EO 14319 risks undermining health equity by discouraging AI models from incorporating DEI frameworks critical to addressing disparities. Without explicit equity safeguards, “neutral” AI may reproduce systemic biases, worsening outcomes for marginalized populations—particularly Black, Latino, and LGBTQ+ communities already facing disproportionate barriers in healthcare. In cities like New York, where nearly 60% of people with HIV are people of color, stripping equity-focused design from AI threatens to deepen inequities rather than reduce them. Many healthcare institutions see DEI frameworks as essential, not as distortions. AI without DEI risks: 1) Reinforcing systemic inequalities; 2) Erasing marginalized communities from representation; 3) Producing “neutral” outputs that actually reproduce the dominant ideology (status quo bias).
A directive issued by the President that manages operations of the federal government. Executive orders have the force of law but must align with existing statutes and constitutional authority.
Who It Impacts: Federal agencies and employees, directing them on how to implement laws or carry out government functions. Executive orders can also influence businesses and individuals when they relate to issues like immigration, trade, or labor policies.
Who Is Not Impacted: Private citizens and businesses do not have to directly follow an executive order unless it leads to regulations or policies that apply to them. For example, an executive order directing federal agencies to increase renewable energy use does not mandate action from private companies, but it may influence policy shifts that eventually affect them.
Summary
EO 14319 risks undermining health equity by discouraging AI models from incorporating DEI frameworks critical to addressing disparities. Without explicit equity safeguards, “neutral” AI may reproduce systemic biases, worsening outcomes for marginalized populations—particularly Black, Latino, and LGBTQ+ communities already facing disproportionate barriers in healthcare. Stripping equity-focused design from AI threatens to deepen inequities rather than reduce them.
Impact Analysis
Legal Challenges
EO14319 faces potential legal challenges on several fronts. Critics may argue it exceeds executive authority over procurement and relies on vague terms like “neutrality” and “ideological judgments” that are difficult to enforce. The order could also be contested under the First Amendment as viewpoint discrimination or compelled speech, and it may conflict with existing civil rights laws such as Title VI or the ADA. Vendors might further challenge neutrality requirements under the Administrative Procedure Act or contract law as arbitrary or improperly imposed.
Take Institutional Action
We recommend healthcare institutions seeking to provide equitable services:
Be transparent about value choices → acknowledge that every AI is shaped by choices in data and design and clearly communicate the institution’s reliance on AI (or lack thereof) via internal and patient communications per regulatory and legal guidelines.
Leverage existing data to demonstrate historical inequities and invest in strategies, research, and practices to inform investments in AI tools designed to reduce bias and eliminate inequities in care delivery practices.
Associated or Derivative Policies
EO 14319 builds on earlier Trump-era AI directives—EO 13859 (2019) on Maintaining American AI Leadership and EO 13960 (2020) on Promoting Trustworthy AI—while reversing Biden’s EO 13985 (2021) on Advancing Equity and Support for Underserved Communities, which emphasized DEI in federal programs. In Congress, H.R. 4873 (2025) seeks to codify EO 14319 into law, signaling an intent to embed its “neutrality” standards beyond executive authority. These associated and derivative policies collectively reshape federal AI governance, tilting away from equity frameworks toward neutrality mandates.
Policy Prior to 2025
Policy Before January 2025: EO 14148 (Jan. 20, 2025) — On his first day, the administration rescinded many Biden-era DEI EOs, including EO 13985, making room for new policy direction.
Additional Resources
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