Trump says the system will be ‘entirely opt-in,’ but HHS is looking to encourage, require or mandate digital identity schemes for all: perspective
As part of the White House’s efforts to modernize the health tech ecosystem the US Department of Health and Humans Services (HHS) is exploring how to encourage, require, and in some cases mandate digital ID for patients, providers, and payers.
On Wednesday, the White House held a “Make Health Tech Great Again” event to give an update on where the digitization and public-private partnerships are heading.
“Patients will simply be able to grant their doctors access to their records at the push of a button […] This system will be entirely opt-in, and there will be no centralized government-run database”
President Donald Trump, Make Health Tech Great Again, July 2025
President Donald Trump spoke about an effort to “Kill the Clipboard” in which patients can give their healthcare providers a QR code for instant access to their records.
The president assured that this type of digital identity system would be “entirely opt-in.”
However, an HHS request for information (RFI) on the “Health Technology Ecosystem” shows how the administration has been looking to encourage, require, and in some cases even mandate, the adoption of digital identity schemes.
“Regarding digital identity implementation: What impact would mandatory use of the OpenID Connect identity protocol have?
Department of Health and Human Services, Request for Information; Health Technology Ecosystem, May 2025
“What would providers need help with to accelerate the transition to a single set of trusted digital identity credentials for the patient to keep track of, instead of one for each provider?”
Department of Health and Human Services, Request for Information; Health Technology Ecosystem, May 2025
Published on May 16, 2025, the HHS “Request for Information; Health Technology Ecosystem” makes multiple inquiries into how to get patients, providers, and payers all on digital identity schemes.
From the RFI (highlights mine):
Encouraging Patients and Caregivers to Accept Digital Identity
Encouraging Providers to Require Digital Identity Credentials
Encouraging Payers To Accept Digital ID:
Between May and June, the RFI received received 980 comments from members of the private sector, with 315 of those comments directly related to “digital identity credentialing.”
Of those 315 commenters, 33 (by this author’s count) expressed opposition to mandatory digital IDs while almost 300 commenters were in favor of some type of digital ID and/or interoperable data sharing scheme.
For the summaries of the 33 commenters opposed to digital ID, scroll to the bottom of this article.
Meanwhile, the hundreds of comments encouraging digital identity schemes, including mandates, came mostly from business representatives.
Here are some example summaries of the nearly 300 commenters recommending, advocating, urging, or offering services for digital ID implementation:
- Oura urges CMS and ONC to foster a more interoperable digital health ecosystem by improving API standards, reducing friction in data access, expanding Medicare coverage for wearables, and supporting standardized digital identity credentials
- Apple advocates for a privacy-centric, standards-based digital health ecosystem where individuals have secure and seamless access to their health information and identity credentials.
- The Better Identity Coalition urges HHS/CMS to broaden its consideration of digital identity standards in healthcare beyond current NIST levels to include emerging verifiable credentials like mDLs, and cautions against prematurely mandating specific protocols like OpenID Connect given ongoing market and standards developments.
- Accenture Federal Services, 1HealthSciences, and HL7 advocate for CMS to transform its vast claims data into a semantically interoperable, FHIR-native health ecosystem, leveraging AI and digital identity to empower patients and providers, reduce burdens, and advance value-based care.
- DirectTrust urges CMS to mandate and incentivize the adoption of standards-based digital identity and a nationwide provider directory, advocating for Direct Secure Messaging’s inclusion in TEFCA, and emphasizing comprehensive cybersecurity measures to foster a secure, efficient, and trusted health technology ecosystem.
- Providence strongly advocates for mandatory OpenID Connect (OIDC) for patient identity and improved, scalable Bulk FHIR APIs to enhance data interoperability, empower patients, and streamline Value-Based Care.
- Kaiser Permanente urges CMS to modernize health IT infrastructure through standards-based, flexible interoperability, prioritized implementations, and administrative burden reduction, focusing on digital identity, provider directories, and expanded TEFCA use to enhance value-based care.
- CommonWell Health Alliance advocates for enhanced, secure, and standardized health data interoperability, emphasizing patient access, improved directories, stronger digital identity, and robust federal oversight for exchange frameworks like TEFCA.
- Maximus offers its expertise and patented technology to modernize CMS systems, proposing a digital front door, a nationwide patient ID, improved dual-eligible coordination, and proactive fraud prevention to enhance beneficiary experience and reduce costs.
- Private Identity LLC recommends that CMS adopt a credential-based digital identity infrastructure (iTrust Identity) for real-time enforcement of identity, consent, and delegated access across all programs to enhance trust, interoperability, and fraud resistance.
- ID.me urges CMS to adopt and mandate federated, NIST-compliant digital identity solutions to reduce healthcare costs, combat fraud, and improve data interoperability and access for patients, providers, and payers across the U.S. health technology ecosystem.
In the end, over 60 companies were selected as “early adopters” to buildout the US Health Technology Ecosystem, with all the companies making different pledges across six areas of interoperable digital healthcare:
- Data Networks
- Health Systems and Providers
- Patient Facing Apps — Conversational AI Assistants
- Patient Facing Apps — Diabetes and Obesity
- Patient Facing Apps — Kill the Clipboard
- Payers
Below are the early adopters and their pledges:
Back at the “Make Health Tech Great Again” event on Wednesday, White House AI and Crypto Czar David Sacks praised HHS Secretary Robert Kennedy, Jr. and CMS Administrator Mehmet Oz for getting the first adopters to unlock their data to feed AI systems.
“The more data that AI has, the better it performs. Kudos to Dr. Oz and Secretary Kennedy for this pledge today. They were able to get 60 major companies across different sectors of the economy to agree to unlock their data, so that AI can use it to drive better patient outcomes”
David Sacks, Make Health Tech Great Again, July 2025
“CMS is working to add modern digital identity to Medicare.gov this year, exploring approaches that enhance security without disrupting current user accounts and services”
Centers for Medicare and Medicaid Services, Press Release: “White House, Tech Leaders Commit to Create Patient-Centric Healthcare Ecosystem,” July 2025
The current administration’s efforts to modernize health tech focuses on two broad areas:
- Promoting a CMS Interoperability Framework to easily and seamlessly share information between patients and providers
- Increasing the availability of personalized tools so that patients have the information and resources they need to make better health decisions.
These efforts are indeed achievable and millions of people could benefit enormously from such an ambitious rollout.
At the same time, this is how a population gets nudged into accepting digital ID schemes, which start out optional and voluntary, but can quickly become mandatory at any time, for any reason, by any regime.
We saw this happen with COVID vaccine passports.
More recently, both the UK and Australia introduced a backdoor into digital ID by requiring online age checks to access certain content, including social media.
And platforms like Spotify and Google have already begun testing machine learning to determine a user’s age across geographical locations.
The White House is taking enormous efforts to completely overhaul the health care system, and yet the president guarantees it will all be “entirely opt-in.”
Meanwhile, the HHS and CMS are telling you point-blank in their RFI that they want interoperable digital ID and massive data sharing to be either encouraged, required, or mandated.
The US government is also proud to collaborate with big tech companies like Amazon, Anthropic, Apple, Google, Microsoft, OpenAI, Oracle, and Samsung.
Do you trust either the government or big tech to keep your best interest at heart?
How about the two together working in tandem?
Do you have faith in public-private partnerships — the fusion of corporation and state — to do what’s best by you?
Here are the summaries of the 33 commenters (by this author’s count) who were concerned about, or outright against digital ID mandates in the HHS RFI:
- An individual advocating for privacy rights and parental autonomy opposes mandatory digital IDs, biometric data collection, and wearable technology for healthcare access, advocating for informed consent and the right to be forgotten.
- A New York-based educator group Teachers for Choice opposes medical mandates and requests that digital IDs, biometric data, mandatory wearables, and data retention without consent be prohibited for healthcare access.
- A Medicare recipient who values privacy and quality of care over data collection, seeking improvements in Medicare provider reimbursement for functional medicine and faster claims processing. My health information is private and belongs to me, and I am concerned about its widespread dissemination without my explicit consent.
- An anonymous concerned citizen believes excessive government oversight, particularly concerning digital IDs, biometrics, and mandatory wearables for healthcare access, is dangerous in the AI age and advocates for individual control over health data.
- An individual citizen opposes all medical mandates and calls for stringent patient privacy protections, including the prohibition of digital IDs, biometric data collection, and mandatory wearable technology for healthcare access, while advocating for the right to data deletion.
- An individual healthcare provider/association believes privacy rights are human rights and opposes mandated digital IDs, biometric data, or wearable technology for healthcare access, advocating for an individual’s right to control their data
- A certified and licensed athletic trainer in Florida requests that no digital IDs, biometric data, or mandated wearable technology be required for healthcare access, emphasizing patient privacy, parental rights, and the right to be forgotten
- An individual concerned about health technology privacy requests no digital ID or biometric data requirements for healthcare access, no mandated wearable technology, and the right for patients to control the storage or deletion of their data gathered by AI
- An individual opposing digital IDs due to privacy concerns and a belief that adherence to the Constitution would negate the need for such measures
- An individual from the healthcare industry in New York opposes any digital ID requirements for healthcare access and advocates for patients’ right to control their data by choosing to store or delete it.
- An individual seeks autonomy in managing their health, opposing government interference, increased centralization, and mandatory digital or biometric identification for healthcare access, advocating for the right to be forgotten.
- An individual who vehemently opposes national digital IDs, biometric data collection, mandated wearables, and data sharing in healthcare, refusing to participate in the proposed health technology ecosystem.
- An American citizen and business owner advocating for robust patient and parental privacy rights in health technology, opposing digital IDs, biometric mandates, and mandatory wearables, while supporting the right to data deletion.
- An individual concerned that mandatory digital IDs for care or benefits threaten personal privacy and autonomy.
- An individual from the healthcare industry expresses strong opposition to mandatory digital IDs, citing privacy concerns and the sufficiency of existing identification methods.
- An individual concerned about privacy and parental rights requests no digital ID, biometric data, or mandated wearable technology for healthcare access, emphasizing informed consent and the right to be forgotten.
- The Health Freedom Defense Fund opposes mandatory digital IDs and biometrics for healthcare access, advocates for the right to refuse wearable technology, and supports the “right to be forgotten” regarding AI-driven medical data, citing concerns over civil liberties and human dignity.
- An American citizen urging protection of freedoms and privacy by opposing mandatory digital IDs, biometric data, and wearable technology for healthcare access, advocating instead for informed consent and the right to data deletion.
- An individual from New York strongly opposes federal health technology initiatives that would require digital IDs, mandate biometric data or wearable devices, or limit the “right to be forgotten,” advocating for foundational principles of privacy, autonomy, and consent.
- An individual Pilates studio owner and instructor concerned about privacy, requests no digital ID, biometric data, or mandated wearables for healthcare access, and the right to be forgotten for patient data.
- An individual from California emphatically opposes any mandated digital ID, biometric data collection, or wearable technology for healthcare access, advocating instead for individual control over data storage and deletion.
- This anonymous government commenter requests that no digital ID, biometric data, or mandated wearable technology be required for healthcare access, and supports the right to be forgotten for patient data.
- An attorney advocates against mandatory digital IDs, biometrics, or wearable technology for healthcare access, emphasizing the need for informed consent and the patient’s right to control their data.
- A public school teacher from NYC requests that healthcare access not require digital IDs or biometric data, and opposes mandated wearable technology, advocating for patient control over data storage and deletion.
- An individual is concerned about patient and parental rights regarding health information access and opposes mandates for digital IDs, biometric data, or wearable technology in healthcare.
- An individual healthcare professional is concerned about privacy and government overreach in digital health records, advocating against mandatory digital IDs, biometric data collection, and mandated wearables, while supporting the right to be forgotten and protection against discrimination.
- An individual strongly opposes digital IDs, fearing government overreach and control.
- A former Imaging Technologist and US Congressional Candidate opposes medical mandates and digital health IDs, advocating for patient privacy and the right to be forgotten.
- An anonymous federal government commenter asserts that healthcare decisions are solely individual choices and advocates for no government-mandated digital IDs, biometric data, wearable technology, or personal data requirements.
- A healthcare professional advocates for a patient-centric, decentralized medical system prioritizing in-person care, privacy, and informed consent, while railing against corporate interference, digital mandates, and systemic failures impacting the elderly and chronic disease management.
- An individual commenter is concerned about privacy and consent regarding health technology, specifically opposing mandated wearable tech, digital IDs, and mandatory biometric data collection, and advocating for patient consent for AI-gathered data.
- An individual strongly opposes government-mandated digital IDs, biometric data collection, and wearable technology for healthcare access, advocating instead for individual control over data and informed consent.
- An individual concerned about privacy and consent regarding health technology, specifically opposing mandates for wearable technology, digital IDs, and the storage of AI-gathered data without consent, as well as mandatory biometric data provision.
Image Source: Screenshot of HHS Secretary Robert Kennedy, Jr (L), President Donald Trump (C), CMS Administrator Mehmet Oz (R) from the White House YouTube channel.
