Equity Work

“As the oldest committee in Congress, it is our responsibility to work tirelessly toward achieving a more perfect Union for all Americans, including those often overlooked and left out.” – Chairman Richard E. Neal


Under the leadership of Chairman Richard E. Neal (D-MA), the Committee on Ways and Means is committed to identifying the drivers of health, economic, geographic, and racial disparities in American society and promoting legislation that can mitigate those inequities. While there is no magic pill to break down the barriers people from marginalized communities have faced over the past 400 years, the well-being of our nation depends on Congress tackling the challenges head on. As Chairman Neal has noted: “Some actions we can pursue almost immediately. Other advancements may take longer to become law. But inaction is not an option. Complacency cannot be tolerated.”

Since the beginning of the 116th Congress, Chairman Neal has prioritized equity in the Committee’s work, first by forming the bipartisan Rural and Underserved Communities Health Task Force. In the 117th Congress, the Chairman issued a framework that charted the course for the Committee’s legislative priorities and later created the Racial Equity Initiative (REI) to ensure maximum inclusivity for Ways and Means policies.

Racial Equity Initiative

On March 4, 2021, Chairman Neal announced the creation of the Committee’s Racial Equity Initiative and appointed Rep. Terri Sewell (D-AL), Rep. Jimmy Gomez (D-CA), and Rep. Steven Horsford (D-NV) to lead the working group. The REI represents the next phase of the Committee’s work to address the role of racism and other forms of discrimination in perpetuating health and economic inequalities in the United States. The creation of the REI followed a report, “Something Must Change: Inequities in U.S. Policy and Society,” and framework, “A Bold Vision for a Legislative Pathway Toward Health and Economic Equity,” that the Committee issued in January 2021 highlighting the policy proposals and the pillars the Committee is focusing on as it works to advance equity.

In July of 2021, as Congress worked to craft major infrastructure policy, the REI leaders shared their priorities and recommendations for the legislation. In a memorandum to Chairman Neal, the co-chairs highlighted the ways measures related to transportation, jobs, health care, climate change mitigation, and community investment can purposely counteract generations of discriminatory policy across racial and ethnic lines and expand opportunities for historically marginalized communities, helping to improve the quality of life for all Americans.


Health Equity

Rural and Underserved Communities Health Task Force

Prior to the establishment of the REI, in the 116th Congress, the Committee launched a bipartisan Rural and Underserved Communities Health Task Force. The group examined the challenges of delivering health care in rural and underserved areas, and explored holistic bipartisan policy options that could improve outcomes and care in those communities.

Task force Request for Information 

Shortly after its creation in 2019, the task force issued a Request for Information (RFI) soliciting input on priority topics that affect health status and outcomes in the United States. 

Democratic staff report on longstanding inequities in the U.S. health system

In July 2020, Chairman Neal released a majority staff report, titled “Left Out: Barriers to Health Equity for Rural and Underserved Communities,” analyzing the barriers to health care in underserved communities and the challenges associated with scalable, sustainable solutions. The report includes new qualitative analysis to help inform the current debate, working from the nearly 200 responses received from the RFI coupled with a thorough review of recent literature.

Democratic staff report on the misuse of antipsychotics in U.S. nursing homes

Also in July 2020, Committee Democratic staff released a report exposing the longstanding misuse of antipsychotics and the minimal enforcement in preventing patient harm in nursing homes nationwide. The report, titled “Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes,” shows how many facilities resort to the use of these potentially dangerous drugs in lieu of proper staffing and underscores the urgent need for robust oversight of the nursing home industry and improved deployment of existing tools to prevent such harm in the first place.

Democratic staff report on the misuse of race in clinical algorithms

In October of 2021, Committee Democratic staff released a report examining the misuse of race in clinical algorithms and exploring potential strategies to address inequities in clinical decision support tools (CDSTs) that lead to disparities in patient outcomes. The report, titled “Fact versus Fiction: Clinical Decision Support Tools and the (Mis)Use of Race,” also includes analyses of stakeholders’ responses to a 2020 Request for Information Chairman Neal issued to solicit input and recommendations on the matter.

Neal RFI on the health care industry’s impact on the climate crisis

In March of 2022, Chairman Neal issued an RFI soliciting input from 12 health care organizations regarding their work to combat the climate crisis. The RFI included a series of questions that prompt recipients to provide input on climate-related disruption to operations and patient care, the ways their organizations integrate climate-related policies into their daily operations to mitigate carbon emissions, and any future plans they have in this area. It also requested feedback on ways the federal government can support organizations in operationally addressing their climate impacts in the short- and long-term.


Additional resources

Fact Sheets

Chairman Neal Op-Eds

Full and Subcommittee Hearings Examining Issues Affecting Economic, Health, and Racial Inequities (116th and 117th Congresses) 

Chairman Neal’s June 2020 letter to then-HHS Secretary Azar requesting information on the Trump Administration’s plan for addressing the disproportionate impact of COVID-19 on communities of color 

Chairman Neal’s February 2021 statement applauding the Biden Administration’s leadership on addressing health disparities faced by communities of color.

Chairman Neal's April 2022 statement applauding the Biden Administration for releasing over 90 Equity Action Plans.