Bilirakis (R-FL) for introducing the Collecting and Analyzing Resources Integral and Necessary for Guidance (CARING) for Social Determinants Act of 2019. The bill would require the Department of Health and Human Services to provide guidance for states to address social determinants of health under Medicaid and the Children’s Health Insurance Program (CHIP). This is an important bipartisan step in the right direction to help states address social determinants of health.

UNDERSTAND ACT Letter of Support

Aligning for Health is proud to support the introduction of S. 1323, the Utilizing National Data, Effectively Reforming Standards and Tools, to Address Negative Determinants of Health (UNDERSTAND) Act, which would improve the collection of data related to the social determinants of health for Medicare and Medicaid beneficiaries.

Aligning for Health has also endorsed the following legislation: CARING for Social Determinants Act of 2021 (H.R. 3894); Addressing Social Determinants of Health in Medicare Advantage Act (H.R. 4074); Building a Sustainable Workforce for Healthy Communities Act (S. 3479); White House Conference on Food, Nutrition, Hunger, and Health Act (H.R. 5724/S. 3064); John Lewis Equality in Medicare & Medicaid Treatment (EMMT) Act (S. 4067/H.R. 7755); Social Determinants of Health Data Analysis Act (H.R. 4026); IMPACT to Save Moms Act (H.R. 950/S. 334); Moms Matter Act (H.R. 909/S. 484); Kira Johnson Act (H.R. 1212/S. 1042); Social Determinants for Moms Act (H.R. 943/S. 851).

Read More about SDAA
Read More About LINC

Other Social Determinants Legislation

Here is a full list, updated regularly, of other pieces of legislation related to social determinants, health disparities, health equity and maternal health in the 118th Congress.

To see a full list of the legislation related to social determinants, health disparities, and health equity from the 116th Congress, click here.

To see a full list of legislation related to social determinants, health disparities/health equity, and maternal health from the 117th Congress, click here.

House of Representatives

H.R. 68 – Housing Fairness Act of 2023

  • Introduced by Rep. Green (D-TX), this bill would authorize funds to prevent housing discrimination through the use of nationwide testing, to increase funds for the Fair Housing Initiatives Program.

H.R. 309 – Opportunity to Address College Hunger Act

  • Introduced by Reps. Bonamici (D-OR) and 54 cosponsors, this bill would require institutions of higher education to provide notice to students receiving work-study assistance about potential eligibility for participation in the supplemental nutrition assistance program.

H.R. 476 – Helping Households And Neighbors Distribute Services (HANDS) for Families Act (bipartisan)*

  • Introduced by Reps. Miller (R-WV) and Chu (D-CA), this bill would allow community supports to meet specific needs of families and children through an electronic care portal under the MaryLee Allen Promoting Safe and Stable Families program. The bill would permit states to use already-allocated money to access online portals that connect families in need with resources such as pregnancy centers, child care programs, food pantries, churches, and non-profits.

H.R. 479 – Targeting Child Care Funds Based on Poverty Act

  • Introduced by Rep. Miller (R-WV), this bill would target additional childcare funds by allocating to States based on the number of children in poverty in each state. This legislation will provide federal resources to families who need them most through greater flexibility and access to affordable child care, and paid family and medical leave.

H.R. 491 – Return Home to Housing Act (bipartisan)

  • Introduced by Reps. Williams (D-GA), Tenney (R-NY), Jacobs (D-CA) and Garbarino (R-NY), this bill would adjust the rate of per diem payments provided by the Secretary of Veterans Affairs to grantees that provide services to homeless veterans.

H.R. 516 – Fighting Homelessness Through Services and Housing Act*

  • Introduced by Reps. Lieu (D-CA), Kamlager-Dove (D-CA), and Garcia (D-CA), this bill would authorize a $1 billion annual grant program within HRSA for housing programs that offer comprehensive services and intensive case management for homeless individuals and families.

H.R. 523 – Veterans Jobs Training Act

  • Introduced by Reps. Neguse (D-CO) and Bowman (D-NY), this bill would increase the authorization of appropriations for homeless veteran reintegration programs.

H.R. 645 – Healthy Foundations for Homeless Veterans Act

  • Introduced by Rep. Cherfilus-McCormick (D-FL) and nine cosponsors, this bill would permanently authorize the use of certain funds to improve flexibility in the provision of assistance to homeless veterans.

H.R. 706 – SNAP Access for Medically Vulnerable Children Act

  • Introduced by Reps. Brown (D-OH), Kaptur (D-OH), Hayes (D-CT), and Bishop (D-GA), this bill would allow households with children with chronic medical conditions to deduct allowable medical expenses incurred by such household member that exceeds $35 per month.

H.R. 773 – Homelessness and Behavioral Health Care Coordination Act

  • Introduced by Reps. Dean (D-PA) and Garcia (D-TX), this bill would help persons in the United States experiencing homelessness and significant behavioral health issues, including substance use disorders, by authorizing a grant program within the Department of Housing and Urban Development to assist State and local governments, Continuums of Care, community-based organizations that administer both health and homelessness services, and providers of services to people experiencing homelessness, better coordinate health care and homelessness services.

H.R. 837 – Restoring Communities Left Behind Act

  • Introduced by Reps. Kaptur (D-OH), Tlaib (D-MI), and 10 cosponsors, this bill would direct the Secretary of Housing and Urban Development to establish a grant program to help revitalize certain localities, including through activities such as homeowner rehabilitation assistance, weatherization, improved housing accessibility for seniors and people with disabilities, housing counseling, and more.

H.R. 893 – Heating and Cooling Relief Act*

  • Introduced by Rep. Bowman (D-NY) and 35 cosponsors, this bill would amend the Low-Income Home Energy Assistance Act of 1981 to increase the availability of heating and cooling assistance.

H.R. 981 – One Stop Shop Community Reentry Program Act

  • Introduced by Reps. Kamlager-Dove (D-CA) and Brown (D-OH), this bill would authorize implementation grants to community-based nonprofits to operate one-stop reentry centers that centralize housing, job training, mental health counseling, and other vital services in a single location.

H.R. 1066 – Collecting and Analyzing Resources Integral and Necessary for Guidance (CARING) for Social Determinants Act of 2023 (bipartisan)

  • Introduced by Reps. Blunt Rochester (D-DE) and Bilirakis (R-FL), this bill would require the Secretary of HHS to issue and disseminate guidance to states to clarify strategies to address social determinants of health under Medicaid and CHIP.

H.R. 1230

  • Introduced by Rep. Carson (D-IN) and 34 cosponsors, this bill would direct the Secretary of Agriculture to make grants to states to support the establishment and operation of grocery stores in underserved communities.

H.R. 1269 – Healthy Meals Help Kids Learn Act

  • Introduced by Rep. McGovern (D-MA), this bill would permanently increase federal reimbursement rates of school meals to help address funding challenges, enhance menus, increase access to locally grown food, and support expanded services like afterschool snacks and breakfast in classrooms.

H.R. 1334 – Liberty City Rising Act*

  • Introduced by Rep. Wilson (D-FL), this bill would reform requirements regarding the safety and security of families living in public and federally assisted housing located in high-crime areas.

H.R. 1424 – Helping Schools Feed Kids Act (bipartisan)

  • Introduced by Reps. Spanberger (D-VA) and Fitzaptrick (R-PA), this bill would extend additional reimbursement rates for certain child nutrition programs.

H.R. 1427 – SNAP Second Chance Act

  • Introduced by Reps. Trone (D-MD), Correa (D-CA), McGovern (D-MA), Watson Coleman (D-NJ), Smith (D-WA), and Del. Norton (D-DC), this bill would limit the use of business integrity and reputation factors when determining the eligibility of a retail food store or a wholesale food concern to be approved to redeem supplemental nutrition assistance program benefits.

H.R. 1509 – Healthy Food Financing Initiative (HFFI) Reauthorization Act of 2023*

  • Introduced by Reps. Lee (D-CA), Brown (D-OH), and Evans (D-PA), this bill would reauthorize the Healthy Food Financing Imitative, a critical public-private partnership that combats America’s obesity epidemic by providing access to affordable, healthy, and fresh food options. HFFI provides loan and grant financing to attract grocery stores and other fresh food retailers to underserved, urban, suburban, and rural areas, and renovates and expands existing stores so they can provide the healthy foods communities need.

H.R. 1510 – Improving Access to Nutrition Act

  • Introduced by Rep. Lee (D-CA), Adams (D-NC) and 40 cosponsors, this bill would repeal the particular work requirement that disqualifies able-bodied adults for eligibility to participate in SNAP to ensure that all Americans have access to nutritious food and the ability to stay healthy in everyday life.

Senate

S. 24 – Fighting Homelessness Through Services and Housing Act*

  • Introduced by Sens. Feinstein (D-CA), Padilla (D-CA), Klobuchar (D-MN), and Shaheen (D-NH), this bill would authorize a $1 billion annual grant program within HRSA for housing programs that offer comprehensive services and intensive case management for homeless individuals and families.

S. 32 – Choice in Affordable Housing Act of 2023 (bipartisan)

  • Introduced by Sens. Coons (D-DE), Cramer (R-ND), Warnock (D-GA), Smith (D-MN), and Moran (R-KS), this bill would increase the number of landlords participating in the Housing Choice Voucher program.

S. 73 – Helping Households And Neighbors Distribute Services (HANDS) for Families Act (bipartisan)*

  • Introduced by Sens. Rubio (R-FL) and Casey (D-PA), this bill would allow community supports to meet specific needs of families and children through an electronic care portal under the MaryLee Allen Promoting Safe and Stable Families program. The bill would permit states to use already-allocated money to access online portals that connect families in need with resources such as pregnancy centers, child care programs, food pantries, churches, and non-profits.

S. 290 – Preserving Our Commitment to Homeless Veterans Act

  • Introduced by Sen. Rubio (R-FL), this bill would require the Secretary of Veterans Affairs to ensure that the supported housing program of the Department of Veterans Affairs has not fewer than one program manager for every 35 rental assistance cases under such program.

S. 324 – Study, Treat, Observe, and Prevent (STOP) Neglected Diseases of Poverty Act

  • Introduced by Sen. Booker (D-NJ), this bill would authorize the Secretary of HHS to carry out activities relating to neglected diseases of poverty. The bill would create an Interagency Task Force to provide recommendations to the HHS Secretary, provide resources to states to implement a public health surveillance system to determine prevalence and distribution of these illnesses, require the development of educational programs, and facilitate research to address and eliminate these diseases.

S. 405 – Heating and Cooling Relief Act*

  • Introduced by Sens. Markey (D-MA), Warren (D-MA), Gillibrand (D-NY), Blumenthal (D-CT), Booker (D-NJ), Sanders (I-VT), and Padilla (D-CA), this bill would amend the Low-Income Home Energy Assistance Act of 1981 to increase the availability of heating and cooling assistance.

S. 497 – Military Family Nutrition Access Act (bipartisan)

  • Introduced by Sens. Duckworth (D-IL), Murkowski (R-AK), and 15 cosponsors, this bill would exclude a basic allowance for housing from income for purposes of eligibility for SNAP. The bill aims to support active duty military families experiencing food insecurity and prevent hunger in these families.

S. 578 – Liberty City Rising Act*

  • Introduced by Sen. Rubio (R-FL), this bill would reform requirements regarding the safety and security of families living in public and federally assisted housing located in high-crime areas.

S. 643 (bipartisan)

  • Introduced by Sens. Ossoff (D-GA) and Ernst (R-IA), this bill would modernize the farmers’ market nutrition program under the special supplemental nutrition program for women, infants, and children.

S. 657 – Neighborhood Homes Investment Act (NHIA) (bipartisan)

  • Introduced by Sens. Cardin (D-MD), Young (R-IN), Wyden (D-OR), Moran (R-KS), and Brown (D-OH), this bill would establish a tax credit for neighborhood revitalization in distressed neighborhoods. The bill would cover the cost between building or renovating a home in these areas so that homeowners can renovate and stay in their homes, and caps the price of sales for each home to ensure they are affordable housing options in the community.

S. 665 – Conrad State 30 and Physician Access Reauthorization Act (bipartisan)

  • Introduced by Sens. Klobuchar (D-MN), Collins (R-ME), and 17 cosponsors, this bill would provide incentives to physicians to practice in rural and medically underserved communities.

S. 680 – Decent, Affordable, Safe Housing for All (DASH) Act

  • Introduced by Sen. Wyden (D-OR), this bill would provide rental vouchers for the homeless, expand essential services to ensure permanent housing stability, create new down payment tax credit for first-time homebuyers, and expand the production of affordable housing for low-income and middle-income families.

S. 703 – Physicians for Underserved Areas Act (bipartisan)

  • Introduced by Sens. Rosen (D-NV) and Boozman (R-AR), this bill would make improvements to the redistribution of residency slots under the Medicare program to give medical residency programs in areas with physician shortages a greater chance of gaining available residency slots after hospital closures take place elsewhere in the country.

S. 705 – Specialty Physicians Advancing Rural Care (SPARC) Act (bipartisan)

  • Introduced by Sens. Rosen (D-NV) and Wicker (R-MS), this bill would authorize a loan repayment program to encourage specialty medicine physicians and non-physician specialty providers to serve in rural communities experiencing a shortage of specialty medicine physicians.

S. 735 (bipartisan)

  • Introduced by Sens. Reed (D-RI), Collins (R-ME), Van Hollen (D-MD), Cortez Masto (D-NV), and Klobuchar (D-MN), this bill would strengthen the United States Interagency Council on Homelessness.

S. 760 – Healthy Food Financing Initiative (HFFI) Reauthorization Act of 2023*

  • Introduced by Sens. Casey (D-PA) and Gillibrand (D-NY), this bill would reauthorize the Healthy Food Financing Imitative, a critical public-private partnership that combats America’s obesity epidemic by providing access to affordable, healthy, and fresh food options. HFFI provides loan and grant financing to attract grocery stores and other fresh food retailers to underserved, urban, suburban, and rural areas, and renovates and expands existing stores so they can provide the healthy foods communities need.

* Denotes bicameral legislation

House of Representatives

H.R. 232 – Real Justice for Our Veterans Act of 2023

  • Introduced by Rep. Jackson Lee (D-TX), this bill would prioritize veterans treatment court programs that ensure equal access for racial and ethnic minorities and women, and requires DOJ’s Bureau of Justice Assistance to implement a pilot program to make grants for local governments to improve retention in veteran treatment court programs and drug court programs.

H.R. 417 – Tribal Healthcare Careers Act

  • Introduced by Rep. Gomez (D-CA), this bill would require the Department of Health and Human Services (HHS) to reserve a portion of Health Profession Opportunity Grants for Indian tribes, tribal organizations, and tribal colleges and universities.

H.R. 418 – Affordable Housing Equity Act of 2023

  • Introduced by Rep. Gomez (D-CA), this bill would designate projects serving extremely low-income households for purposes of allocating the State housing credit ceiling and determining an increased amount of low-income housing tax credit.

H.R. 420 – Language Access for Medicare Beneficiaries Act of 2023

  • Introduced by Rep. Gomez (D-CA), this bill would provide for enhanced Medicare beneficiary information through access to annual Medicare notifications in multiple languages.

H.R. 613 – Wayne Ford Racial Impact Statement Act of 2023

  • Introduced by Reps. Torres (D-NY), Kamlager-Dove (D-CA), and Crockett (D-TX), this bill would establish a process for the creation of minority impact assessments to determine whether pending bills, if enacted, are likely to create or exacerbate disparate outcomes among racial or ethnic minority groups

H.R. 827 – Home Internet Accessibility Act (bipartisan)

  • Introduced by Reps. Williams (D-GA) and Timmons (R-SC), this bill would require the Comptroller General to submit to Congress a report on the capacity of federally assisted housing to support broadband service, and would task the Department of Housing and Urban Development with producing an action plan to close internet service gaps across the country.

H.R. 834 – Rural Physician Workforce Production Act of 2023 (bipartisan)*

  • Introduced by Reps. Harshbarger (R-TN), Schrier (D-WA), Cuellar (D-TX), and Bacon (R-NE), this bill would support rural residency training funding that is equitable for all States. The bill would improve Medicare reimbursements and enhance the current structure of the Medicare-funded graduate medical education program to bring more medical residents and doctors to rural areas.

H.R. 1041 – American Opportunity Accounts Act*

  • Introduced by Rep. Pressley (D-MA) and 30 cosponsors, this bill would establish American opportunity accounts, or federally funded savings accounts, for every child in order to make economic opportunity a birthright for every American and help close the racial wealth gap.

H.R. 1412 – Digital Equity Foundation Act*

  • Introduced by Reps. Matsui (D-CA), Bonamici (D-OR), Eshoo (D-CA), Smith (D-WA), Grijalva (D-AZ), and Carter (D-LA), this bill would establish the Foundation for Digital Equity, a nonprofit foundation that would channel public and private investments into making progress in closing the divide on digital equity, inclusion, and literacy.

H.R. 1589

  • Introduced by Reps. Leger Fernandez (D-NM), McGovern (D-MA), Stansbury (D-NM), and Gallego (D-AZ), this bill would improve nutrition in tribal areas.

Senate

S.230 – Rural Physician Workforce Production Act of 2023 (bipartisan)*

  • Introduced by Sens. Tester (D-MT), Barrasso (R-WY), and 10 cosponsors, this bill would support rural residency training funding that is equitable for all States. The bill would improve Medicare reimbursements and enhance the current structure of the Medicare-funded graduate medical education program to bring more medical residents and doctors to rural areas.

S. 441 – American Opportunity Accounts Act*

  • Introduced by Sen. Booker (D-NJ) and 15 cosponsors, this bill would establish American opportunity accounts, or federally funded savings accounts, for every child in order to make economic opportunity a birthright for every American and help close the racial wealth gap.

S. 460 – Urban Indian Health Confer Act (bipartisan)

  • Introduced by Sens. Smith (D-MN) and Mullin (R-OK), this bill would establish an urban Indian organization confer policy for the Department of Health and Human Services to meet the unique needs of Indigenous communities and improve care, therefore creating parity between urban Indian organizations and other components of the Indian Health System.

S. 599 – Digital Equity Foundation Act

  • Introduced by Sens. Lujan (D-NM), Feinstein (D-CA), Klobuchar (D-MN), Blumenthal (D-CT), Heinrich (D-NM), Markey (D-MA), Merkley (D-OR), and Durbin (D-IL), this bill would establish the Foundation for Digital Equity, a nonprofit foundation that would channel public and private investments into making progress in closing the divide on digital equity, inclusion, and literacy.

* Denotes bicameral legislation

House of Representatives

H.R. 477 – Community Mentors for Moms Act*

  • Introduced by Rep. Miller (R-WV), this bill would establish a grant program for community-based maternal mentoring programs for low-income mothers to support and prepare them to raise their children for success.

H.R. 982 – Pregnant Women in Custody Act (bipartisan)

  • Introduced by Rep. Kamlager-Dove (D-CA) and Lesko (R-AZ), this bill would address the health needs of incarcerated women related to pregnancy and childbirth.

H.R. 1117 – Advancing Safe Medications for Moms and Babies Act of 2023 (bipartisan)

  • Introduced by Reps. Castor (D-FL), Fitzpatrick (R-PA), and Underwood (D-IL), this bill would implement certain recommendations to promote the inclusion of pregnant and lactating women in clinical research.

Senate

S. 48 – Community Mentors for Moms Act*

  • Introduced by Sen. Rubio (R-FL), this bill would establish a grant program for community-based maternal mentoring programs for low-income mothers to support and prepare them to raise their children for success.

S. 712 – Connected Maternal Online Monitoring (MOM) Act (bipartisan)

  • Introduced by Sens. Cassidy (R-LA), Hassan (D-NH), Young (R-IN), Carper (D-DE), Thune (R-SD), and Rosen (D-NV), this bill would  identify and address barriers to coverage of remote physiologic devices under State Medicaid programs to improve maternal and child health outcomes for pregnant and postpartum women.

* Denotes bicameral legislation

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SDOH Bills
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Health Equity/Disparities Bills
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Maternal & Infant Health Bills