Health Equity blog

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.

Idaho continues to be a focal point for ongoing legal battles over state laws that totally ban or otherwise severely restrict access to abortion services from health care providers. As expected, in early March the Trump Administration dismissed a pending DOJ federal lawsuit brought against the State of Idaho under the Biden Administration, which sought a ruling that Idaho’s ban on abortions conflicted with the hospital’s Emergency Medical Treatment & Labor Act (EMTALA) emergency care obligations. Idaho’s AG announced on March 5 that the DOJ was dismissing the lawsuit because EMTALA does not require abortions that otherwise would arguably conflict with Idaho’s Defense of Life Act. Rather, the Idaho statute permits an abortion based upon the medical judgement of a physician who, in good faith, believes the mother’s life is threatened. In a separate lawsuit filed by St. Luke’s Health System – Idaho’s largest hospital network – against the State, a federal judge issued an injunction on March 20. The injunction temporarily shields St. Luke’s and its providers from criminal prosecution under Idaho’s abortion law for performing abortions in emergencies, which will remain in effect while the case continues to be litigated.

In the aftermath of Dobbs v. Jackson Women’s Health Organization in 2022, New York became one of eight states that subsequently enacted a “telemedicine abortion shield law” intended to protect abortion providers who prescribe abortion pills – such as mifepristone – to patients in other states. Testing the shield law’s legalities, in January, Louisiana indicted a New York physician for prescribing abortion pills to one of its residents. Earlier this month, the same physician was civilly fined $100,000 by the Texas Attorney General under similar circumstances involving a patient residing within its jurisdiction. Both Texas and Louisiana enforce strict near-total bans on abortion. These cases highlight the deep political divide that exists among the states with regard to abortion and at least one of these cases is expected to make its way to the U.S. Supreme Court.

In the aftermath of Dobbs v. Jackson Women’s Health Organization in 2022, New York became one of eight states that subsequently enacted a “telemedicine abortion shield law” intended to protect abortion providers who prescribe abortion pills – such as mifepristone – to patients in other states. Testing the shield law’s legalities, in January, Louisiana indicted a New York physician for prescribing abortion pills to one of its residents. Earlier this month, the same physician was civilly fined $100,000 by the Texas Attorney General under similar circumstances involving a patient residing within its jurisdiction. Both Texas and Louisiana enforce strict near-total bans on abortion. These cases highlight the deep political divide that exists among the states with regard to abortion and at least one of these cases is expected to make its way to the U.S. Supreme Court.

The latest report from the Centers for Disease Control and Prevention (CDC) on maternal mortality rates in the United States reveals a concerning statistic. In 2023, the maternal death rate overall, as well as among specific races, fell below prior year levels, with one notable exception – Black women. The maternal death rate among Black women in 2023 remained essentially the same as 2022, at a rate of approximately 50 per 100,000 births. White women, on the other hand, saw a significant decrease, dropping from a rate of 19 to 14.5 per 100,000 births. Hispanic and Asian women also experienced a significant decrease in maternal mortalities in 2023.

The 2025 Rural Health State of the State report issued by the Chartis Center for Rural Health exposes the dire circumstances facing sustained access to care in rural areas of the United States. “Care deserts” continue to proliferate at a time when the population health status of the more than 46 million residents living in these rural areas is already on a downward spiral. The Chartis report also opines that nearly half of all rural hospitals in the United States are operating in the red, and 432 rural hospitals are vulnerable to permanently closing their doors. In the past year alone, 18 rural hospitals have already either ceased operations or discontinued inpatient services.

President Trump has issued an unprecedented number of executive orders so early in his presidency, many of which have health equity implications, such as those impacting transgender care. While a president may issue executive orders to direct federal agencies to take steps within the scope of the president’s constitutional authority or as delegated by Congress, executive orders may not exceed that authority or otherwise override federal laws and statutes. Many of President Trump’s administrative actions are being challenged in court as exceeding that authority. Just Security, an online platform affiliated with NYU School of Law, has established a webpage that tracks litigation in response to executive orders, memoranda, proclamations, and other actions taken by the Trump Administration. With the rapidly evolving legal challenges to President Trump’s actions, Just Security’s well-organized website provides a handy tool to stay abreast of the latest developments.