H.R. 6238: NIH IMPROVE Act
Sponsor
Lauren Underwood
Democrat · IL-14
Congress wants NIH focused on preventable maternal deaths
Why it matters
$63.4 million a year is on the table for maternal health research and community interventions. H.R. 6238 would turn NIH's IMPROVE effort into a formal, five-year program aimed at preventing maternal deaths, severe pregnancy-related illness, and disparities.
H.R. 6238 would authorize $317 million over five years for NIH to study and test ways to prevent maternal deaths, severe pregnancy-related complications, and persistent disparities.
The bill formally establishes the IMPROVE Initiative inside the National Institutes of Health and puts the NIH director in charge. Instead of treating maternal health as a scattered set of projects, it creates a single federal effort with a defined mission.
That mission is broader than pregnancy alone. The bill says NIH should improve health before, during, and after pregnancy, reduce preventable maternal deaths and severe maternal morbidity, and focus on populations with worse outcomes than the national rate.
This is not just about publishing studies — NIH could fund grants, contracts, and community-based interventions meant to work in places where maternal health outcomes are especially poor.
The regional piece matters too. The bill tells NIH to build evidence for what works in specific parts of the country, while also studying biological, behavioral, and other factors behind the leading causes of maternal harm.
The catch is that authorization is not the same as a check: Congress would still need to appropriate the $63.4 million each year from 2026 through 2030.
Bill Progress
Latest Action · Jul 21, 2026
Passed the House, received in Senate
H.R. 6238 Bill Summary
What H.R. 6238 actually does.
Maternal health becomes a formal NIH priority
H.R. 6238 would formally establish the IMPROVE Initiative within NIH, turning an existing effort into a named federal program led by the NIH director.
Research targets preventable deaths and severe complications
The initiative would focus on reducing preventable maternal mortality and severe maternal morbidity, while studying the leading causes and risk factors behind those outcomes.
Postpartum health is part of the mission
The bill covers health before, during, and after pregnancy, so the federal research agenda would not stop at delivery.
Hard-hit communities get specific attention
NIH would be directed to address disparities in populations with maternal health outcomes worse than the national rate, including through community-based interventions.
NIH can fund projects multiple ways
To carry out the initiative, NIH could use grants, contracts, cooperative agreements, and other transactions, giving the agency flexibility to support researchers and on-the-ground partners.
Five years of funding is authorized
The bill authorizes $63.4 million a year from 2026 through 2030 — about $317 million total if Congress provides the full amount.
Who benefits from H.R. 6238?
Pregnant and postpartum women
You are the bill's intended focus if you need better answers on what prevents maternal deaths, severe complications, and health problems after childbirth.
Women in communities with worse maternal outcomes
The bill specifically directs NIH to focus on populations with disproportionately high rates of maternal mortality and severe maternal morbidity compared with the national rate.
Hospitals, universities, and maternal health researchers
These groups could compete for NIH funding through grants, contracts, and cooperative agreements if the full $63.4 million a year is appropriated.
Local organizations working with mothers
Community groups could become partners in interventions the bill says NIH should implement and evaluate in places where outcomes are especially poor.
Who is affected by H.R. 6238?
National Institutes of Health
NIH would have to run the initiative, set priorities, distribute funding, and connect research with community-based intervention work.
Maternal care providers and health systems
Clinicians and hospitals could see new NIH-backed evidence shape care practices, especially around preventing severe complications and improving postpartum care.
Congressional appropriators
Lawmakers would still have to decide each year whether to provide the authorized funding. Without appropriations, the five-year dollar figure stays a plan on paper.
Communities with poor maternal health outcomes
If the bill is funded, these communities could see more research attention and pilot interventions. If it is not, the gap between authorization and implementation remains.
Cost & Funding
Authorization
$63,400,000 per year for 2026 through 2030, or about $317 million total over five years
- This is an authorization, not automatic spending.
- Congress would still need to appropriate the money each year.
- At the full authorized level, the initiative would average $63.4 million annually.
- Funds could move through grants, contracts, cooperative agreements, and other transactions.
What Congress Is Saying
H.R. 6238 has come up 7 times in the Congressional Record so far.
H.R. 6238 also appeared in 1 more House floor reference and 4 routine cosponsor filings.
HR6238 Legislative Journey
Committee Action
Jul 21, 2026
Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
House: Vote Held
Jul 20, 2026
On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H4651)
House: Committee Action
Jul 9, 2026
Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 119-734.
House: Vote: 46-0
May 21, 2026
Ordered to be Reported (Amended) by the Yeas and Nays: 46 - 0.
House: Committee Action
Nov 20, 2025
Referred to the House Committee on Energy and Commerce.
About the Sponsor
Lauren Underwood
Democrat, Illinois's 14th congressional district · 7 years in Congress
Committees: Appropriations
View full profile →
Cosponsors (4)
This bill has 4 cosponsors: 3 Democrats, 1 Republican, reflecting bipartisan support. Cosponsors represent 4 states: District of Columbia, Maryland, Pennsylvania, and 1 more.
Committee Sponsors
Health, Education, Labor, and Pensions Committee
0 of 23 committee members cosponsored
No committee members have cosponsored this bill
Energy and Commerce Committee
0 of 54 committee members cosponsored
No committee members have cosponsored this bill
34 Democrats across these committees haven't cosponsored yet. Mobilize their constituents
H.R. 6238 Quick Facts
- Committee
- Health, Education, Labor, and Pensions
- Chamber
- House
- Policy
- Health
- Introduced
- Nov 20, 2025
Passed the House, received in Senate
Jul 21, 2026
Official Sources
Official legislative status page for the NIH IMPROVE Act, including actions, text, and cosponsors.
The NIH office closely tied to women's health research and the home base for maternal health initiative information.
Official U.S. Code location for the Public Health Service Act part the bill would amend to add the IMPROVE Initiative.
Official NIH grants portal relevant because the bill authorizes NIH to use grants, contracts, and cooperative agreements to carry out the initiative.
H.R. 6238 Common Questions
How much money does H.R. 6238 authorize?
H.R. 6238 authorizes $63.4 million a year from 2026 through 2030 for the NIH IMPROVE Initiative — about $317 million over five years if Congress funds it all.
Does H.R. 6238 actually spend the money automatically?
No. The bill authorizes funding, but Congress would still have to approve the money in annual spending bills before NIH could use the full amount.
What would the NIH IMPROVE Initiative do?
It would fund research and intervention work aimed at reducing preventable maternal deaths, severe pregnancy-related complications, and disparities in maternal health outcomes.
Does H.R. 6238 cover postpartum health too?
Yes. The bill says NIH should improve health before, during, and after pregnancy, so postpartum care is part of the initiative.
Who would run the program under H.R. 6238?
The National Institutes of Health would run it, and the NIH director would lead the initiative.
Would NIH only fund lab research under H.R. 6238?
No. H.R. 6238 also allows NIH to support community-based interventions and to study what works in specific regions of the country.
Who is H.R. 6238 meant to help most?
The bill is aimed at pregnant and postpartum women, especially populations with maternal health outcomes worse than the national rate.
Where is H.R. 6238 now?
It has passed the House side of the process far enough to reach the Senate, where it was read twice and referred to the Senate health committee.
Based on H.R. 6238 bill text
H.R. 6238 Bill Text
“To establish the IMPROVE Initiative within the National Institutes of Health.”
Source: U.S. Government Publishing Office
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