Chiropractic at a Crossroads: How Trump’s Executive Order Could Shake Up Accreditation and Licensing
Originally published: 2025-03-20
On March 20, 2025, President Donald Trump signed an executive order aimed at dismantling the U.S. Department of Education (USDE)—a bold move fulfilling a key campaign promise. While the order’s immediate effects on higher education are uncertain, its potential impact on chiropractic accreditation and licensing could be profound. If the USDE’s recognition process for accrediting agencies collapses, chiropractic institutions and licensing pathways—already fraught with political and regulatory tensions—may face a moment of reckoning.
This development could expose long-standing structural problems in chiropractic accreditation, particularly with the Council on Chiropractic Education (CCE), while simultaneously opening the door for competition in this space such as the growing efforts of the International Agency for Chiropractic Evaluation. The potential shake-up also raises critical questions about state licensing authority and the power of the National Board of Chiropractic Examiners (NBCE), which has long controlled the licensing process through its state by state monopoly.
How USDE’s Collapse Could Disrupt Chiropractic Accreditation
Accrediting agencies like the CCE depend on USDE recognition to maintain their status and authority. Under federal law, only USDE-recognized accrediting agencies can qualify institutions for participation in federal student aid programs (Title IV funding). If the executive order ultimately leads to the collapse of the USDE, accreditors could lose their formal recognition status, leaving institutions without access to crucial federal funding.
For chiropractic institutions, this raises immediate concerns:
CCE’s monopoly on chiropractic accreditation – The CCE holds near-exclusive control over which chiropractic colleges receive accreditation, and by extension, which graduates qualify for state licensure. Without USDE recognition, the CCE’s authority could weaken, opening the door for alternative accrediting bodies like the IACE to gain traction.
Regional accrediting agencies also affected – Many chiropractic colleges are accredited not only by the CCE but also by regional accrediting agencies, such as the Higher Learning Commission (HLC) and the Southern Association of Colleges and Schools (SACS). If these agencies lose their USDE recognition, chiropractic programs could face a dual crisis, where both their chiropractic-specific and regional accreditation statuses are at risk, compounding the threat to their funding and legitimacy.
Loss of student aid – Chiropractic colleges, like other institutions of higher learning, rely heavily on federal student aid to support tuition costs and operations. If Title IV funds are disrupted, chiropractic students could find themselves cut off from financial aid.
State licensing tied to CCE accreditation – Most state chiropractic boards require graduation from a CCE-accredited institution for licensing eligibility. If the CCE’s recognition lapses, state boards may need to quickly adapt their standards—or risk a breakdown in the licensing pipeline.
This vulnerability stems from decades of state-level abdication of responsibility. State licensing boards have largely surrendered their authority to decide how chiropractors are licensed to the CCE and the NBCE, creating a centralized and tightly controlled licensing apparatus. A breakdown at the federal level would force states to reassess these relationships and reclaim control over accreditation and licensing standards.
An Opportunity for the IACE?
While the CCE’s monopoly has been a source of frustration for many in the chiropractic profession, the collapse of the USDE could be an unprecedented opportunity for the IACE. Over the past several years, the IACE has been expanding its accreditation activities, offering options to the chiropractic educational marketplace.
If the CCE’s authority weakens due to the loss of USDE recognition, the IACE could step up as an increasingly attractive option providing chiropractic institutions with an alternative accrediting body aligned more closely with the core principles of vertebral subluxation-based chiropractic care.
The IACE’s rise could:
Introduce more competition and accountability into chiropractic education.
Allow chiropractic colleges to align their curriculum more closely with subluxation-based care, rather than the CCE’s medical standards.
Encourage state licensing boards to recognize other accrediting agencies breaking the CCE’s monopoly stranglehold over the profession due to naming them as a private corporation in statutes.
The loss of USDE oversight could also shift the broader accrediting framework to state governments or other federal agencies. If states are forced to reconsider which accrediting agencies they recognize, the IACE could position itself as a more authentic and philosophically consistent alternative to the CCE.
Beyond this, states would be under increasing scrutiny and legal jeopardy by continuing to name a single private corporation in their statutes while simultaneously not recognizing a competing agency.
The NBCE Power Grab and the Licensing Crisis
The executive order also casts a spotlight on the NBCE’s recent centralization of the Part IV examination—a move widely viewed as a power grab. By consolidating and centralizing their control over the clinical licensing process and the adoption of this by states, the NBCE has effectively shifted the power of final arbiter of competency to themselves. Without their blessing no one can get a license. Schools become the place you get the piece of paper you need to take the test that declares you competent.
This is an insult to the faculty and Deans at every chiropractic institution who certify the competency of every graduate that walks across the stage to the President, Board of Trustees and the state in which its chartered.
However, if the CCE’s recognition weakens or collapses, state boards may be forced to reassess their reliance on the NBCE’s monopoly and the Part IV exam since the schools already provide this. This could create an opportunity for states to reclaim authority over the licensing process, potentially allowing for greater diversity in examination standards and alternative pathways to licensure.
The NBCE’s consolidation of power has long been a point of contention within the profession. The executive order could create the necessary disruption for states to finally break free from the NBCE’s grip and explore more localized or competitive licensing solutions.
State Boards Must Reclaim Their Authority
The looming collapse of the USDE could serve as a wake-up call for state chiropractic boards that have become complacent under the CCE-NBCE regime. For too long, state boards have relied on federal oversight and CCE accreditation as a shortcut to regulating the profession. If the federal framework falls apart, state boards will need to take back responsibility for evaluating chiropractic programs and licensing processes.
This moment represents both a crisis and an opportunity. If state boards fail to act, the resulting regulatory vacuum could create chaos for chiropractic education and licensing. On the other hand, proactive state boards could seize this moment to introduce competition, embrace alternative accrediting bodies like the IACE, and diversify the licensing process beyond the NBCE’s centralized examination model.
Conclusion: Chiropractic’s Fork in the Road
Trump’s executive order to shut down the USDE signals a seismic shift in American education policy. For chiropractic, the implications are profound: the CCE’s dominance over accreditation, the NBCE’s control over licensing, and state board complacency are all on shaky ground.
This disruption presents a rare opportunity for chiropractic to reclaim its philosophical roots and chart a more independent future. The IACE’s growing influence could offer chiropractic institutions a more authentic accreditation pathway, while state boards have the chance to reclaim their authority over licensing and examination standards.
The question is whether the chiropractic profession will seize this moment—or remain shackled to a crumbling federal system and outdated power structures. The future of chiropractic hinges on the decisions made in the coming months.
