Multiple Wisconsin health care systems have removed diversity, equity and inclusion language or resources from their websites in the wake of President Donald Trump’s federal ban on funding for DEI programming.

The systems include SSM Health, Aurora Health, UW Health and, most recently, Ascension. Froedtert ThedaCare Health has maintained its DEI webpage, though it removed a link to its equal employment opportunity policy in recent months. 

Aurora Health, Ascension, Froedtert and SSM Health made the changes quietly, without directly alerting the public. UW Health, however, released an op-ed in Madison 365 April 8 explaining the changes.

“As we enter the next phase of this important work, we are further aligning with our organizational mission under the name of Social Impact and Belonging,” the op-ed said. “This reflects both the evolved nature of the work and our desire that these mission-focused priorities endure despite the current tumultuous political environment.”

The changes occurred in the weeks after President Donald Trump’s executive order abolishing DEI programs from all federally funded institutions and programs. 

The executive order, issued Jan. 20, states the “Biden Administration forced illegal and immoral discrimination programs, going by the name ‘diversity, equity, and inclusion’ (DEI), into virtually all aspects of the Federal Government, in areas ranging from airline safety to the military.” 

In response to attacks on DEI programs by the federal government, some organizations have pushed back, arguing Trump’s actions are a threat to a multiracial democracy. Some institutions are also suing the federal government for its actions, such as threatening to withhold federal grants and funding. 

Harvard University has filed a lawsuit, citing First Amendment principles to protect “academic freedom” and “private actors’ speech.”

But while some federally funded institutions are pushing back, others are not.

Different approaches to DEI purge

In the past couple of months, SSM Health removed the word “diversity” from its website, including changing a page titled “Our Commitment to Diversity” to “Our Commitment to Healthy Culture.”

SSM has hospitals located throughout Wisconsin including Ripon, Fond du Lac, Waupun, Baraboo, Janesville, Madison and Monroe.

In changing the webpage, SSM Health also removed an entire section regarding its commitment to fostering a diverse workplace and health care center, including a section that read, “​​SSM Health makes it a point to work with diverse organizations broadening our reach into the communities we serve to support and promote a more inclusive society.”

SSM Health also notably replaced the section discussing diversity with comment on SSM Health’s mission as a Catholic ministry. On the updated page, the system discusses its commitment to follow in the footsteps of its founders to ensure “all people have access to the high-quality, compassionate care they need.” 

In removing the word “diversity,” SSM replaced the statement “At SSM Health, diversity is an integral part of who we are and a reflection of our mission and values” with “At SSM Health, inclusion is an integral part of who we are and a reflection of our Mission, Vision and Values.”

”Today, our belief that every person was created in the image of God with inherent dignity and value calls us to foster a healthy culture, inviting each person to be the best version of themselves,” SSM Health communications consultant Shari Wrezinski said when asked for comment. 

Wrezinski said the organization’s mission has remained the same, and its communications, policies, programs and practices reflect the organization’s mission.

“This has not and will not change,” Wrezinski said. “As such, our website and other communications materials are continually updated as we strive to clearly convey our commitment to a welcoming environment where everyone feels valued and respected.”

Despite removing the section on diversity, SSM Health has maintained its equal opportunity section.

Froedtert did the opposite, by maintaining its webpages on diversity, equity and inclusion, but removing its equal opportunity policy document from the pages. 

The equal opportunity document, which can still be found online but was removed from the DEI website, specifically outlines Froedtert’s commitment and policy to maintain equitable and nondiscriminatory recruitment, hiring and human resources practices. 

The document outlines two policies specifically: “FH is committed to its affirmative action policies and practices in employment programs to achieve a balanced workforce” and “FH will provide equal opportunity to all individuals, regardless of their race, creed, color, religion, sex, age, national origin, disability, military and veteran status, sexual orientation, gender identity, marital status or any other characteristics protected by state or federal law.”

Froedtert did not respond to requests for comment. 

The Froedtert system serves patients primarily in the Milwaukee area. Froedtert recently merged with ThedaCare, serving Wisconsin residents in the Fox Valley and Green Bay. In 2020, the system reported receiving tens of millions in federal funding through the CARES Act in response to the COVID-19 pandemic.

While removing a link to an equal opportunity document may be a simple change, the Rev. Marilyn Miller, a partner in Leading for Racial Equity LLC, said every small change pushes society further back in achieving full access and equity. 

“So it might be a small tweak now, but what does that open the door to later? So, yeah, it’s impactful because any change that’s stepping back from full equity is a problem,” Miller said. “There’s populations that don’t feel any security anymore.”

Aurora Health Care also has removed DEI language in the past couple of months since the executive order. 

In 2018, Aurora merged with Advocate Health, a system with more than 26 hospitals throughout the Midwest. Advocate Aurora Health later merged with Atrium Health in 2022, creating the third largest nonprofit in the nation.

Earlier this year, Aurora removed an entire page on diversity, equity and inclusion. The page now redirects to Advocate’s page titled “Access & Opportunity.”

That change cut statements such as: “Our diversity, equity and inclusion strategy is anchored by our purpose to help people live well and to deliver safe, consistent, and equitable health outcomes and experiences for the patients and communities we serve.” 

A spokesperson for Aurora Health Care said the organization will continue to “deliver compassionate, high-quality, consistent care for all those we serve.”

“As our newly combined purpose and commitments state, we lift everyone up by ensuring access and opportunity for all,” the spokesperson said. “To provide our patients and communities clear and consistent information that explains our programs, policies and services, we are making various changes to our websites.”

Ascension, one of the largest nonprofit hospital systems in the nation, took down the entire page on diversity, equity and inclusion. The health care system currently operates at over 165 locations in Milwaukee, Racine, Appleton and Fox Valley.  The system still has modules on “Identifying & Addressing Barriers to Health” and “Ensuring Health Equity.” Ascension did not respond to a request for a comment.

Making a statement

UW Health removed its page on diversity, equity and inclusion, replacing it with a page titled “social impact and belonging.” In doing so, UW Health removed “anti-racism” from its entire website. It used to be one of the main themes.

UW Health removed the anti-racism modules titled “Being a leader in anti-racism” and “anti-racism funding,” and now in their place are modules called “Being a social impact leader” and “Community giving.” 

Chief Social Impact Officer Shiva Bidar-Sielaff and CEO Alan Kaplan addressed the changes in a video, stating social impact and belonging align with their mission, values and strategies as a health care organization.

“At UW Health, social impact refers to the effects health care policies, practices and interventions have on the well-being of individuals and communities, improving health outcomes, access to care and quality of life,” Bidar-Sielaff said. “Belonging is the understanding that you are valued and respected for who you are as an individual.”

The UW-Madison School of Medicine and Public Health, which has faculty who also work for and provide clinical care at UW Health, reported receiving $315 million in federal research funding last year. That total is 37% of all grant funding awarded to UW-Madison. UW Health received roughly $5.1 million in federal grants.

Despite claims by health care centers that missions remain the same, advocacy groups in Wisconsin are raising concerns regarding the impact these changes could have on communities in Wisconsin.

Chris Allen, president and CEO of Diverse & Resilient — an advocacy group focused on health inequities for LGBTQ+ people in Wisconsin — said these quiet language shifts are significant. 

“They send a message that commitments to addressing disparities may be weakening, even if that’s not the stated intention,” Allen said. 

William Parke Sutherland, government affairs director at Kids Forward, a statewide policy center that advocates for low-income and minority families, said many health care partners feel pressured to preserve funding sources.

In Wisconsin, maternal mortality rates are 2.5 times higher for Black women than white women. Maternal morbidities — or serious birth complications — were the highest among Black women and people enrolled in BadgerCare, the state’s largest Medicaid program. From 2020 to 2022 there were 7.8 stillbirth deaths per 1,000 births among Black babies, compared with 4.5 among white babies.

Disparities in maternal and infant mortality rates could be attributed to stress caused by poverty, lack of access to quality care, or systemic racism, according to health care researchers. If a mother is stressed over a long period of time, that can cause elevated levels of stress hormones, which could increase premature births or low birth weights for infants.

For Black women, midwives have been found to reduce the disparities they otherwise may experience during pregnancy, reducing the risk of maternal mortality or morbidity. Access to midwives is currently covered by Medicaid, so losing federal funding could harm these services.

Regardless of language, “Wisconsin’s racial disparities in health access and outcomes aren’t going away on their own,” Sutherland said in an email.

Removing language that acknowledges DEI efforts will not reduce the health care disparities felt by Wisconsin residents, Sutherland said. Federal funding cuts could also hurt rural families in Wisconsin, specifically those who rely on Medicaid for their health care needs. 

“We cannot begin to address these challenges if we’re not willing to acknowledge them,” Sutherland said. “A colorblind approach has not helped in the past.”

Editor’s note: This story was updated to correct a reference to how much federal funding UW Health receives.

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We don’t talk about DEI: Wisconsin hospital systems are quietly removing diversity language is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

People wait outside of the Lyndon B. Johnson Hospital in Houston. For years, states have taxed hospitals and other health care providers to draw down federal matching funds and help finance their Medicaid programs. Now, states may lose their ability to raise or implement new taxes. (Photo by Brandon Bell/Getty Images)

The tax and spending bill the U.S. House approved targets a strategy states have used to boost the Medicaid dollars they get from the federal government. The measure would cap or freeze the taxes states levy on medical providers, potentially leaving states with major holes in their Medicaid budgets.

As a result, states would face the choice of either replacing the lost federal money with state dollars, scaling back services or providing coverage to fewer people.

Medicaid is a joint state-federal program, primarily for people with low incomes. For the traditional Medicaid population — children and their caregivers, people with disabilities and pregnant women — the federal government matches state Medicaid spending on a sliding scale, ranging from 50% for the wealthiest states to 77% for the poorest ones.

Consider a state that gets half of its Medicaid funding from the federal government. If that state collects $100 million by taxing providers, it can use $50 million of the revenue to draw down $50 million in federal matching funds, which it can use to expand Medicaid coverage to more people. Then it can take the remaining $50 million in revenue and use that money to draw down $50 million in federal dollars to pay providers more for caring for Medicaid patients.

Forty-nine states — all but Alaska — use the strategy. In 2018, the most recent year for which data is available, states relied on provider taxes to fund 17% of their Medicaid spending, up from 7% in 2008, according to the U.S. Government Accountability Office.

As part of their effort to cut federal Medicaid spending by roughly $625 billion over the next decade, House Republicans have proposed capping the state provider taxes and freezing them in place, preventing states from raising them or implementing new ones in response to inflation. Under current law, states can levy taxes of up to 6% on tax providers’ net revenue. The GOP measure also would add work requirements for Medicaid recipients, a step that would save money by reducing the rolls.

A report from the Congressional Budget Office, the bipartisan research arm of Congress, says eliminating the taxes entirely could save the federal government hundreds of billions of dollars over the next decade.

Many conservatives say the taxes are an accounting trick that allows states to draw down money from the federal government without having to front their true share of the Medicaid program. Some have even called the provider taxes a “money laundering” scheme.

“States are gaming the system — creating complex tax schemes that shift their responsibility to invest in Medicaid and rob federal taxpayers,” Dr. Mehmet Oz, the administrator of the federal Centers for Medicare & Medicaid Services, said in a May 12 news release.

Brian Blase, president of the Paragon Health Institute, a conservative policy group that is working with Republicans to formulate Medicaid cuts, described provider taxes as “a way that states and providers can rip off the federal government.”

“States need to have some accountability for the spending in their programs,” Blase said.

But advocates of these taxes, including state Medicaid directors and even the hospitals that pay the taxes, describe them as legal and legitimate financial tools that have helped providers cover essential services and states fund their Medicaid programs for years. The result of eliminating these taxes or freezing them, they say, will be hospital closures and service cuts.

“We don’t like to pay these taxes, but the alternative is resources or access to care aren’t there for that community,” said Jason Pray, vice president of legislative affairs at America’s Essential Hospitals, an association representing about 350 hospitals. “The state would more than likely have to then tax individuals to make up for that, to keep the services at the same level and keep the resources at the same level.”

Blase said the provider taxes allow hospitals to make windfall profits from the additional federal matching funds that flow back to them, representing a type of “corporate welfare.”

But Pray said often hospitals in his association are losing money. By allowing states to boost payments to hospitals and other providers that serve Medicaid patients, he said, the tax enables hospitals to stay open in the long run, not garner a windfall.

Pray also noted that in the past, support for the taxes has been bipartisan.

“Republicans for years have shown they support provider taxes and have understood the value of them,” he said.

Edwin Park, a research professor at the Georgetown University McCourt School of Public Policy, pointed out that some hospitals pay the tax and don’t get much back, because they serve few Medicaid patients. The hospitals that benefit most are the so-called safety net hospitals that do care for many low-income patients, he said.

Park said he is worried that once the strategy is off the table, states will have to cut their Medicaid spending to balance their budgets.

Jay Ludlam, deputy secretary for North Carolina Medicaid, is worried about that, too. In North Carolina, Ludlam said, almost all of the tax revenue the state collects from providers helps pay for Medicaid services.

“The money goes to providers when they provide services. It’s not special. It’s just another way that states tax themselves and put money into the program,” Ludlam told Stateline. “If it means that there’s going to be less money in Medicaid … we’ll have to cut eligibility, cut benefits, cut provider rates, in order to maintain the program.”

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.