The group contends neither HHS nor the other agencies have turned over a single document in response to its April 2023 request, which targeted early equity directives stemming from former President Joe Biden’s executive orders on “advancing racial equity.”

“The Biden Administration infected the federal government with ‘equity,’ replacing traditional principles of fairness and need with race-conscious criteria,” said Will Scolinos, legal counsel for the group. “AFL is determined to uncover the complete scope of Biden-era [diversity, equity, and inclusion] policies and will continue to take decisive action to restore colorblind healthcare.”

At issue is a series of federal actions beginning in late 2021 and continuing through 2023 under the Biden administration, when CMS, run by then-Administrator Chiquita Brooks-LaSure, launched a public inquiry into “advancing racial equity” in organ transplantation. At the same time, the HRSA began reporting transplant data by race and ethnicity, and the agency announced a sweeping “modernization initiative” aimed at embedding equity into the organ transplant system.

Also in the lawsuit, AFL cited Executive Order 14091, signed by Biden in February 2023, as further evidence of what it calls a “radical, racist, and fundamentally anti-American overhaul” of federal policy. That order directed agencies to combat discrimination based on race, ethnicity, and other protected traits, including in algorithmic decision-making. AFL argues that this directive, when applied to allocating donated organs to sick patients, signaled a plan to “unlawfully alter” transplant policy by prioritizing organs based on race rather than clinical need.

AFL argues these moves laid the groundwork for discriminatory practices in violation of the National Organ Transplant Act, which requires that organs be allocated based on medical criteria.

The group’s 2023 FOIA request sought internal emails, planning documents, and communications among top officials referencing race, equity, and transplantation policy. Despite confirming receipt, the three agencies failed to provide records and have delayed or deflected further inquiries, the lawsuit claimed.

AFL’s complaint alleged systemic noncompliance with federal transparency law and sought a court order compelling the agencies, now under the direction of Trump appointees, to disclose the records. The lawsuit is part of the group’s broader campaign to relitigate the Biden administration’s DEI framework across government, particularly healthcare.

While not cited in the lawsuit, the Biden administration’s later 2024 rollout of the Increasing Organ Transplant Access model, announced by then-HHS Secretary Xavier Becerra, adds new weight to AFL’s concerns. That initiative, which included financial incentives for hospitals that increase transplants to underserved populations, was framed by HHS Secretary Xavier Becerra as an effort to “remove racial bias” from the transplant system.

AFL contends such initiatives are guided by ideology that prioritizes identity over medical necessity. The group previously threatened litigation in early 2022 over similar race-based allocation policies for COVID-19 treatments in states such as Utah and Minnesota, where minority status was given equal or greater weight than comorbidities.

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“This is about ensuring life-or-death medical decisions are based on science—not social engineering,” Scolinos said.

The Washington Examiner contacted representatives for HHS and CMS but did not receive a response.