The U.S.’s nonprofit hospitals receive enormous public benefits. They enjoy tax exemptions, access to government programs and federal revenue streams, charitable donations, and the implicit trust of communities that their focus is on healing patients. Unfortunately, many of these institutions appear more interested in political activism than patient care.
This concern will be front and center at Tuesday’s hearing by the House Ways and Means Committee, where it will examine rising costs in healthcare, its impact on affordability for patients and families, and whether tax-exempt hospitals are living up to their obligations. The question that needs to be at the forefront of this hearing is: if hospitals are receiving numerous nonprofit group privileges, then why are so many systems behaving like radical advocacy organizations?
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The examples are striking. As I recently testified before the House Ways and Means Subcommittee on Oversight, some major hospital systems have built sprawling bureaucracies devoted to diversity, equity, and inclusion initiatives, climate activism, and social agendas rather than direct care. All while receiving enormous tax breaks and federal dollars.
CORPORATE HOSPITALS ARE DRIVING UP HEALTHCARE COSTS FOR THE REST OF US
Many Americans would be shocked to learn how many resources some health systems devote to woke agendas. Nonprofit hospitals across the United States are prioritizing specialized LGBT advocacy programs, sponsoring pride events, and publicly weighing in on contentious legislative debates.
Take New York-Presbyterian, for example. The hospital system has embraced a broad “health equity” strategy and operates the Dalio Center for Health Justice, an initiative focused on “dismantling systemic factors” and advocating “national change.” The center hosts conferences on “health inequity” and even internal book clubs centered on social justice themes, efforts clearly focused on woke ideology rather than patient care.
Taxpayers deserve to know if a nonprofit hospital’s limited resources are spent on woke political seminars and internal ideological programming while patients struggle with long waits, billing confusion, and rising costs.
The same pattern appears at CommonSpirit Health. The system maintains a DEI and belonging office and lists “advocating for social justice” as a core pillar of its healthcare model. It has funded workforce diversity initiatives, launched programs focused on racial and social justice, and made aggressive climate pledges such as achieving net-zero emissions by 2040.
Nonprofit hospitals should not be political action committees. Their purpose is not to remake society through social engineering or climate campaigns. Their mission is to deliver high-quality care at affordable prices, diagnose illness, perform operations, staff emergency rooms, train doctors and nurses, and research and develop new treatments.
However, core performance metrics often tell a different story. Patients continue to face opaque pricing, surprise bills, staffing shortages, crowded emergency departments, and inconsistent access to care. Rural hospitals are shutting their doors or getting bought up because hidden prices don’t allow them to compete. Families struggle to navigate fragmented systems and are expected to agree to care without knowing the cost. Before a dime is spent on DEI consultants, conferences, ideological offices, and putting their name on stadiums, any surplus should go to improving patient care and outcomes.
Nonprofit status is not an entitlement. It is a public subsidy granted in exchange for a public benefit. If a hospital or health system wants to function as a political institution, then it should do so without special tax treatment. If it wants the privileges of nonprofit status, then it should be held to performing that function, which includes measurable charity care, transparent pricing, expanded patient access, and excellent clinical outcomes.
Congress should modernize reporting requirements so that hospitals clearly disclose how much money goes to direct patient care versus administrative activism. Regulators should demand evidence that community-benefit spending actually benefits communities, not ideological agendas. Boards should certify compliance and explain why taxpayers should continue subsidizing institutions that stray from their mission.
HOSPITALS ARE A PRIME SUSPECT IN THE AFFORDABILITY CRISIS
People don’t expect a hospital to be political. But they do expect an ER to be staffed, their child to receive care, healthcare bills to be understandable, and a commitment to seeing prices in advance so they know their treatment is affordable.
Hospitals exist to heal. When nonprofit systems become political brands, patients inevitably come second. That is a betrayal of the public trust and exactly why congressional scrutiny is long overdue.
Will Hild is the executive director of Consumers’ Research.
