The UNDERSTAND Act requires the federal government to develop a standardized system for collecting information about social determinants of health—such as housing instability, food insecurity, and transportation challenges—from Medicaid and Children's Health Insurance Program (CHIP) beneficiaries. States must use this uniform reporting system within 18 months of the law's enactment and submit annual reports to the federal government, with providers required to conduct regular screenings and share standardized data with state Medicaid agencies. The legislation includes privacy safeguards to protect beneficiary information and allows exemptions for U.S. territories if implementation is deemed impractical. Within four years of implementation, the Secretary of Health and Human Services must report to Congress on trends and findings from the collected data to help identify and address these health-related social factors among Medicaid and CHIP enrollees. The bill does not create new funding streams or authorize additional federal spending for addressing social determinants, focusing instead on data collection and reporting requirements.