If discrimination drives health disparities, then civil rights protections in healthcare settings could help. But bringing our anti-discrimination laws and implementing structures into healthcare operations and insurance is difficult. Organizational practices, data systems, professional norms, and the broader structures of the American political and healthcare systems shape the possibilities of addressing health discrimination. This talk explores how health care civil rights implementation works, particularly what makes it work when it works, and why it so often fails. The talk is based on Professor Kirkland’s newly released book, Health Care Civil Rights: How Discrimination Law Fails Patients (University of California Press, 2025), which is available open access at https://luminosoa.org/books/m/10.1525/luminos.226.