President Donald Trump has initiated a ban on diversity, equity and inclusion (DEI) programs that could have a sweeping effect on the healthcare industry.
The ban—issued through an executive order—forbids federal offices from pursuing DEI and DEIA (accessibility) programs and practices. The order also rids the government of chief diversity officers.
“These illegal DEI and DEIA policies also threaten the safety of American men, women, and children across the Nation by diminishing the importance of individual merit, aptitude, hard work, and determination when selecting people for jobs and services in key sectors of American society, including all levels of government, and the medical, aviation, and law-enforcement communities,” the EO reads.
Alongside the DEI ban, Trump issued another EO that preferences biological sex over gender identity to reduce complexity on government forms and promote biological sex within the federal government.
The EO tasks the secretary of the Department of Health and Human Services to create definitions of biological male and biological female within 30 days that agencies should use in the enforcement and interpretation of federal statute.
The Trump administration says the EOs push forward a commitment to protect single sex spaces used by women, like bathrooms and locker rooms, where Trump says women’s safety is compromised by the presence of trans individuals.
Trump likewise repealed a slate of EOs from former President Joe Biden that condemned discrimination based on gender and sexual orientation.
Both of these actions could disrupt the healthcare industry in several ways.
The American Association of Medical Colleges (AAMC) noted in a blog post that the DEI EO would impact academic medical centers receiving federal funds. The EO directed the Office of Management and Budget (OMB) director to compile a report outlining recommendations for enforcing federal civil rights laws and encouraging the private sector to end illegal discrimination and preferences. "As part of this report, federal agencies are to identify potential civil compliance investigations of entities including large nonprofit associations, state and local medical associations,” the AAMC wrote.
Law firm Morgan Lewis wrote in its LawFlash publication that it expects more actions against DEI programs to come from the Trump administration. “Employers should anticipate additional executive actions from the Trump-Vance administration in the weeks and months to come and should review their DEI programs and equal employment opportunity policies to assess any potential legal risk,” the article says.
Morgan Lewis also noted that organizations will have to stay apprised of any mandates for single sex spaces, as the EO tasks the U.S. Equal Employment Opportunity Commission to prioritize enforcement efforts in this area.
Diverging views on DEI efforts
The National Women’s Law Center (NWLC) wrote that the DEI EOs will open federal workers and contractors to harassment based on race, gender and other aspects of their identities.
“Using his extreme Project 2025 playbook as a guide, Trump and his cronies are doubling down on their attacks against women, people of color, and the LGBTQIA+ community, and opening millions of people up to lower pay, hostile workplace environments, and other types of discrimination and harassment," the NWLC wrote. "This order is an open invitation for federal contractors – who are paid with taxpayer dollars—to deny opportunities to the very people whose hard work line their pockets.”
The Robert Wood Johnson Foundation (RWJF) published the following statement encouraging the continuation of DEI efforts in healthcare.
“Everyone wants healthcare rooted in compassion and respect,” the RWJF said in a statement. “Research shows that greater diversity among doctors improves health outcomes for people of color, disabled people, women, LGBTQIA+ patients, and others whose identities have long been underrepresented in the healthcare field. Plus, strategies aimed at reducing racial disparities in healthcare—such as maternal health and cancer care—lead to better outcomes for all patients. The evidence is clear: a diverse healthcare workforce and inclusive policies serve us all. These executive orders serve no one."
Erec Smith, professor of rhetoric and a researcher at the Cato Institute, discussed with Fierce how the removal of DEI programs will unify the federal workforce and keep the country aligned with the principles set out in the Civil Rights Act of 1964.
Smith writes on the negative impact of DEI programs and “critical social justice,” a school of thought that emphasizes racial difference, on minority populations.
In an interview with Fierce Healthcare, Smith said that Trump’s rollback of DEI programs within the federal government will improve the unity of federal agencies and offices and allow staff to speak openly about DEI.
Smith contrasted critical social justice with the civil rights movement in the 1960s. “This is something very different, girded by an ideology called critical social justice, which basically says … people of color are perpetual victims, white people are perpetual oppressors.”
Smith noted that critical social justice is also based on the false existence of systemic racism and implicit bias.
Smith continued: “These are the issues that the Trump administration is trying to get rid of, or at least mitigate, mainly because it's hard to have a unified front when everybody is divided by the undergirding ideology that they're abiding by. So that's the DEI that is being attacked.”
Smith contended that workplaces do not need separate offices for DEI outside of the human resources department, which is already equipped to handle the potential mistreatment of minority staff.
Federal research dollars are also at risk of drifting away from projects deemed to be too aligned with DEI or not aligned with the administration’s definitions of biological sex.
Many healthcare companies have been striving to improve healthcare access and care quality for underrepresented populations.
Priyanka Jain is the CEO and co-founder of women’s health research startup Evvy. Her company is currently focused on the discovery of novel female biomarkers in the vaginal microbiome to better understand diseases that disproportionately affect women, such as heart disease, Alzheimer's and autoimmune disorders.
“I felt like I spent the first three years at Evvy doing a lot of education, explaining to investors, you know, there's actually this massive overlooked opportunity, and there are dollars here … When Joe Biden got on the national stage and pointed out all of these gaps, I had to do less of that education, because it was being done at a federal level,” Jain explained.
During the Biden administration, particularly in its last year when former First Lady Jill Biden spearheaded the White House Initiative on Women’s Health Research, Jain said her life as a CEO became easier because she didn’t have to explain the need to invest in women’s health.
But Jain caveated that while she appreciates the work of the Bidens to fund women’s health research, the problems facing women’s health care and research are deeply rooted.
“Healthcare has never been designed for women,” Jain said. “The services have never prioritized us. Research budgets have never prioritized us, reimbursements never prioritized us. Like it's just never really been on the agenda. And even though Dr. Biden tried really hard towards the end, there were so many systems to change that just didn't change. And so in some ways, it's almost clear now. It's almost like, 'OK, the system's not going to do it for us, so we must do it for ourselves.'”
Jain believes that women’s health has gained significant momentum among investors and will continue to advance in the private sector, especially because more women have been hired at venture capital firms. “The only thing that's ever changed the system is women investing in women who are solving problems for women,” Jain said.
The growing number of female investors will help the private healthcare market move forward with innovation in women’s health and continue to expand the availability of healthcare services to LGBTQ+ people.
Investors have begun asking questions about regulatory risks to her business now that Trump is in office. “It’s pretty hard to regulate us out of existence,” she said.
Multiple law firms noted in their posts that state and federal anti-discrimination laws still stand, despite the slate of executive actions by Trump. "Laws passed by Congress make clear that workplace discrimination is still illegal, and Trump’s attempts to eliminate basic civil rights will not go unchecked by the courts," the National Women’s Law Center wrote.