A decades-old federal program designed to put Native Hawaiian doctors and nurses to work in some of Hawaiʻi’s most underserved communities has become the target of national conservative activists whose stated mission is to “expose political bias and discrimination in healthcare and medical education.”
Do No Harm, an advocacy group based in Utah, filed a federal lawsuit last week against the U.S. Department of Health and Human Services arguing that its Native Hawaiian Health Scholarship Program is unconstitutional because it discriminates based on an applicant’s race and ethnicity.
Among those claiming they’ve been harmed is a white nursing student who says she was barred from applying for the scholarship because she is not Native Hawaiian.
Conservative activists are targeting Native Hawaiian programs and institutions in federal lawsuits they say are aimed at ending racial discrimination.
The case is just the latest attack on Native Hawaiian programs and institutions, and follows a similar lawsuit filed last year challenging Kamehameha Schools’ admissions policy. That lawsuit was filed by Students for Fair Admissions, a conservative legal advocacy group that successfully convinced the Supreme Court that affirmative action in university admissions is unconstitutional.
While distinct from the lawsuit targeting the Native Hawaiian Health Scholarship Program, Do No Harm’s most recent tax filings from 2024 show that the founder of Students for Fair Admissions, Edward Blum, was on its board of directors.
Blum declined to comment on the lawsuit and referred questions to Do Not Harm, which did not respond to Civil Beat’s request for an interview.
The Native Hawaiian Health Scholarship Program was established by Congress under the Native Hawaiian Health Care Act of 1988 in response to studies that found Native Hawaiians experienced disproportionately higher rates of chronic illness and poorer mental health outcomes than their peers, ranging from heart disease, diabetes and cancer to infant mortality and suicide.
Since its inception, the program has provided financial assistance to more than 320 Native Hawaiians in exchange for the commitment that they spend two to four years providing healthcare services in rural island communities, many of which have sizable Native Hawaiian populations.
The day after the lawsuit was filed, Papa Ola Lōkahi, the nonprofit that runs the scholarship program, issued a statement on its website saying that it “stands tall in the face of a challenge.” The purpose of the program, according to the nonprofit, is to bolster the ranks of Native Hawaiian healthcare workers in the islands who can provide “quality, culturally informed health services” to Native Hawaiians.
“Efforts to dismantle programs like this ignore both the historical context and the ongoing need to safeguard equitable access to care throughout Hawai‘i,” wrote Dr. Sheri-Ann Daniels, CEO of Papa Ola Lōkahi. “These scholars represent the next generation of healers for our communities, a presence that uplifts the health of all.”
In an interview with Civil Beat, Daniels said that Native Hawaiians providing health care to other Native Hawaiians is about more than representation. It’s about trust, honesty and being truly understood.
“It makes a difference, when you can see yourself in that person in the white coat or sitting across from you in therapy, that matters,” she said.
Now those values are being tested in the courts. The lawsuit was filed not against her organization, but against the federal government, which puts the program’s future in the hands of a Trump administration that’s proven hostile toward anything resembling diversity, equity and inclusion. Daniels said she has limited confidence Washington will mount a vigorous defense.
“I don’t have any expectation that they’re going to come riding in on a white horse to save us,” Daniels said. “So I think we have to save ourselves and really be honest about what that means.”
Not The ‘Right’ Race
Do No Harm has targeted healthcare programs and institutions across the country alleging various forms of discrimination. It’s also been at the forefront of state efforts to ban gender-affirming care for transgender youth.
Since March, Do No Harm has filed civil rights complaints against Kaiser Permanente for running a Black health and wellness center in Portland, Oregon and Texas Tech University for favoring foreign-trained physicians over U.S.-trained doctors for a residency program.
This week it called on the IRS to investigate the American Medical Association for running a scholarship program that gives preference to different ethnic groups, including one that requires applicants to be of “Eastern European descent.”
In its lawsuit challenging the Native Hawaiian Health Scholarship Program, Do No Harm argues that the program is race-based and therefore unconstitutional. The complaint pays particular attention to the program’s definition of Native Hawaiian and the fact that blood quantum plays no role.
“Program eligibility turns on whether one is the ‘right’ race to purportedly allow them to provide better or more ‘culturally responsive’ medical care,” the lawsuit states, “excluding someone who is not Native Hawaiian but spent their entire life living in Hawaii and including someone who is 1/200th Native Hawaiian but never even visited the island.”
The lawsuit also argues that the idea that patients benefit from having doctors of the same race is based on a medical theory that has been “debunked.”
Do No Harm states that it represents three individuals — identified in the lawsuit only as Members A, B and C — who applied to the scholarship program, but were rejected because they were not Native Hawaiian.
Member A is described as a white nursing student with disabilities who was applying to government programs to “serve the needy far from home” and believed that working in Hawaiʻi would be “deeply meaningful.” But because none of her ancestors were Native Hawaiian she was unable to apply for the scholarship and lost out on its “generous” benefits, which include tuition assistance, a monthly stipend and other expenses.
“If Member A had just one family member of Hawaiian descent hundreds of years ago,” the lawsuit states, “she would have the requisite blood-quantum to be the ‘right’ race and she would be eligible.”
Members B and C, both of whom are described as full-time medical students, were similarly barred from applying because of a lack of Native Hawaiian ancestry. Member C in particular was described as having a “deep respect for Hawaiian culture” and would “cherish the chance to bring her skills to Hawaii.”
The lawsuit states that if courts decide to open up the program to anyone regardless of race, all three members would apply.
Daniels said Papa Ola Lōkahi is still weighing its options, including whether to intervene in the case. She said she’s bracing for the possibility that this case could become the first domino in a broader effort to unwind other Native Hawaiian programs.
“This isn’t the first and it’s not going to be the last,” she said. “We would be foolish to think differently.”
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This story was originally published by Honolulu Civil Beat and distributed through a partnership with The Associated Press.
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