A conservative legal firm is asking the federal government to reveal the truth about the creation of a race-focused organ transplant policy developed by the Biden administration. 
America First Legal <a href="https://media.aflegal.org/wp-content/uploads/2026/02/06111524/AFL-v-HHS-Complaint.pdf">sued</a> the Department of Health and Human Services and the Centers for Medicare and Medicaid Services earlier this month seeking information on the creation of the model that requires organizations that oversee the transplant process to prioritize &#8220;equity.&#8221; The suit says that the departments have not complied with Freedom of Information Act (FOIA) requests seeking documents on the model’s creation. 
“Biden officials embedded race into organ transplant policy and rebranded discrimination as ‘equity.’ This FOIA lawsuit seeks to expose the outside influence behind the IOTA Model, including the communications and meetings that shaped this program,” said America First Legal lawyer Megan Redshaw.
The policy in question is the Increasing Organ Transplant Access (IOTA) model, which took effect in July 2025 after being implemented in the waning days of Joe Biden&#8217;s presidency. The model is set to be in place for six years.
The rule says that the federal government wanted to <a href="https://www.federalregister.gov/documents/2024/12/04/2024-27841/medicare-program-alternative-payment-model-updates-and-the-increasing-organ-transplant-access-iota">increase</a> “equity in kidney transplantation by creating performance-based incentive payments for participating kidney transplant hospitals tied to” kidney transplant access.
Citing Biden’s <a href="https://www.federalregister.gov/documents/2021/01/25/2021-01753/advancing-racial-equity-and-support-for-underserved-communities-through-the-federal-government">executive order</a> on embedding “racial equity” policies in the federal government, organ procurement organizations are required to submit health equity plans “to address health outcome disparities.” Organ procurement organizations are federally designated non-profits that oversee the organ transplant process. 
The goal of the model was to address “health equity problems” through “financial incentives that reward IOTA participants that improve their kidney organ offer acceptance rate ratios over time and hold them financially accountable for not doing so.”
In August 2025, America First Legal requested documentation from HHS and CMS on whether any organ procurement organizations were involved in the creation of the model. Two organizations mentioned in the lawsuit were the United Network for Organ Sharing and the Association of Organ Procurement Organizations.
The Association of Organ Procurement Organizations said it had no comment on the litigation and that it was not involved in the creation of the model. 
The association told The Daily Wire that it “was not involved in CMS’s development of the IOTA Model. Like many stakeholders, AOPO has participated in formal public comment opportunities on proposed federal policies affecting organ donation and transplantation.”
The request to HHS was submitted on August 18, 2025, and the request to CMS was submitted the same day. America First Legal’s suit says that it has received no records or any communication from HHS or CMS apart from an initial acknowledgment the day the request was submitted. 
“The American people have a right to know who helped design that agenda, who pushed it, and what role outside stakeholders played in shaping policy that governs life-and-death decisions,” said Redshaw. 
HHS told The Daily Wire that it does not comment on pending litigation. 

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Could This Be The End Of Race-Based Organ Transplants?

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Could This Be The End Of Race-Based Organ Transplants?