Trump's Threat to Duke Health Over Racial Policies

Federal Officials Demand Changes in Duke Health Policies

The Trump administration has issued a stern warning to Duke Health, stating that it could cut all federal funding if the medical system fails to address alleged race-based policies within Duke University School of Medicine and its broader health system. In a letter sent on Monday to top Duke University officials, Health Secretary Robert Kennedy Jr. and Education Secretary Linda McMahon accused the institution of engaging in discriminatory practices that they claim make Duke Health unfit for any further financial relationship with the federal government.

In their letter, Kennedy and McMahon criticized what they described as "vile racism" that uses various excuses to justify unfair treatment. They argued that such practices hide behind a sense of superiority that claims certain races have benefited from these policies, rather than competing under merit-based considerations. The officials called on Duke to review its policies for the "illegal use of race preferences" and take action to correct these practices.

While the letter did not provide specific examples or evidence of discrimination, it outlined several areas where the alleged actions might be occurring, including recruitment, admissions, financial aid, mentoring, hiring, and promotion. According to the administration, these practices may violate Section IV of the Civil Rights Act, which prohibits employment discrimination based on religion, sex, national origin, or race, and Section 1557 of the Affordable Care Act, which extends similar protections to healthcare services.

The letter was addressed to Duke University President Vincent Price, Duke University Board of Trustees chair Adam Silver, and Duke University School of Medicine Dean Mary Klotman. It gave Duke 20 business days to respond to the government’s request for information and documents as part of an investigation conducted by the Health Department's Office for Civil Rights.

The Trump administration expressed doubts about Duke’s ability to conduct an honest and trustworthy review of its policies. As a result, they requested that the university form a "Merit and Civil Rights Committee" to examine the health system’s practices over a six-month period. The committee must consist of distinguished members of Duke’s leadership and medical faculty who are committed to genuine excellence in medicine. Additionally, the members must meet federal standards for competence and good faith.

Duke has 10 business days to decide whether it will form this committee. However, the university has not yet released a statement regarding the letter or its potential response.

Duke University is a major recipient of federal funding, particularly through its health system. In 2025 alone, the institution has received nearly $300 million from the National Institutes of Health, making it the top recipient in North Carolina. Last year, Duke received more than $580 million from the NIH.

Since President Donald Trump returned to office in January, the Health Department's Office for Civil Rights has launched seven other investigations into healthcare organizations. In March, the U.S. Department of Education's Office for Civil Rights began investigating 45 universities, including Duke, for possible violations.

The administration has also been involved in disputes with elite private universities over alleged failures to address antisemitic behaviors on campus. Recently, Columbia University agreed to pay $200 million to the federal government in a settlement that restored funding. In June, the Trump administration accused Harvard University of violating the Civil Rights Act and threatened to withdraw financial support.

As one of the largest employers in the Triangle area and among the biggest private employers in North Carolina, Duke faces significant challenges if federal funding is reduced. Its leaders have already reported that workforce reductions have occurred due to funding cuts. On Friday, the university informed faculty and staff that layoffs would begin next month after nearly 600 employees accepted voluntary buyouts.