Trump’s Executive Order Cracks the Chiropractic Cartel Wide Open
Originally published: 2025-04-24
What the Executive Order Changes
On April 23, 2025, President Donald J. Trump signed a landmark Executive Order to reform higher education accreditation in the United States. This sweeping directive targets the monopolistic behavior of accrediting bodies, demanding that they be held accountable for poor performance, ideological coercion, and violations of civil rights law. The Order restores authority to states and educational institutions, encourages the recognition of new accreditors such as the International Agency for Chiropractic Evaluation (IACE), and calls for accreditation standards that are based on real student outcomes—not arbitrary test scores or political agendas. It eliminates barriers to transparency, supports academic freedom, and opens the door for schools and licensing jurisdictions to escape the grip of entrenched monopolies.
All of this is what the Chiropractic Freedom Coalition has been focused on for several years now.
A Federal Strike on a Nationwide Monopoly
President Donald J. Trump’s April 23, 2025 Executive Order on accreditation reform is not just a higher education policy shift—it’s a direct threat to one of the most deeply entrenched monopolies in healthcare education: the chiropractic licensing cartel built by the CCE, NBCE, and FCLB and its network of associated private corporations that support the monopoly and benefit from its existence.
For decades, this cartel has controlled who enters the chiropractic profession by using:
Accreditation (CCE)
Licensing exams (NBCE)
Regulatory enforcement (FCLB and state boards)
And they’ve done so by creating a closed-loop system—one that includes the CCE’s status as the sole recognized accrediting agency in chiropractic by the U.S. Department of Education, the widespread enshrinement of “CCE Only” and “NBCE Only” language in state statutes, rules, and regulations, and the embedded influence of state chiropractic regulatory boards that maintain 'membership' in the FCLB.
Among other things this closed loop system uses CCE's Policy 56 and state licensure laws to funnel every chiropractic student in the country into NBCE’s Part IV exam, regardless of the exam’s educational value or necessity.
“This is not a test of clinical competency—it’s a toll booth. And the toll keeps rising.”
The Cartel’s Origins: A Manufactured Monopoly
The foundations of the Chiropractic Cartel were laid in the early 1970s. In 1971, the American Chiropractic Association (ACA) separated its internal accreditation arm and created the Council on Chiropractic Education (CCE) as an independent entity. The newly formed CCE sought federal recognition from the United States Office of Education (USOE) but was initially denied.
At that time, there were two accrediting agencies—the CCE and the Association of Chiropractic Colleges (ACC, which is unrelated to today’s ACC). Because neither could claim to represent the entire profession, the USOE would not recognize either one.
Despite efforts to encourage the two agencies to merge—including resolutions by the Federation of Chiropractic Licensing Boards (FCLB)—the CCE proceeded independently. In June 1972, the Florida State Board of Chiropractic Examiners revised its regulations to only accept graduates from CCE-accredited schools. This move was quickly replicated by other states.
By May 1974, the CCE obtained federal recognition from the USOE—after privately submitting its application in breach of an agreement to hold off so the two bodies could present a unified front. The FCLB then issued a sweeping resolution encouraging all state boards to adopt CCE-only recognition policies, embedding CCE control in state laws and regulations nationwide.
“This action by the FCLB and the state response remains the single most consequential maneuver securing CCE’s dominance over chiropractic education and licensing.”
The Machinery of Coercion: Policy 56 and State Law Collusion
Among other things this closed loop system uses CCE's Policy 56 and state licensure laws to funnel every chiropractic student in the country into NBCE’s Part IV exam, regardless of the exam’s educational value or necessity.
“This isn’t education policy—it’s institutionalized extortion, disguised as accreditation.”
CCE often claims that it "plays no role in setting examination requirements for jurisdictional licensing authorities," but this statement is deeply misleading. In practice, CCE’s Policy 56 reinforces NBCE’s monopoly by embedding its exam scores—especially Part IV—into the accreditation framework as a proxy for student achievement and licensure. Despite the fact that all schools already measure clinical competency prior to graduation.
While CCE asserts that schools may use proof of licensure as an alternative to NBCE score submission, this is a disingenuous claim for several reasons:
Tracking licensure rates is logistically impossible. There are 50 U.S. states and over 120 countries where chiropractic graduates may seek licensure. Schools would be forced to collect official data from a wide array of licensing boards, many of which lack mechanisms to share that data or decline to report it at all. No infrastructure currently exists to support this, meaning institutions would have to build it from scratch.
If licensure were a viable alternative, NBCE Part IV would be obsolete. The real reason schools default to NBCE data is not convenience—it’s necessity. State laws, strategically shaped over decades by the CCE, NBCE, and FCLB, mandate NBCE exams for licensure. The notion of substituting those scores with licensure data is nothing more than a theoretical loophole, never intended to be practical.
CCE has made no attempt to create a viable alternative. If CCE were serious about using licensure as a metric, it would partner with chiropractic schools and the Association of Chiropractic Colleges (ACC) to fund and manage an independent licensure tracking system. But no such effort has been made.
Instead, every U.S. state has codified NBCE Part IV into its licensure statutes, rules, or regulations—language lobbied for and strategically embedded by the FCLB to cement the NBCE and CCE as the sole gatekeepers of educational quality and clinical competency.
In essence students do not get the ability to practice from schools they get it from the NBCE and the schools are held captive by the CCE, NBCE and FCLB scheme which is all funded by student loan money and its resulting debt.
“For fifty years, the CCE, NBCE, and FCLB have operated not as public protectors, but as private partners in a closed system built to enrich themselves.”
As of today:
All states and all U.S. jurisdictions require NBCE Part IV for licensure.
These requirements were not based on evidence, but rather adopted through FCLB influence, NBCE lobbying, sheer regulatory inertia and the laziness of state boards to do their jobs.
These laws force chiropractic students—who are often $200,000+ in debt—to pay a private corporation (NBCE) to gain access to a public license.
“This isn’t public protection. It’s government-enforced profit protection for the NBCE.”
The Smoking Gun: NBCE and FCLB’s Secret Revenue Pact
According to a recent article in Dynamic Chiropractic (Is the NBCE Robbing Students), in 2008, the NBCE and the Federation of Chiropractic Licensing Boards (FCLB) entered into a confidential, 25-year agreement where In exchange for the FCLB’s exclusive endorsement, the NBCE pays the FCLB 5% of what it charges chiropractic students to take examinations.
This means:
FCLB profits when state boards require NBCE exams.
State board's and their members have a financial conflict of interest due to their membership in the FCLB.
The system is incentivized not to reform, but to protect its own revenue.
“The very people mandating the exam are getting a cut from the company selling it. That’s regulatory capture. That’s corruption.”
The NBCE contributed a total of $3,593,574.00 to the FCLB from 2018 to 2022 alone and this relationship has been going on for a very long time. The increasing trend in both grants and free rent and utilities signifies the NBCE's commitment to the FCLB's activities and possibly reflects a deepening relationship between the two organizations. And making matters worse the FCLB is just one of the lucky recipients of the funneling of student loan money to NBCE’s patrons.
Read more about who is getting a cut here
What the Executive Order Changes
President Trump’s order:
Demands accreditors be held accountable for poor performance and civil rights violations.
Calls for recognition of new accreditors, such as the International Agency for Chiropractic Education (IACE) in chiropractic.
Prioritizes real outcomes—not proxies like NBCE test scores.
Requires transparency and eliminates unlawful discriminatory standards.
Gives cover to states and schools to break away from the monopoly.
Most importantly, it restores power to state governments and educational institutions to make decisions based on outcomes, freedom, and accountability—not cartel loyalty.
The Virtual Cartel & Monopoly
The federal government has long been aware of the monopolistic nature of the chiropractic accreditation and licensing system. During a meeting of the U.S. Department of Education’s advisory body—the National Advisory Committee on Institutional Quality and Integrity (NACIQI)—members raised serious concerns about the Council on Chiropractic Education (CCE) and its entrenchment. Lawrence DeNardis, a respected committee member explicitly referred to the system as a “monopoly control of a profession which has led to the establishment of a virtual cartel.” Another member, attorney and higher education expert Anne Neal, drew a stark analogy to organized crime, stating: “In a monopoly situation, the climate of fear that we’ve been hearing about... is about as voluntary as accepting an offer from Tony Soprano.” She criticized the Department of Education itself for enabling this environment, warning, “I’m not sure we’re playing fair or the Department is playing fair.” These warnings have only grown more relevant in the years since, as the CCE, NBCE, and FCLB have further consolidated their control through a closed-loop system sustained by regulation, accreditation, and professional intimidation.
The Chiropractic Profession Has a Choice
This Executive Order is the federal government’s declaration that the accreditation and licensing cartel is overripe for reform. The only question now is: Will the profession stay in the cage? Or walk through the door?
The NBCE is not the profession. The FCLB is not the profession. The CCE is not the profession.
You are. CLICK HERE Sign the petition to stop NBCE’s Part IV today!
CLICK HERE to read the President’s Executive Order
