CFER’s New Lawsuit Against Black Infant Equity and ACA 7

In the minds of today’s progressives, 2026 is certainly no better than 1964, when it comes to race relations and socioeconomic outcomes based on race. Disparities are everywhere, all of which must be attributed to the mythical, yet omnipotent phenomenon called “systemic racism.” Nowhere else in the nation trumps the progressive icon of America – California – in employing the heavy weight of government action to redress seemingly rampant racial disparities. From being the first in the nation to assemble a statewide taskforce on reparations to socially engineering unprecedented racial diversity on college campuses in defiance of Prop. 209, the Golden State has done it all. 

The impulse of using race to guide public policies is also evident in health care. Riding the cocktail of 2020’s summer of “racial reckoning,” the California Legislature passed Senate Bill 17 in 2021. While the final version of the bill established the Racial Equity Commission “to advance racial equity and address structural racism,” its previous version sought to declare racism as a public health crisis. Operating from the “disparity equals discrimination equals racism” rationale, the state has implemented a series of race-based infant and maternal health initiatives. Some of the notable examples include:

• The Black Baby Equity Clinic (BLOOM) at the University of California, San Francisco: a program run by the UCSF Benioff Children’s Hospital in Oakland that matches “Black families” with “Black pediatricians, health educators, therapists, navigators, family support specialists, and breastfeeding coaches.”
• The Perinatal Equity Initiative (PEI) in the California Department of Health: a state model to address racial disparities in infant mortality and maternal deaths. 
• The California Abundant Birth Project (CA ABP): a guaranteed income program that provides cash stipends to Black expecting mothers in Alameda, Contra Costa, Los Angeles, or Riverside counties.

Established in 1989, the California Black Infant Health (BIH) is the longest-running one among all these initiatives. For the last 37 years, the California Department of Public Health (CDPH) has expended taxpayer funds on BIH, to “help participants enhance life skills within a culturally affirming and supportive environment that honors the unique history of Black women and birthing people, reduces stress, and build social support.” 

On April 21^st, the Californians for Equal Rights Foundation (CFER), three member co-plaintiffs and the American Civil Rights Project (ACR Project) took the state to court to challenge BIH. We allege that the State of California has engaged in racial discrimination through BIH, violating the U.S. and California Constitutions, as well as Title VI in the Civil Rights Act of 1964. Our lawsuit compliments a parallel class-action challenge against BIH launched by another CFER member, represented by the Pacific Legal Foundation, in federal court. In January, with the help of the ACR Project, CFER settled with the City and County of San Francisco for a 2023 lawsuit. The defendants agreed to defund four guaranteed income projects, one of which was the San Francisco portion of the Abundant Birth Project. But the statewide version of ABP still remains to be challenged in court. 

There is no question that protecting the health of all pregnant women and newborns—of all races—is a worthy social goal. When governments go beyond that kind of laudable commitment to advance the health and safety of only pregnant women and newborns of a single race to the exclusion of others, that is something else entirely. Aside from the blatant illegality, these programs are also backed by dubious research and flawed data. 

For instance, the infamous “racial pairing” argument, that Black families are best served by Black doctors, is supported by a debunked 2020 study. A scholarly review by Do No Harm shows that the authors of the study ignored a crucial contradicting data point and did not control for low birth weight as an intermediate factor. Regardless of intellectual criticisms, the flawed study has been cited nearly 800 times. It even made its way into a Supreme Court case brief in a 2023 dissent opinion written by Justice Ketanji Jackson!

By the same token, the claim of “obstetric racism,” a narrative undergirding all of the abovementioned public welfare programs, rests primarily on over-the-top grievance studies. One such study, purportedly evidencing racism against “Black birthing people,” is a 2023 Social Science & Medicine journal article, which draws from a measly sample of 34 participants. The article then proceeds to furnish an outlandish policy suggestion that “the Black Lives Matter Movement is necessary.” Another piece of research is a Medical Anthropology article by an anthropologist who analyzes “the birth stories of Black women living in the United States.” In the best-case scenario, advocates for race-based infant health initiatives misuse otherwise rigorous research, such as a cohort analysis of 2,339,696 pregnancies in a five-year period, to downplay more consequential individual-level factors like preexisting health conditions. 

One would think nearly four decades of public policy support should have at least alleviated poor birth outcomes for “Black mothers and birthing people.” But the proliferation of similar programs, all for the grandiose purpose of eradicating racism as the root cause of health disparities, seems to only accentuate the problem. 

Alas, proof of efficacy is never a requirement for ideological advancement.