How the Biden CMS Corrupted Healthcare With Radical Identity Politics

As the federal agency responsible for administering core national health insurance programs, the Centers for Medicare & Medicaid Services (CMS) should aim to promote a healthcare system free from divisive politics or discriminatory practices.

Yet during the Biden administration, CMS adopted a number of policies actively working against this ideal. These policies were often in pursuit of the administration’s “health equity” agenda, and encouraged medical providers to advance radical identity politics or even outright discriminate on the basis of race. 

Since our founding in 2022, Do No Harm has worked to expose and combat these harmful policies. We’ve repeatedly submitted comments opposing CMS’ divisive agenda and supported litigation against the agency’s discriminatory rules.

It is absolutely imperative that CMS ditch these regressive practices. 

A CMS that promotes a robust healthcare system cannot at the same time promote racial discrimination: the two concepts are mutually exclusive.

‘Health Equity’

The core organizing premise of CMS’ discriminatory policies is “health equity,” which holds that the racial disparities in health outcomes and healthcare are due to systemic racism.

Most recently, CMS proposed a rule to implement a new payment model, the Increasing Organ Transplant Access (IOTA) Model, to reduce perceived disparities in treatment for kidney issues. The model, justified on the basis of “health equity,” would encourage hospitals to racially discriminate in the kidney transplantation selection process in order to receive incentive payments.

Do No Harm called on CMS to withdraw the rule in June 2024, arguing it exceeded the agency’s statutory authority as well as promoted illegal discrimination.

“In short, the proposed rule would encourage providers to adopt plans that favor some racial

groups in the kidney-transplant process over others,” Do No Harm’s comment stated. “As a matter of policy, law, and morality, this cannot stand.”

Multiple media outlets, including the Washington Free Beacon, covered the proposed rule and Do No Harm’s reaction.

In November 2024, CMS announced the finalized rule which dropped the proposed requirement for hospitals to submit ‘health equity plans’ to receive incentive payments.

This is a major victory, but this particular policy is just the tip of the iceberg when it comes to CMS’ racially divisive agenda. Since the beginning of the Biden administration, CMS has worked to inject radical concepts like DEI into the healthcare and medical fields.

On his first day of office on January 20, 2021, President Joe Biden issued Executive Order 13985, directing federal agencies to address perceived “systematic racism” and promote “equity.” 

CMS, relying on this executive order, published a rule in July 2021 proposing to create an “anti-racism plan” that encourages CMS to address “health equity” and reduce racial disparities, as well as potentially administering anti-racism and implicit bias trainings. In particular, the rule would financially reward doctors for adopting “anti-racist” policies in their practices.

“As physicians try to abide by this policy, they will find it harder and harder to provide equal access to care,” wrote Do No Harm Senior Fellow Benita Cotton-Orr in the New York Post.

Do No Harm supported a lawsuit against CMS over the rule that argued the regulation was not supported by statutory authority and encouraged doctors to engage in racial discrimination. The lawsuit is ongoing, with a federal judge denying the federal government’s motion to dismiss the complaint in 2023. Do No Harm also praised Congressman Gary Palmer (R-AL) for introducing the Prevent Racism in Medicare Act, which would revoke the anti-racist incentive policy.

Then in April 2022, CMS issued a proposed rule for inpatient and long-term hospitals, forcing them to report information on patient race, ethnicity, income, geographic location, sexual orientation, and gender identity. This information could then be used to financially reward or punish healthcare providers based on their adherence to identity politics. Do No Harm urged the public to comment on the rule in July 2022, and submitted comments later that month raising the alarm about the rule’s potential for abuse.

In 2023, CMS proposed two rules that would modify quality reporting programs for skilled nursing facilities and cancer hospitals, respectively. These reporting programs use payment incentives and payment reductions to ensure facilities are providing adequate care.

However, the modifications instead promote the concept of “health equity” once again by including a health equity scoring system in the quality reporting guidelines. This encourages providers to promote health equity, which in practice is essentially racial discrimination. The finalized version of the rules went into effect later in 2023. 

Moreover, in September 2023, Do No Harm submitted comments on a CMS rule that would alter physicians’ fee schedule within Medicare and Medicaid to promote health equity, expressing concern that the rule would financially encourage providers to discriminate against their patients.

“Stated plainly, the proposed rule change would directly incentivize healthcare providers to deliver more services to patients of certain races/ethnicities, sexualities, and religions,” the comment stated. “Such a system would constitute a clear violation of the Civil Rights Act of 1964, and pushing individual patients to the front of the line based on any factor other than their health status is morally wrong.”

That rule also went into effect later in 2023.

Unwinding Racial Discrimination

These policies represent the most visible manifestations of how CMS has injected racially discriminatory ideals into the healthcare system.

Financially incentivizing doctors to discriminate against their patients and promote radical ideology goes against the very foundation of medical ethics: to do no harm. These CMS policies instead subjugate public health to an insidious agenda that views Americans by their race, and not by their health needs. 

The next administration should take action immediately to unwind these harmful regulations and promote a healthcare system that is free and equal – and not one that punishes Americans based on their race.