Global Health Institute

On March 11, 2025, the Conversations in Global Health: Global to Local class welcomed Katie Keith (L’12) for a conversation on health policy litigation, challenges to gender-affirming care, and carving out a non-traditional path in the health care space.

Previously, Keith served as the director of the Health Policy and the Law Initiative at Georgetown University O’Neill Institute for National and Global Health Law. She also served under the Biden administration as the deputy assistant to the president and deputy director of the White House Gender Policy Council.

With a joint J.D. and MPH, Keith centered her career on tracking the growing intersection between public health and the courts. Following the signing of the Affordable Care Act (ACA) in 2010, Keith anticipated a marked shift in the health policy life cycle—namely, that passing legislation no longer guarantees implementation.

As a contributor to Health Affairs’ “Following the ACA” column, Keith analyzed what became the most litigated statute in American history. Over the course of five years, she tracked an evolving docket of over 50 lawsuits against the ACA.

This playbook has since been applied to a range of health issues. One example, Keith noted, is the negotiation of Medicare drug prices. Introduced in 2022 under the Inflation Reduction Act, the program faces various legal challenges from the pharmaceutical industry, including charges that it levies excessive fines and violates property rights. This has elevated the need to have a prepared legal strategy to secure health outcomes.

Keith stated that this trend has accelerated under the Trump administration, particularly as it relates to LGBTQ+ care. In his first 50 days in office, President Donald Trump issued executive orders disputing the concept of gender identity and blocking minors’ access to gender-affirming care. Keith also said she was closely watching United States v. Skrmetti, a pending Supreme Court case on whether providing transgender care to minors violates the Equal Protection Clause. The arguments, Keith believes, highlight a perceived tension in scope: Is this a case about sex discrimination or states’ rights to regulate health care?

Much of Keith’s career has centered on gender issues. This peaked during the Biden administration, where she supported women’s economic security initiatives, including work on paid leave and childcare and gender-related grievance procedures. 

Despite this, Keith notes that she never expected to work at the White House. “I’m a big advocate of non-traditional careers,” she said. “I [only] wanted to be in the room where decisions are made.” She emphasized: “I like to work on the headlines — the Affordable Care Act, LGBTQ+ care, [or] abortion access. I want to be in the fight.”

This continues to guide Keith’s work today. Currently, she writes for Health Affairs’ “Health Policy at a Crossroads” series. In this position, she sheds light on underreported executive orders, such as Trump’s expansion of in vitro fertilization and his pardons for health care executives convicted of Medicare fraud. 

Given the pace of recent policy changes, Keith’s clarifying authority is essential. Perhaps more than ever before.

Ula Ekmecic (SFS’26) is an undergraduate at Georgetown University majoring international politics. She is a student in the Conversations in Health: Global to Local class.