H.R. 7496

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7496 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 7496

To provide for the designation of areas as Health Investment Zones to 
reduce health disparities and improve health outcomes in such areas, 
and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

February 11, 2026

Mr. Harder of California introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committees on Ways and Means, and Education and Workforce, for a 
period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
committee concerned

_______________________________________________________________________

A BILL

To provide for the designation of areas as Health Investment Zones to 
reduce health disparities and improve health outcomes in such areas, 
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 ``Health Investment Zones Act of 
2026''.

SEC. 2. DESIGNATION OF HEALTH INVESTMENT ZONES.

(a) Designation.--
(1) In general.--Not later than 2 years after the date of 
enactment of this Act, the Secretary shall, pursuant to 
applications submitted under subsection (c), designate areas as 
Health Investment Zones to reduce health disparities and 
improve health outcomes in such areas.
(2) Eligibility of area.--To be designated as a Health 
Investment Zone under this section, an area shall--
(A) be a contiguous geographic area; and
(B) have measurable and documented geographic 
health disparities and poor health outcomes, 
demonstrated by--
(i) average income below 150 percent of the 
Federal poverty line (as defined by the Office 
of Management and Budget based on the most 
recent data available from the Bureau of the 
Census);
(ii) a rate of participation in the special 
supplemental nutrition program under section 17 
of the Child Nutrition Act of 1966 (42 U.S.C. 
1786) that is higher than the national average 
rate of participation in such program;
(iii) lower life expectancy than the 
national average;
(iv) a higher percentage of instances of 
low birth weight than the national average; or
(v) designation under section 332 of the 
Public Health Service Act (42 U.S.C. 254e) as a 
health professional shortage area.
(3) Publication of designee information.--Not later than 1 
year after the date on which all areas are designated as Health 
Investment Zones under paragraph (1), the Secretary shall 
publish on the website of the Department of Health and Human 
Services--
(A) the name of each such Health Investment Zone, 
together with the names of each coalition partner; and
(B) a description of all areas so designated.
(b) Solicitation of Applications.--Not later than 1 year after the 
date of enactment of this Act, the Secretary shall solicit applications 
under subsection (c).
(c) Submission of Applications.--
(1) In general.--To seek the designation of an area as a 
Health Investment Zone, a community-based nonprofit 
organization or local governmental agency, in coalition with 
health care providers, hospitals, nonprofit community health 
clinics, health centers, social service organizations, and 
other related organizations, shall submit an application to the 
Secretary.
(2) Applications for grants.--As part of an application 
under this subsection, a community-based nonprofit organization 
or local governmental agency may include an application for a 
grant under section 4(a). Such community-based nonprofit 
organization or local governmental agency shall describe how 
the use of grant funds would be consistent with the plan 
submitted pursuant to subsection (d)(1) and whether such 
community-based nonprofit organization or local governmental 
agency intends to award subgrants or implement innovative 
public health strategies under section 4(b).
(d) Contents.--An application under subsection (c) shall--
(1) include an effective and sustainable plan with respect 
to the area proposed for designation--
(A) to reduce health disparities;
(B) to reduce the costs of, or to produce savings 
to, the health care system;
(C) to improve health outcomes; and
(D) to utilize one or more of the incentives 
established pursuant to section 5, section 51 of the 
Internal Revenue Code of 1986 (as amended by section 
3(a)), for wages paid to qualified Health Investment 
Zone workers (as defined in section 51(d)(16) of such 
Code), section 25G of the Internal Revenue Code of 1986 
(as added by section 3(b)), or subsection (ee) of 
section 1833 of the Social Security Act (42 U.S.C. 
1395l) (as amended by section 6) to address health care 
provider capacity, improve health services delivery, 
effectuate community improvements, or conduct outreach 
and education efforts; and
(2) identify specific diseases or indicators of health for 
improvement of health outcomes in such area, including at least 
1 of the following:
(A) Cardiovascular disease.
(B) Asthma.
(C) Diabetes.
(D) Behavioral health.
(E) Maternal and birth health.
(F) Obesity.
(e) Considerations.--The Secretary--
(1) shall consider geographic diversity, among other 
factors, in selecting areas for designation as Health 
Investment Zones; and
(2) may conduct outreach efforts to encourage a 
geographically diverse pool of applicants, including for 
designating Health Investment Zones in rural areas.
(f) Priority.--In selecting areas for designation as Health 
Investment Zones, the Secretary shall give higher priority to 
applications based on the extent to which an area demonstrates the 
following:
(1) Support from, and participation of, key stakeholders in 
the area proposed for designation, including residents and 
local governments of such area.
(2) A plan for long-term funding and sustainability.
(3) Integration with any applicable State health 
improvement process or plan.
(4) A plan for evaluation of the impact of designation of 
such area as a Health Investment Zone.
(5) A plan to utilize existing State tax credits, grants, 
or other incentives to reduce health disparities and improve 
health outcomes in the proposed Health Investment Zone.
(6) Such other factors as the Secretary determines are 
appropriate to demonstrate a commitment to reduce health 
disparities and improve health outcomes in such area.
(g) Period of Designation.--The designation under this section of 
an area as a Health Investment Zone shall be in effect until the date 
that is 10 years after the date on which the first such area is so 
designated.

SEC. 3. TAX INCENTIVES.

(a) Work Opportunity Credit for Hiring Health Investment Zone 
Workers.--
(1) In general.--Section 51(d)(1) of the Internal Revenue 
Code of 1986 is amended by striking ``or'' at the end of 
subparagraph (I), by striking the period at the end of 
subparagraph (J) and inserting ``, or'', and by adding at the 
end the following new subparagraph:
``(K) a qualified Health Investment Zone worker, to 
the extent that the qualified first-year wages with 
respect to such worker are paid for qualified Health 
Investment Zone work.''.
(2) Qualified health investment zone worker.--Section 51(d) 
of such Code is amended by adding at the end the following new 
paragraph:
``(16) Health investment zones.--
``(A) Qualified health investment zone worker.--The 
term `qualified Health Investment Zone worker' means 
any individual who is certified by the designated local 
agency as having (as of the hiring date) a principal 
place of employment within a Health Investment Zone.
``(B) Qualified health investment zone work.--The 
term `qualified Health Investment Zone work' means 
employment by a Health Investment Zone practitioner, 
the primary official duties of such employment being to 
promote access to healthcare in a Health Investment 
Zone.
``(C) Related terms.--For purposes of this 
paragraph, the terms `Health Investment Zone' and 
`Health Investment Zone practitioner' have the same 
meaning given such terms under section 8 of the Health 
Investment Zones Act of 2026.''.
(3) Effective date.--The amendments made by this subsection 
shall apply to amounts paid or incurred after the date of the 
enactment of this Act to individuals who begin work for the 
employer after such date.
(b) Credit for Health Investment Zone Workers.--
(1) In general.--Subpart A of part IV of subchapter A of 
chapter 1 of the Internal Revenue Code of 1986, as amended by 
section 70411 of Public Law 119-21, is amended by inserting 
after section 25F the following new section:

``SEC. 25G. CREDIT FOR QUALIFIED HEALTH INVESTMENT ZONE WORKERS.

``(a) Allowance of Credit.--In the case of a qualified Health 
Investment Zone worker, there shall be allowed as a credit against the 
tax imposed by this chapter for a taxable year an amount equal to 30 
percent of wages received for qualified Health Investment Zone work 
during such taxable year.
``(b) Definitions.--For purposes of this section--
``(1) Qualified health investment zone worker.--The term 
`qualified Health Investment Zone worker' means, with respect 
to wages, an individual whose principal place of employment 
while earning such wages is within a Health Investment Zone (as 
such term is defined in section 8 of the Health Investment 
Zones Act of 2026).
``(2) Qualified health investment zone work.--The term 
`qualified Health Investment Zone work' has the same meaning 
given such term in section 51(d)(16)(B).''.
(2) Clerical amendment.--The table of sections for subpart 
A of part IV of subchapter A of chapter 1 of such Code, as 
amended by section 70411 of Public Law 119-21, is amended by 
inserting after the item relating to section 25F the following 
new item:

``Sec. 25G. Credit for qualified Health Investment Zone workers.''.
(3) Effective date.--The amendments made by this subsection 
shall apply to wages received after the date of the enactment 
of this Act.

SEC. 4. GRANTS.

(a) Authorization.--For each area designated as a Health Investment 
Zone, the Secretary may award a grant to the community-based nonprofit 
organization or local governmental agency that applied for such 
designation to support such applicant and its coalition partners in 
reducing health disparities and improving health outcomes in such area.
(b) Use of Funds.--Programs and activities funded through a grant 
under this section shall be consistent with the grantee's plan 
submitted pursuant to section 2(d)(1) and may include the following:
(1) Subgrants to health care practitioners.--
(A) In general.--For the purpose of improving or 
expanding the delivery of health care in the respective 
Health Investment Zone, the grantee may award subgrants 
to Health Investment Zone practitioners to defray costs 
related to innovative strategies listed in paragraph 
(2).
(B) Eligibility.--To be eligible to receive a 
subgrant pursuant to subparagraph (A), a Health 
Investment Zone practitioner shall--
(i) own or lease a health care facility in 
the Health Investment Zone; or
(ii) provide health care in such a 
facility.
(C) Amount.--The amount of a subgrant under 
subparagraph (A) may not exceed the lesser of--
(i) $5,000,000; or
(ii) 50 percent of the costs of the 
equipment, or capital or leasehold 
improvements.
(2) Innovative strategies.--A grantee (or subgrantee) may 
use a grant received under this section (or a subgrant received 
under paragraph (1)) to implement innovative public health 
strategies in the respective Health Investment Zone, which 
strategies may include--
(A) internships and volunteer opportunities for 
students who reside in the Health Investment Zone;
(B) funding resources to improve health care 
provider capacity to serve non-English speakers;
(C) operation of medical, mental and behavioral 
health, and dental mobile clinics;
(D) provision of transportation to and from medical 
appointments for patients;
(E) funding resources to improve access to healthy 
food, recreation, and high-quality housing;
(F) capital or leasehold improvements to a health 
care facility in the respective Health Investment Zone; 
and
(G) medical or dental equipment to be used in such 
a facility.

SEC. 5. STUDENT LOAN REPAYMENT PROGRAM.

(a) In General.--The Secretary shall carry out a loan repayment 
program under which the Secretary enters into agreements with eligible 
Health Investment Zone practitioners to make payments on the principal 
and interest of the eligible educational loans of such practitioners 
for each year such practitioners agree to provide health care services 
in a Health Investment Zone.
(b) Limitations.--In entering into loan repayment agreements under 
this section, the Secretary may not agree to--
(1) make payments for more than 10 years with respect to a 
practitioner; or
(2) pay more than $10,000 per year, or more than a total of 
$100,000, with respect to a practitioner.
(c) Relationship to Other Benefits.--
(1) Counting of payments.--A payment made to, or on behalf 
of, an eligible Health Investment Zone practitioner under this 
section shall be considered a qualifying payment counted toward 
any total number of required payments for forgiveness or 
cancellation on an otherwise applicable student loan plan or 
program under the Higher Education Act of 1965 or the Public 
Health Service Act, such as under subsection (m) or (q) of 
section 455 or section 493C of the Higher Education Act of 1965 
(20 U.S.C. 1087e; 1098e).
(2) No double payments.--No borrower may, for the same 
service, receive a payment for an eligible educational loan 
under--
(A) this section; and
(B) another federally supported loan program that 
provides a payment to, or on behalf of, that borrower.
(3) No reimbursement.--An eligible Health Investment Zone 
practitioner shall not receive a payment or reimbursement under 
this section for an eligible educational loan that has been 
forgiven, cancelled, or repaid.
(d) Definitions.--In this section:
(1) Eligible educational loan.--The term ``eligible 
educational loan'' means any federally funded or guaranteed 
student loan, as determined appropriate by the Secretary, in 
consultation with the Secretary of Education.
(2) Eligible health investment zone practitioner.--The term 
``eligible Health Investment Zone practitioner'' means a Health 
Investment Zone practitioner who--
(A) agrees to provide full-time health care 
services in a Health Investment Zone for a specified 
period that is not less than 1 year; and
(B) has 1 or more eligible educational loans.

SEC. 6. INCENTIVE PAYMENTS FOR MEDICARE PART B ITEMS AND SERVICES 
FURNISHED IN HEALTH INVESTMENT ZONES.

Section 1833 of the Social Security Act (42 U.S.C. 1395l) is 
amended by adding at the end the following new subsection:
``(ee) Incentive Payments for Items and Services Furnished in 
Health Investment Zones.--
``(1) In general.--In the case of items and services 
furnished under this part in an area that is designated as a 
Health Investment Zone under section 2(a)(1) of the Health 
Investment Zones Act of 2026, in addition to the amount of 
payment that would otherwise be made for such items and 
services under this part, there also shall be paid (on a 
monthly or quarterly basis)--
``(A) an amount equal to 10 percent of the payment 
amount for the item or service under this part;
``(B) for such an item or service furnished at a 
freestanding physician office or clinic (as defined in 
paragraph (2)) or a Federally qualified health center 
(as defined in section 1861(aa)(3)), in addition to any 
applicable additional payment amount under this 
paragraph, an amount equal to 5 percent of the payment 
amount for the item or service under this part; and
``(C) for an annual wellness visit (HCPCS codes 
G0438-G0439), diabetes self-management training (CPT 
codes 98960-98962), chronic care management (CPT codes 
99487-99491), and a preventative screening such as a 
mammography or colorectal cancer screening, in addition 
to any applicable additional payment amount under this 
paragraph, an amount equal to 10 percent of the payment 
amount for such item or service under this part.
``(2) Definition of freestanding physician office or 
clinic.--In this subsection, the term `freestanding physician 
office or clinic' means a clinic that--
``(A) bills by place of service code 11 (office) or 
22 (independent clinic) in the physician fee schedule 
under section 1848; and
``(B) is not directly or indirectly owned or 
controlled by a hospital system enrolled in the 
Medicare Provider Enrollment, Chain, and Ownership 
System (commonly referred to as `PECOS').
``(3) Coordination with other payments.--The amount of the 
additional payment for an item or a service under this 
subsection and subsection (m) shall be determined without 
regard to any additional payment for the item or service under 
subsection (m) and this subsection, respectively. The amount of 
the additional payment for an item or a service under this 
subsection and subsection (z) shall be determined without 
regard to any additional payment for the item or service under 
subsection (z) and this subsection, respectively.''.

SEC. 7. REPORTING.

(a) In General.--Not later than the day that is 10 years after the 
first Health Investment Zone is designated, the Secretary shall submit 
to Congress a report on the implementation of this Act (and the 
amendments made by this Act) and the results thereof.
(b) Contents.--Each report under subsection (a) shall--
(1) specify the number and types of incentives provided 
pursuant to this Act in each Health Investment Zone; and
(2) include evidence of the extent to which the incentives 
utilized by each Health Investment Zone have--
(A) succeeded--
(i) in attracting health care practitioners 
to practice in Health Investment Zones;
(ii) in reducing health disparities and 
improving health outcomes in Health Investment 
Zones; and
(iii) in reducing health costs and hospital 
admissions and readmissions in Health 
Investment Zones; and
(B) impacted access to primary care services and 
utilization of emergency room services.

SEC. 8. DEFINITIONS.

In this Act:
(1) The term ``Health Investment Zone'' means an area 
designated under section 2 as a Health Investment Zone.
(2) The term ``Health Investment Zone practitioner'' means 
a health care practitioner who--
(A) is licensed or certified in accordance with 
applicable State law to treat patients in the 
applicable Health Investment Zone;
(B) provides--
(i) primary care, which may include 
obstetrics, gynecological services, pediatric 
services, or geriatric services;
(ii) behavioral health services, which may 
include mental health or substance use disorder 
services; or
(iii) dental services; and
(C) is a participating provider of services or 
supplier under the Medicare program under title XVIII 
of the Social Security Act (42 U.S.C. 1395 et seq.) or 
a participating provider under a State plan under title 
XIX of such Act (42 U.S.C. 1396 et seq.).
(3) The term ``Secretary'' means the Secretary of Health 
and Human Services.

SEC. 9. AUTHORIZATION OF APPROPRIATIONS.

To carry out this Act, there is authorized to be appropriated such 
sums as may be necessary for the period beginning on the date of 
enactment of this Act and ending on the last day of the 10-year period 
that begins on the date on which the first Health Investment Zone is 
designated.
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