Thinking strategically about health equity today 

Several executive orders potentially impacting healthcare benefits have been issued since President Trump took office. For many employers, the executive orders may raise questions about current or planned initiatives in their health programs that aim to address health equity.

In a survey of about 700 organizations conducted last spring, the majority – 61% – of large employers (500 or more employees) said they had taken action specifically to improve health equity in their populations or planned to do so in 2025. Among very large employers (5,000 or more employees), that number rises to 75%. It’s important to remember that health equity is a broad concept, and there are many different actions employers can take to identify and address health inequities or disparities that may be impacting their populations. According to CMS, health equity means “the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, sexual orientation, gender identity, socioeconomic status, geography, preferred language or other factors that affect access to care and health outcomes.”

There are many factors that impact health equity in employer-sponsored health plans – access to care, affordability, language barriers and health literacy, to name a few. A comprehensive, solution-based health equity strategy seeks to remove barriers to access and address social determinants of health to improve health outcomes for underserved populations.

Developing a health equity strategy to address unique needs

Understanding the specific needs of the covered population is a good place to start. Data analysis can identify gaps in care and opportunities to enhance health outcomes in populations with unique access challenges, such as rural and low-wage workers. Claims data can reveal health disparities within the population such as elevated maternal mortality rates among women of color.

Armed with a better understanding of where problems lie, employers can target actions for the greatest impact. Some examples:

• Providing resources to address the social determinants of health that lead to health disparities such as health literacy, food deserts and access to transportation.
• Reviewing benefits plan design for inclusivity, with a focus on changes that will positively impact groups experiencing gaps in care and disparate health outcomes.
• Addressing gender affirmation to understand what services are covered by medical, pharmaceutical and disability carriers to help inform future strategy direction.

Whatever actions a health equity strategy includes, the ultimate goal is essentially the same as the goal for the larger employer-sponsored health program: Better health for more people.

When considering the executive orders, keep in mind that the full effect of each order may take time to materialize, as most call for administrative policy changes and regulatory action. In addition, legal challenges may slow implementation. Employers will need to work with their legal counsel to evaluate the executive orders as they pertain to their business.