THE LATEST: On August 4, 2023, a coalition of the country’s leading medical organizations representing thousands of physicians dedicated to improving the health and well-being of all people—including the American Medical Association (AMA) and the National Medical Association (NMA)—filed a friend of the court brief in the U.S. District Court in the Southern District of Mississippi in support of the Centers for Medicare & Medicaid Services’ (CMS) legal authority to incentivize health care providers to create anti-racism plans. The coalition’s brief details how anti-racism plans fall well within the “improvement activities” Congress authorized CMS to consider for the purposes of its Merit-based Incentive Payment System (MIPS), which CMS uses to determine reimbursement rates for health care providers.  

The case—yet another example of right-wing actors seeking to undermine racial equity through the courts—is State of Mississippi v. Becerra, a lawsuit brought by Attorneys General from Mississippi, Alabama, Arkansas, Kentucky, Louisiana, Missouri, and Montana to stop CMS from including anti-racism plans as an optional clinical practice improvement activity for providers. The coalition is represented by Democracy Forward Foundation and Wilmer Cutler Pickering Hale and Dorr LLP.. 

In the brief, the coalition explains for the Court how racism threatens public health and how anti-racism plans improve health outcomes for all patients. It warns that blocking federal agencies from creating optional incentives to promote health equity will make it much more difficult to address the racial inequities in our health care system.


In 2015, Congress authorized the Centers for Medicare & Medicaid Services (CMS) to establish a Merit-based Incentive Payment System (MIPS) that scores providers along several performance measures, including “clinical practice improvement activities.” In deciding to count optional anti-racism plans as one of more than 100 improvement activities—one of ten targeted specifically at achieving health equity—CMS acknowledged the need to move beyond simply documenting racial disparities and address their root causes.  

The health harms of racism, including inequities in the quality of clinical care for BIPOC individuals, and Black patients in particular, are widely recognized. The efficacy of anti-racism plans to improve clinical practice and health outcomes for all individuals is firmly accepted within the medical and public health community.   

This lawsuit brought by a group of far-right state attorneys general is another example of extremists seeking to use the courts to strike down policies designed to promote racial equity and improve public health. Diversity, Equity and Inclusion initiatives, race-based affirmative action in college admissions, and public education about systemic racism have all been the targets of coordinated legal and political attacks by far-right actors—who have only been emboldened by recent Supreme Court decisions.