Doctors and health experts in Hawaii say a decades-old federal program meant to support Native Hawaiians through medical school and better serve some of the islands’ most underserved communities is under attack after a conservative group filed suit.
For more than 35 years, hundreds of medical students have received support under the Native Hawaiian Health Scholarship Program and, to give back, worked in underserved areas on the islands in the following years.
But Do No Harm, a Utah-based advocacy group, sued the federal government in March, arguing “generous” financial aid is being withheld from non-Hawaiian students who would be able to apply if they had “just one family member of Hawaiian descent hundreds of years ago”. The lawsuit seeks to have the program declared unconstitutional and for the scholarships to be opened up to all, regardless of race.
The group says three of its members tried to apply and were told no because they are not Native Hawaiians.
“Our complaint challenging the Native Hawaiian Health Scholarship Program is aimed at ensuring well-deserving applicants can qualify to compete for the financial relief the scholarship provides,” Stanley Goldfarb, the chair of the group, said in a statement.
Sheri-Ann Daniels, the CEO of Papa Ola Lōkahi, the body that administers the program on the islands, said the case discounted the need for Native Hawaiians to be able to access equitable healthcare.
“Efforts to dismantle programs like this ignore both the historical context and the ongoing need to safeguard equitable access to care throughout Hawaii,” Daniels said in a statement after the lawsuit was filed. “These scholars represent the next generation of healers for our communities, a presence that uplifts the health of all.”
The case is the latest in a multi-pronged, coast-to-coast effort by conservative advocacy groups to unwind programs meant to support minority groups, part of a broader surge that arose after the US supreme court, under a conservative supermajority, ended race-conscious admissions in higher education in 2023.
The Native Hawaiian Health Scholarship Program was established by Congress in 1988, under a law called the Native Hawaiian Health Care Act. The law came in response to a landmark report several years earlier that found Native Hawaiians on the islands lacked accessible healthcare and suffered from disparate rates of morbidity, mortality and chronic disease. Many of those statistics continue today.
Hawaii has the longest life expectancy at birth of any state in the US, but those figures are strikingly different based on ethnic groups. Native Hawaiians and other Pacific Islanders have much lower life expectancy when compared with other groups, according to a recent study from the University of Hawaii.
Nearly 12% of Native Hawaiians also had no health insurance in 2024 compared with 8% of the total US population, according to figures from the Department of Health and Human Services.
The scholarship was modeled after the National Health Service Corps, which has provided thousands of primary care workers with scholarships and loan repayment plans in exchange for their work in historically underserved and rural communities.
Over the past 35 years, the Native Hawaiian healthcare scholarship has helped 324 people receive their education, including 108 nurses, 71 doctors, 49 social workers and many others in fields spanning psychology, dentistry, pharmacy and therapy.
Papa Ola Lōkahi said each one of those people has been placed in service “to a medically underserved area in Hawaii to serve the communities where care is most needed”.
“Most remain in medically underserved communities beyond their obligated service tenures, often rising to positions of leadership,” the group said in a statement after the lawsuit. Those postings include community health centers, community-based non-profits on all islands, as well as Hawaiian healthcare systems.
Dr Daniel Garcia, an internist and medical director at the Maui Medical Group, received the Native Hawaiian healthcare scholarship in 1991. At the time, he was living in a garage with limited family support and cleaning people’s yards to get by, trying to figure out how to pay for medical school.
“The scholarship was extremely beneficial because it allowed me to focus on my studies,” Garcia told the Guardian. “As part of the repayment for the Native Hawaiian scholarship, I was placed in Maui, that’s where my family is from, and I wanted to make sure that I came back to my community to help the Hawaiians there. It’s very much an underserved population.”
Garcia has stayed at the same medical group since his posting began in 2000.
“Coming from a demographic that wasn’t really supposed to go into medicine, I was just, you know, struggling, and having that resource allowed me to focus and eventually get into medicine and thrive,” he said.
Garcia added that, for him, it was important in the years after he finished school to do his part, building a clientele of Native Hawaiian patients that “look like me, act like me and talk like me”.
“They didn’t really trust western medicine, they didn’t trust the other physicians that didn’t look like them,” he said. “Native Hawaiians are a very prideful people, and if there’s a tone of condescension or arrogance, they just won’t go.”
Do No Harm disagrees with that sentiment.
“Patients of all races and ethnicities want one thing, and that is a great doctor who can help them feel better,” Kristina Rasmussen, the group’s executive director, told the Guardian in a statement. “Great doctors are not defined by their skin color or background. Native Hawaiians, along with every other American, should have equal access to federal programs that should be squarely centered on merit.”
The suit takes particular issue with how Native Hawaiian ancestry is assessed.
“Because this definition of Native Hawaiian requires only one Native ancestor, it equally includes a student whose mom is Native Hawaiian (50% Native Hawaiian) and a student whose great-great-great-great-great-great-great grandmother is Native Hawaiian (0.2% native Hawaiian),” the suit reads. “There is no valid reason to make federal scholarships turn on race or ethnicity.”
“That this program still exists even after the efforts by this administration to course correct proves just how widespread institutional race discrimination has become,” Goldfarb said in a statement.
The Trump administration has aggressively targeted diversity and equity initiatives on college campuses during Trump’s second term. He attempted to cut billions of dollars of Harvard’s federal funding, demanding the university shutter any programs related to diversity, equity and inclusion. The Department of Justice also joined a lawsuit in February which alleged policies at public schools in Los Angeles were discriminatory against white students.
The Department of Education celebrated such efforts, declaring on Facebook that, under Trump, “DEI is DEAD!”.
Daniels told the local media company Honolulu Civil Beat that it was notable that the lawsuit was filed against the Department of Health and Human Services.
“I don’t have any expectation that they’re going to come riding in on a white horse to save us,” Daniels told the Civil Beat last month. “So I think we have to save ourselves and really be honest about what that means.”
Dee-Ann Carpenter, an associate professor at the University of Hawaii’s John A Burns School of Medicine, said the scholarship program was an important prong in the islands’ health system.
“This scholarship is so important to further the education of our Native Hawaiians, who otherwise would not be able to pay for their education,” Carpenter, who received a scholarship through the Native Hawaiian Higher Education Program in the early 1990s, said. That program was a precursor to the healthcare scholarship, and Carpenter said receiving it afforded her the ability to finish medical school.
She had to give back hours of service for receiving the funds.
She said the health scholarship program extends its reach far beyond just medical school, supporting many Native Hawaiians who go on to work in essential services, including social work, nursing or other fields in medicine.
“We need our graduates to be in the community to care for our lāhui [our people],” Carpenter said. “It is truly awesome for our patients to see faces who look like them in their medical care, almost an automatic connection and trust. This scholarship is so needed.”
The effort to crack open the scholarship to other ethnic groups is strikingly similar to another lawsuit, filed last year, targeting a private school system meant to educate thousands of Native Hawaiians. The conservative advocacy group Students for Fair Admission sued the Kamehameha schools, saying the institution’s policy of prioritizing Native Hawaiian students is unfair.
The group noted that the Kamehameha schools were “a great school system” that has a preference “so strong that it is essentially impossible for a non-Native Hawaiian student to be admitted”.
“We believe that focus on ancestry, rather than merit or need, is neither fair nor legal,” the group wrote at the time.
Garcia said he doesn’t understand the effort to roll back a program that, through his own work as a doctor, he has seen help close the gap in access to healthcare.
“In a word, it sounds evil, to tell you the truth,” he said. “Some people, some folks just have a darkness in their hearts and they’re called into action whenever they see people being lifted up. I don’t know what motivates people to do that.
“I would say that the program worked remarkably. Putting someone like myself in a position where I can help the community and help other Native Hawaiians seek higher education, just say: ‘Hey, you can do this as well’ … all of that seems good.”
