S4540-119

What This Bill Does

The Reproductive Health Care Accessibility Act builds a federal program package around accessible sexual and reproductive health care for individuals with disabilities. The bill finds that adults with disabilities, including people who can become pregnant and parents with disabilities, face barriers to reproductive health care such as inaccessible facilities, lack of accessible medical diagnostic equipment, transportation barriers, delays in preventive services, and provider training gaps. It also finds that individuals with disabilities face higher reproductive-related cancer mortality, higher maternal mortality and morbidity, earlier menopause, reproductive autonomy barriers, and lower representation in medical and allied health education.

The bill amends the Public Health Service Act to create a HRSA training program for health care professionals and trainees on equitable sexual and reproductive health care for individuals with disabilities. Eligible public or private nonprofit entities include multidisciplinary providers such as federally qualified health centers and Title X clinics, institutions of higher education, disability-led entities, reproductive rights and justice entities, Indian Tribes, Tribal organizations, Urban Indian organizations, and consortia. Training must cover disability clinical care curricula, intersectional discrimination, culturally and linguistically competent care, self-determination, disability rights, and evidence-based or evidence-informed reproductive health practices. Award recipients must evaluate outcomes, report to HHS within 180 days after the award period, and HHS must compile and publish annual reports in accessible formats. The bill authorizes $10 million per year for fiscal years 2027 through 2031 for this training program.

The bill also creates a provider workforce pipeline program to help individuals with disabilities enter sexual and reproductive health care careers, including abortion care and maternal health care. It authorizes grants, contracts, or cooperative agreements to nonprofit health and educational entities such as medical schools, osteopathic medical schools, nursing schools, and other higher education institutions. Funds may support applicant pools, education pipelines, mentorship, recruiting and retaining students and faculty with disabilities, curricula, faculty and student research, community-based training experiences, and stipends that do not count against Federal or State benefit resource limits. The bill authorizes $15 million per year for fiscal years 2027 through 2031 for this provider workforce program and creates a parallel reproductive nursing workforce expansion under Public Health Service Act section 821, also authorized at $15 million per year for fiscal years 2027 through 2031.

The bill creates a reproductive health education grant program for accessible sexual and reproductive health education for individuals with disabilities, including youth, abortion care options, perinatal health needs, and legal rights. It authorizes $10 million per year for fiscal years 2027 through 2031 for the education program. It directs HHS, acting through the Administration for Community Living, to establish a National Technical Assistance Center with $10 million per year for fiscal years 2027 through 2031 to provide best practices to states, territories, Indian Tribes, Tribal organizations, and Urban Indian organizations; help providers deliver accessible reproductive care; help covered entities comply with Federal laws; and develop resources related to accessible diagnostic equipment and the Barrier-Free Health Care Initiative. It also requires an HHS study, authorized at $15 million for fiscal year 2027, on effective programs, Federal-State-Tribal-local partnerships, and interagency agreements needed for data and public health research, with a report to Senate and House committees within three years.

Who Benefits and How

Individuals with disabilities who need sexual and reproductive health care benefit because the bill funds provider training, patient education, technical assistance, research, and coordination aimed at reducing barriers to accessible, comprehensive, culturally and linguistically appropriate care. Disabled people who can become pregnant, disabled parents, youth with disabilities, and people seeking contraception, preventive services, abortion care options, perinatal care, family planning, cancer screening, and maternal health care benefit from programs focused on accessibility and reproductive autonomy. Individuals with disabilities pursuing careers in sexual and reproductive health care or reproductive nursing benefit from education pipelines, mentorship, stipends, faculty recruitment, research support, and benefit-protection language. FQHCs, Title X clinics, medical schools, nursing schools, institutions of higher education, disability-led entities, reproductive rights and justice entities, Indian Tribes, Tribal organizations, Urban Indian organizations, states, territories, and providers can receive grants, contracts, cooperative agreements, training, or technical assistance.

Who Bears the Burden and How

HHS, HRSA, the Administration for Community Living, and the Secretary of Health and Human Services bear the largest administrative burden because they must design grant criteria, award grants, contracts, and cooperative agreements, consult across agencies, evaluate reports, publish accessible compilations, establish a National Technical Assistance Center, conduct a research study, and report to Congress. Grant recipients bear application, program design, evaluation, reporting, accessible-format, stakeholder engagement, training, and subaward management duties. Federal taxpayers bear the cost of multiple authorizations: $10 million per year for workforce training, $15 million per year for provider workforce expansion, $15 million per year for nursing workforce expansion, $10 million per year for reproductive health education, $10 million per year for the technical assistance center, and $15 million for fiscal year 2027 for the research study.

Key Provisions

• Establishes a HRSA reproductive health care training program for health care professionals and trainees serving individuals with disabilities, with recipient evaluations, HHS annual compilations, public accessible posting, and $10 million per year for fiscal years 2027 through 2031.
• Creates a $15 million per year provider workforce program for fiscal years 2027 through 2031 to recruit, mentor, retain, and support individuals with disabilities entering sexual and reproductive health care careers, including abortion care and maternal health care.
• Expands reproductive nursing workforce grants by authorizing $15 million per year for fiscal years 2027 through 2031 for education pipelines, mentorship, stipends, faculty recruitment, research, and community-based training for individuals with disabilities.
• Authorizes $10 million per year for fiscal years 2027 through 2031 for accessible reproductive health education programs for individuals with disabilities, including youth, abortion care options, perinatal needs, and legal rights.
• Establishes a National Technical Assistance Center funded at $10 million per year for fiscal years 2027 through 2031 to provide best practices, provider technical assistance, compliance resources, and resources on accessible medical diagnostic equipment.
• Requires an HHS research study and three-year congressional report on effective accessible reproductive health programs, partnerships, memoranda of understanding, interagency agreements, and data needs, with $15 million authorized for fiscal year 2027.