Even with a decade plus of initiatives to increase racial and ethnic diversity in clinical trials for new medicines, today most trials do not enroll diverse populations. As a result, trial data does not reflect the people who take the medicines. At the 2022 Health Datapalooza and National Health Policy Conference, panelists discuss the federal guidance and private sector efforts and compare this to challenges to achieving diversity in data gathered for new drug approvals. The panel considers the need to go beyond guidance and establish regulatory incentives (expedited review, data exclusivity) for trial sponsors making good faith efforts to achieve diverse trials.