Health Equity blog

A newly issued report from the Center for Healthcare Quality & Payment Reform (CHQPR) claims that, just since 2020, over 100 rural hospitals have stopped delivering babies or will by the end of this year. Moreover, a mere 42% of all rural hospitals still offer labor and delivery services. These figures are daunting for pregnant women because the implications include longer commutes to find a hospital that provides these vital services, which can be life-threatening for medically complicated pregnancies. The CHQPR report does, however, outline possible actions that can be taken to curb this alarming trend.

In accordance with the Trump Administration’s February 2025 memorandum – Radical Transparency About Wasteful Spending – the Department of Health and Human Services (HHS) has been terminating numerous grants. HHS maintains the Tracking Accountability in Government Grants System (TAGGS), a database of grants awarded by HHS’s twelve operating divisions, including the NIH, and the running list of terminated grants can be found here.

The original study conducted on cancer antigen 125 (CA-125) in 1981 involved mostly White women as subjects, which established the thresholds applied universally to all women for early detection of ovarian cancer. A March 2025 study published in JAMA Network Open, however, concluded that the healthy levels of CA-125 in Black women were 10 to 37% lower, and for Native American women up to 20% lower, compared to White women. Consequently, these diverse populations have experienced delays in treatment and poorer health outcomes due to underdiagnosis based upon CA-125 test results.

As part of his “Make America Healthy Again” (MAHA) platform, HHS Secretary Robert F Kennedy, Jr announced his initial plans to reduce perceived waste and inefficiencies within the Department, which includes an additional reduction in personnel by 10,000 FTEs, purportedly saving taxpayers $1.8 billion annually. In addition, the previous 28 divisions within HHS will be reduced to 15 newly restructured and repurposed divisions. The plans establish the Administration for a Healthy America (AHA), which will combine multiple agencies including the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH) as one entity.  Meanwhile, a MAHA caucus has been established in both the House and Senate to align legislative efforts with the Secretary’s societal health goals, including improving access to primary care and nutritious food sources.

On April 10, the Centers for Medicare and Medicaid Services (CMS) sent a letter to all state Medicaid directors, informing them that CMS would no longer be approving proposed 1115 Medicaid waivers’ inclusion of programs with a non-medical purpose, such as housing, nutrition, and transportation assistance. CMS’s rationale is that such programs have historically not otherwise been covered under Medicaid and should not be subject to federal matching funds as part of new Section 1115 applications (nor will existing ones be allowed as part of any renewals).

Another JAMA Network Open study published earlier this month determined that individual social risk screenings are more accurate in assessing and adequately determining patients’ needs for outpatient services compared to the traditional local community level screenings that rely upon the federal Neighborhood Deprivation Index (NDI). Individual self-reported social risk screening requires patients to indicate their specific social needs, such as financial assistance, food, housing, or transportation. Although these individualized screenings may be more productive, they are nonetheless hampered by dependency upon a greater concentration of resources, as well as patients’ reluctance to participate due to the perceived stigma, among other challenges.

On March 15, President Trump signed into law the Full- Year Continuing Appropriations and Extensions Act, 2025, narrowly averting a partial federal government shutdown. Buried within this Act are certain provisions that impact health care delivery. Section 2207 extends Medicare flexibilities for telehealth services provided by rural health clinics and Federally Qualified Health Centers (FQHCs) – previously extended in the Consolidated Appropriations Act, 2023 – through September 30, 2025. Similarly, Section 2208 extends the Acute Hospital Care at Home initiative, as currently authorized under Centers for Medicare and Medicaid Services (CMS) waivers and flexibilities, through September 30 as well.

In accordance with President Trump’s Executive Order 14173, which is aimed at eradicating discrimination and restoring merit-based opportunities, HHS’s Office of Civil Rights (OCR) is investigating four medical schools and hospitals that receive HHS funding. In response to alleged violations of Title VI of the Civil Rights Act of 1964, OCR is assessing whether these medical schools and hospitals are operating medical education, training, or scholarship programs that discriminate on the basis of race, color, national origin, or sex. Executive Order 14173 directs federal agencies to enforce long-standing civil rights laws and “to combat illegal private sector DEI preferences, mandates, policies, programs, and activities.”

California’s Department of Healthcare Access and Information published a new online set of resources that provides a framework for furthering efforts that strengthen demographic healthcare quality data collection, analysis, reporting, and equity planning. The toolkit is the progeny of California’s Hospital Equity Measures Reporting Program, which seeks to improve healthcare quality data and address historical health disparities by requiring the development of hospital equity plans and bolstering more accurate reporting of racial and demographic data.

In the aftermath of Dobbs v. Jackson Women’s Health Organization in 2022, New York became one of eight states that On March 4, CMS’s Center for Medicaid and Children’s Health Insurance Plan (CHIP) Services announced its rescission of two Center Informational Bulletins (CIBs) that described opportunities available under Medicaid/CHIP to cover certain services that address health-related social needs (HRSN). CMS states that the recission is necessary while it evaluates policy options consistent with Medicaid/CHIP program requirements and objectives.