When To Speak Out

Kevin Davidson

The United States today is deeply riven by polarization and politicization, and the healthcare industry certainly isn’t immune. Issues such as insurance coverage, reproductive rights, drug pricing, vaccine mandates—or lack thereof—scientific integrity and government funding have become flashpoints in the broader cultural and political divide, often overshadowing efforts to find common ground on patient care and public health.

Patients, policymakers and providers alike are navigating an era where the scientific and medical considerations behind public health policy and patient care are frequently ensnarled with partisan rhetoric, making it increasingly challenging to implement long-term, consensus-driven solutions. This environment has heightened mistrust among stakeholders and underscored the challenge of advancing policies that balance access, affordability and quality while avoiding ideological pitfalls.

More than ever, organizations in the health ecosystem face an increasingly high-stakes communications dilemma: determining when to speak publicly and when silence is the wiser choice.

From the corporate communications perspective, today’s healthcare environment may be fraught with potential pitfalls, but it’s also full of opportunity. Sweeping changes to federal agencies, politically charged policies and shifting enforcement priorities mean that every public statement carries both potential value alongside real risk. Speaking out recklessly can expose any organization to selective scrutiny; yet remaining silent at the wrong moment can erode connectivity among stakeholders. The challenge isn’t only deciding “if” to speak, but “how” to frame messages that align with mission, resonate with the intended target and minimize the risk of unintended fallout.

Rather than speaking directly about contested issues such as reproductive health, vaccine mandates or gender-affirming care, many experts are deliberately reshaping the lexicon into terminology that avoids conversation shutdown. For example, organizations may use broader phrases like “patient-centered access” or “community wellness initiatives” instead of more polarizing phrasing. This shift reflects a growing need to balance advocacy with risk management: advancing core health priorities while avoiding punitive measures, funding cuts or public backlash. In effect, healthcare communications are evolving to where word choice is as much about political survival as it is about clarity.

When commenting on policy changes, companies are increasingly using neutral, patient-centered framing rather than potentially polarizing partisan language. For example, during past administrations, companies who would have said “We oppose proposed Medicaid cuts” have now shifted to statements such as “Proposed funding reductions risk disrupting care for X million beneficiaries and could force closures of Y hospitals.” “Health equity” has been largely sidelined by “individual responsibility.”

At the same time, many pharmaceutical companies haven’t retreated from their commitments to diversity, equity and inclusion, even as the broader corporate landscape has seen heightened scrutiny. While the healthcare sector hasn’t yet experienced the same intensity of backlash directed at consumer-facing brands, leading firms continue to frame DEI as integral to their operations and culture. Pfizer, for example, has emphasized its approach by explicitly spelling out “diversity, equity and inclusion” in its materials while also underscoring “merit-based” advancement to preempt criticism. Bristol Myers Squibb highlights its efforts under the banner of “Global Inclusion & Diversity,” supported by a detailed suite of programs and initiatives. AstraZeneca, likewise, keeps inclusion and diversity prominently positioned in its corporate messaging, while Regeneron integrates the concept into “inclusion & culture,” reinforced through employee resource groups and community-building efforts.

These approaches illustrate an important lesson in healthcare communications: organizations must define the terms of engagement on sensitive topics before external forces do so for them. By choosing language and frameworks that align with organizational values while anticipating areas of vulnerability, companies can maintain credibility and continuity even in polarized environments. As one seasoned communications leader observed, the key lies in “choosing the waves you can ride successfully,” focusing on conversations where the organization can authentically contribute and shape outcomes, rather than being swept into reactive cycles of controversy.

Companies and organizations in healthcare shouldn’t default to the assumption that staying silent is “safe.” Rather, sometimes silence can be more damaging than a misstep. Yet, it’s not necessary for a company to make sweeping endorsements of the MAHA agenda. Instead, focus on elements that are backed by evidence and proof points and are relevant to your organization, then speak out about how your efforts are in line with that part of the discussion.

For example, commending a concerted federal focus on chronic disease management and treatment isn’t the same as endorsing a particular officeholder; it’s about rising above the political divide.

Take emotion out of decision-making when it comes to deciding next steps in communications. Develop a rubric framework and customize it per issue. Key questions to ask are: Does this issue have direct relevance to the company’s industry and stakeholders? Do stakeholders have a high expectation that you should speak out? Is this topic strongly aligned with the company’s established values and track record?

Perhaps most important: be keen to discern the distinction between offering a “naked” point of view, versus one that’s backed by behavior in the relevant context. For instance, when Florida made the move to roll back pediatric vaccine mandates, a company might feel compelled to insert itself into the conversation. If the organization doesn’t operate in Florida, we would strongly counsel against this, as it would needlessly insert itself into a volatile debate, absent any opportunity to build equity through behavior. Since then, several organizations and their trade associations have wisely committed at the national level—and in their own markets—to maintain their vaccine coverage policies throughout 2026.

Take note of one subtle characteristic in such a response: there’s nothing per se “critical” or “controversial” about it. No administration member or policy is being taken to task; it’s simply a statement of what the organization believes in and its determination to act on that belief. It adheres to what surveys have said for years: The vast majority of Americans seek accessible, affordable, quality healthcare above the political fray.

Before making a go-or-no go decision, it always pays to evaluate the alternative of taking a stand with others. It may be your trade association or the Chamber of Commerce or another group in the community. Solidarity could also come from like-minded CEOs or other executives. This can provide multiple benefits such as avoiding selective scrutiny and gaining greater media interest in the position.

In this climate, healthcare communicators must weigh not only the message but also the messenger, medium, timing and likely interpretations.

When to speak out

When company operations or patients are directly impacted. If federal action threatens your ability to serve patients or sustain your business model, a public statement isn’t just justified—it may be necessary. For example, payer groups have openly lobbied against cuts to Medicaid and ACA subsidies, citing direct threats to members and customers. Communicators should frame such advocacy around patient impact first, business second. One option worth considering is to align your statement with that of one or more medical societies, nationally or in your markets.

Defending core mission and values. When silence would undermine the credibility of your organization’s mission—for instance, if patient safety or equitable access is at risk—speaking out helps reinforce trust. Communications leaders should tie messages to longstanding commitments, not the politics of the day.

In response to stakeholder expectation. If employees, patients, investors or other key stakeholders are demanding clarity, absence of a statement may erode trust. The communications role here is to listen first, gauge internal and external pressure, and then ultimately craft a response proportionate to the expectations.

When silence could be interpreted as agreement. On morally charged issues, staying quiet may be perceived as tacit approval. Communicators should advise leadership when reputational risk from silence outweighs risk of speaking.

When holding back may serve you best

If the issue is not directly relevant. Commenting on issues far removed from your core business or marketplace can dilute your voice and expose you needlessly. Communicators should stress relevance: Does this issue directly affect our patients, workforce or vertical?

When the retaliation risk is too high. For smaller organizations or those heavily dependent on federal contracts, public opposition to administration policies may invite scrutiny. In such cases, a quieter approach working through trade associations or private channels may be more effective.

When messaging risks inconsistency. If recent corporate actions don’t align with a proposed statement, or if the issue is so politically charged that nuance will be lost, communicators should push for alignment first.

When impact will be minimal. If it’s clear that a policy decision is already locked in and a public statement won’t change the outcome, consider saving reputational capital for battles where you can make a difference.

Whether speaking out or holding back, don’t forget to prepare for internal communications. Employees are often the first audience to ask, “Why did we—or didn’t we—speak up?” Aligning internal messaging with external statements, or silence, is critical to maintaining trust.

Keep on the pulse. The dynamics are ever-changing. In short: speak when it matters most, stay silent when it matters least and always ensure that words match values.

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Kevin Davidson is an EVP Brand and Corporate Communications, JPA Health.