HHS Ends Race-Based Sorting in Civil Rights Enforcement

The Department of Health and Human Services (HHS) announced Thursday that it will shift its approach to civil rights enforcement, moving away from race-based sorting and instead focusing on individual status in its investigations. This change updates HHS regulations to align more closely with the Civil Rights Act of 1964 and recent Supreme Court precedent, marking a significant policy adjustment in how the federal agency addresses discrimination claims in health care and related settings.

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The new policy is part of a final rule issued by the HHS Office for Civil Rights. According to the department, the rule is designed to restore what it calls "common sense and true equality" to civil rights enforcement. The update also brings HHS policy into compliance with President Donald Trump’s Executive Order 14281, signed in April 2025, which directed federal agencies to focus on "Restoring Equality of Opportunity and Meritocracy."

New Enforcement Approach

Paula M. Stannard, director of the HHS Office for Civil Rights, explained the department’s revised stance in a public statement. She emphasized that HHS "will not pressure doctors, hospitals, universities, or state agencies to sort people by race to satisfy a statistic."

"Civil rights laws protect Americans as individuals." — Paula M. Stannard, director, HHS Office for Civil Rights

Under the new rule, HHS will continue to investigate complaints and conduct compliance reviews when there is evidence of discrimination based on race, color, or national origin. However, the department clarified that enforcement actions will now focus on intentional discrimination, rather than relying solely on statistical disparities to identify potential violations.

This marks a departure from previous practices, in which federal agencies, including HHS, sometimes used statistical evidence of disparate outcomes as a primary basis for investigating and addressing discrimination. Critics of the old approach argued that it encouraged institutions to sort or treat people differently based on racial categories in order to avoid negative findings, even in the absence of direct evidence of discriminatory intent.

The department’s new policy aims to ensure that civil rights laws are enforced on an individual basis. HHS officials say this approach is more consistent with the original intent of the Civil Rights Act, which prohibits discrimination against individuals on the basis of race, color, or national origin in programs and activities receiving federal financial assistance.

Impact of Executive Order 14281

President Trump’s Executive Order 14281, issued in April 2025, played a central role in prompting the regulatory change. The order eliminated the use of the disparate-impact doctrine as a standalone basis for federal agencies to target employers or organizations for discrimination. The disparate-impact doctrine previously allowed agencies to take action when a policy or practice had a negative effect on a protected class, even if there was no direct evidence of discriminatory intent.

Under the new HHS rule, statistical disparities may still be considered as part of an investigation, but only in conjunction with other evidence that could indicate intentional discrimination. The department says this approach is intended to ensure that enforcement actions are based on actual evidence of wrongdoing, rather than on outcomes alone.

Supporters of the change argue that it will prevent federal agencies from imposing race-based requirements or quotas on institutions, and will help restore a focus on individual rights. They contend that the previous reliance on disparate-impact analysis sometimes led to unintended consequences, such as institutions making decisions based on race in order to comply with federal expectations.

Ongoing Civil Rights Reviews

Despite the policy shift, the HHS Office for Civil Rights stated that it will continue to review complaints and monitor compliance in health care and related settings. The department emphasized that civil rights laws remain in force to protect individuals from discrimination based on race, color, and national origin.

HHS officials noted that the department will still investigate allegations of discrimination and take enforcement action when there is evidence of intentional bias. The department says it remains committed to ensuring equal access to health care and other federally funded services, consistent with the requirements of the Civil Rights Act.

However, the department did not directly address criticism from some civil rights advocates, who argue that eliminating disparate-impact enforcement could weaken protections for minority groups. These advocates contend that focusing solely on intentional discrimination may make it more difficult to address systemic disparities that can arise even in the absence of overt bias.

The new rule is expected to affect how hospitals, universities, state agencies, and other organizations that receive federal funding approach civil rights compliance. HHS says it will provide guidance and technical assistance to help institutions understand and implement the updated requirements.

The department’s announcement reflects an ongoing debate over the best way to enforce civil rights protections in the United States. While supporters of the change say it restores fairness and individual rights, critics warn that it could leave some forms of discrimination unaddressed. HHS maintains that its revised approach is both legally sound and consistent with the principles of equality under the law.