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Simkins v. Cone (1963)

In 1883, the Supreme Court declared that the Equal Protection clause applied only to government entities, not private groups and organizations, in The Civil Rights Cases (1883). The 1883 precedent had remained the law of the land until the Supreme Court eventually reversed its decision in Sweatt v. Painter (1950), Brown v. Board of Education (1954), and Simkins v. Cone (1963).

In the early 1960s, only nine hospitals existed for African Americans in North Carolina, and most were overcrowded and offered inadequate healthcare. According to historian Karen Thomas, “Most hospitals in North Carolina and throughout the South did not accept black patients on an equal basis and did not allow black physicians to admit patients or train as interns.”  Even though most North Carolina hospitals were privately operated, some accepted state and federal funds and that implicated possible government discrimination.

Moses H. Cone Memorial Hospital and Wesley Long Community Hospital, two Greensboro hospitals, had received state and federal funds via the 1946 Hill-Burton Hospital Survey and Construction Act.  George Simkins and other African American doctors and patients filed a suit against the two Piedmont hospitals alleging that the facilities refused to accept black patients.

After his patient had been denied by the Cone and Long Hospitals, Simkins discovered that the same facilities had been built with federal funding. This fact opened a pathway for a possible legal remedy. Because the hospitals had accepted government funds they were not strictly private, Simkins and other plaintiffs filed their suit on these grounds. In addition, the plaintiffs alleged that Public Health Service Regulations providing separate-but-equal services violated the Fifth and Fourteenth Amendments of the U.S. Constitution.

The NAACP assisted the plaintiffs as they gained support behind their petition, and the activist group hired Conrad Pearson, an NAACP attorney from Durham, to file the petition to federal district court. On December 5, 1962, the U.S. District Court of the Fourth Circuit decided in the hospitals’ favor. Judge Stanley contended that Moses H. Cone and Wesley Long were both private hospitals, not government entities. Relying on The Civil Rights Cases (1883) reasoning, Judge Stanley opined that the two hospitals had a right to discriminate if they chose to.

Even though the plaintiffs lost, they appealed to the U.S Court of Appeals, and in November of 1963, the court overruled the previous court’s decision. The appellate court found that the hospitals had violated the Fifth and Fourteenth Amendments because they were connected to the government through the Hill-Burton funds. In addition, the court found that the two Greensboro hospitals had violated the Constitution. Although the black health facilities were separate from white hospitals they most definitely were not equal.

After their loss, the hospitals filed a petition to the U.S. Supreme Court. Attorney General Robert F. Kennedy filed a brief for Simkins and the other plaintiffs, but the Supreme Court denied the case. According to Karen Kruse Thomas, the Simkins v. Cone (1963) “decision marked the first time that federal courts applied the Equal Protection clause of the Fourteenth Amendment to prohibit racial discrimination by a private entity” (Encyclopedia of N.C., p. 1038). The year after the Simkins decision, Congress passed the Civil Rights Act of 1964, officially prohibiting private discrimination in public places.


“Simkins v. Cone.” Karen Kruse Thomas. William S. Powell, ed. Encyclopedia of North Carolina (University of North Carolina Press: Chapel Hill, NC 2006).

“Desegregating Hospitals.” Learn NC - North Carolina Digital History, Achieving Civil Rights, 1960 - 1965. The University of North Carolina at Chapel Hill Online,, (accessed May 8, 2012).

“Hospitals and Civil Rights, 1945 - 1963: The Case of Simkins v. Moses H. Cone Memorial Hospital.” P. Preston Reynolds, MD, PhD. American College of Physicians - Internal Medicine., (accessed May 8, 2012).

By Jonathan Martin, North Carolina History Project

See Also:

Related Categories: Civil Rights Movement, African American
Related Encyclopedia Entries: Reginald Hawkins (1923-2007), Civil Rights Movement, Henry E. Frye (1932- ) , Restrictive covenants, Residential segregation, Dorothy Counts (1942- ), Griggs v. Duke Power, Swann v. Charlotte-Mecklenburg Board of Education, Greensboro Sit-In, North Carolina Mutual Life, Kenneth R. Williams (1912-1989), Voting Rights Act of 1965, Greensboro Shootings, Robert Franklin Williams (1925-1996), SNCC (Student Nonviolent Coordinating Committee)., Ella Baker ( 1903 - 1986), Appeal to the Coloured Citizens of the World, David Walker (1785 – 1830), Incidents in the Life of a Slave Girl, Aaron McDuffie Moore (1863-1923), Harriet Jacobs (1813-1897) , Leonard Medical School, Concerned Parents Association, Secret Basketball Game of 1944, Claude Sitton (1925-), Soul City, Charles B. Aycock (1859-1912), Wilson Carey (1831-1905?), Robeson County (1787), The Freedmen’s Conventions, Charlotte Hawkins Brown (1883-1961)
Related Commentary: Speaker Ban Law, Frederick Douglass Re-emerging As American Icon, Success of Postwar Freedmen A Worthy Study for Historians

Timeline: 1946-1990 , 1990-present
Region: Piedmont Plateau

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