Dear friends,
Something almost unprecedented happened at our recent webinar on risks and opportunities for health equity in a time of uncertainty: 2,554 people, our second-highest number ever, registered to attend.
That makes sense, because much of what is happening now in health policy and U.S. policy more broadly is also unprecedented. The near-record number reflects the confusion, distress, and fear that many health equity champions are feeling—plus the practical uncertainty about what to do.
Right now, a flood of actions by the Trump administration is freezing funds and pausing programs across all kinds of health equity work. Pending actions by the White House and Congress also threaten to dramatically slash Medicaid, which covers 1 in 5 Americans and which states increasingly use to address health-related social needs. Amid the chaos, some healthcare institutions are defensively halting equity programs before actually being ordered to.
The effect can be, perhaps not unintentionally, paralytic. Yet we remember that health equity work has never been easy. It requires pivots, persuasion, and persistence. And if we pause to understand and reflect, we see that we have agency and options to respond.
On our webinar, “Complying in Advance: Understanding Risks and Opportunities for Health Equity Work in a Time of Uncertainty,” expert panelists spelled out three steps we can all take to navigate uncertainty effectively.
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Understand threats: Amid uncertainty, we need to make sense of the new policies, clarify what they mean and distinguish between those which are actual threats or just words. This means reading the whole text of executive orders and seeking reliable sources to assess their legality. Ken Thomas, Constitutional expert and former legislative attorney with the Congressional Research Service, delineated the distinct powers of the president, Congress, and federal agencies and pointed out that executive orders are only valid to the extent that they comply with existing law. Megan Thomas of Aurrera Health Group walked through what’s at stake if Medicaid cuts go through. Health equity advocates can use the Sheppard Mullin law firm’s executive actions tracker to monitor White House actions and the Just Security litigation tracker to follow legal challenges to them.
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Assess the risks of federal actions to your institution, the patients you serve, your employees, and your community. This should not be an abstract exercise. Established risk assessment approaches and tools can help institutions move past fight-or-flight mode to weigh their strengths, challenges, and potential mitigating actions. For example, Annie Chang from the Nonprofit Finance Fund offers the NFF’s Scenario Planning Tool to help nonprofit leaders quantify what-ifs and plan how to address interruptions of each major funding stream. The risks you assess should not only be legal ones, but should include risks to mission, brand reputation, staff morale, patient care, and many other critical priorities.
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Take action to protect our institutions and the people we serve and employ. Channel the anxiety spurred by uncertainty into a thoughtful response—institutionally, individually, collectively. Healthcare risk management specialist Josh Hyatt explained that it’s critical to implement risk management approaches with integrity, addressing financial, legal, and reputational risk in a way that safeguards institutional viability and public trust. True risk management, he said, goes beyond crisis and compliance; it’s about our long-term commitment to clients and staff.
HealthBegins is committed to helping our health-equity community navigate this moment’s challenges with sound information, moral clarity, and effective tools. In addition to the webinar recording, you can access our blog on how to prepare and respond to immigration enforcement in healthcare settings. New blogs about safeguarding care for transgender and immigrant communities are coming soon.
One of our biggest efforts is the forthcoming Health Equity Policy Hub to help professionals stay informed with rapid updates on executive branch policies that impact health equity—from executive orders to HHS informational bulletins that affect HRSN supports in Medicaid—plus tools to assess risks and resources to take action. Sign up to stay notified when the hub launches and learn how you can get involved.
Historically, institutions have been an essential bulwark against harmful policy. Get informed and stay steady. Our communities need us now as much as ever.
Best,
Rishi Manchanda, MD, MPH. Sadena Thevarajah, JD
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