How Project 2025, which Trump disavowed, is shaping his health policies
In the first weeks of his presidency, few voters had anticipated President Donald Trump’s plan to cut billions from the nation’s top federal cancer research organization.
However, Trump claimed he had no knowledge of the National Institutes of Health (NIH) funding until Project 2025’s “Mandate for Leadership,” a conservative governance strategy. His administration has now accepted it.
The Heritage Foundation, a conservative research organization in Washington, compiles a 922-page playbook that calls for capping payments to universities and their hospitals to “help reduce federal taxpayer subsidy of leftist agendas.”
According to universities, the policy will destroy current and upcoming biomedical science, which is currently set to suffer significant budget cuts in agency grants that will cover these overhead costs. A federal judge temporarily halted the cuts to medical research , on February 10 , after they drew legal challenges from medical institutions and 22 states.
Project 2025 as prologue
Many of Project 2025’s goals were quickly adopted, indicating that Trump supporters have quietly laid the groundwork for years to change the country’s healthcare system. Many of its contributors were first-term residents and some have since joined his second administration. That runs counter to Trump’s insistence on the campaign trail, after Democrats made Project 2025 a potent attack line, that he was ignorant of the document.
“I have no idea what Project 2025 is”, Trump said on October 31, 2024, at a rally in Albuquerque, New Mexico – one of many times he disclaimed any knowledge of the plan. “I’ve never read it, and I never will”.
But opposition groups and some state Democratic leaders claim they can react quickly to Trump’s legal maneuvers because his administration adheres so closely to the playbook put together by The Heritage Foundation.
They are now preparing for Trump to act on Project 2025 recommendations for some of the nation’s largest and most important health programmes, including Medicaid and Medicare, and for federal health agencies.
According to Noah Bookbinder, president of Citizens for Responsibility and Ethics in Washington, “there has been a lot of planning on the litigation side to challenge the executive orders and other early actions from a lot of different organisations.” “Project 2025 allowed for some preparation”.
The plan, for example, calls for state flexibility to impose premiums for some beneficiaries, work requirements, and , lifetime caps or time limits on Medicaid coverage for some enrollees in the programme for low-income and disabled Americans, which could lead to a surge in the number of uninsured after the Biden administration vastly expanded the programme’s coverage.
The final result would be fewer people with health coverage, according to Larry Levitt, executive vice president for health policy at Kaiser Family Foundation (KFF), a health information nonprofit that includes KFF Health News. “These proposals don’t directly alter eligibility for Medicaid or the benefits provided. “When you ration coverage based on complexity and ability to pay,” says one expert on Medicaid. “When you erect barriers to enrolling people, such as premiums or documentation of work status, you end up rationing coverage.”
A budget proposal that could result in the elimination of Medicaid over the course of ten years by hundreds of billions of dollars is being considered by congressional Republicans.
Project 2025 called for expanding access to , health plans that don’t comply , with the Affordable Care Act’s strongest consumer protections. That may result in more choices and lower monthly premiums for buyers, but unwitting consumers could incur potentially high out-of-pocket expenses for care that plans won’t cover.
Additionally, Planned Parenthood affiliates’ Medicaid funding should be stopped, according to Project 2025. The organisation, an important healthcare provider for women across the country, gets roughly $700m annually from Medicaid and other government programmes, based on its 2022-23 report. According to the report, abortion accounts for roughly 4% of the services the organization offered patients.
The administration’s steps to scrub words such as “equity” from federal documents, erase transgender identifiers, and , curtail international medical aid – all part of the Project 2025 wish list – have already had sweeping ramifications, hobbling access to healthcare and eviscerating international programmes that aim to prevent disease and improve maternal health outcomes.
Under a , memorandum issued in January, for example, Trump reinstated and expanded a ban on federal funds to global organisations that provide legal information on abortions.
According to research, the “global gag rule” or “Mexico City Policy” has squandered millions of dollars to foreign aid organizations that didn’t comply with it. It’s also had a chilling effect: In Zambia, one group removed information in brochures on contraception, and in Turkiye, some providers stopped talking with patients about menstrual regulation as a form of family planning.
The gag rule, according to Project 2025, “should be drafted broadly so that it applies to all foreign assistance,” should be reinstated by the next president.
Trump also signed an executive order rolling back transgender rights by , banning federal funds , for transition-related care for people under age 19.  , An order he signed also directed the federal government to recognise only two sexes, male and female, and use the term “sex” instead of “gender”.
The authors of Project 2025 advocate for the elimination of the term “gender identity” from federal laws, regulations, and grants, as well as for the unwinding of policies and procedures used to promote a “radical redefinition of sex. In addition, it states that Department of Health and Human Services programmes should “protect children’s minds and bodies”.
The Project 2025 road map states that “racially active individuals within and outside of government are promoting harmful identity politics that replace biological sex with subjective notions of “gender identity.”
Data disappears
According to health researchers, the Centers for Disease Control and Prevention (CDC) removed data on LGBTQ+ health and removed information related to gender identity as a result of Trump’s order on gender identity. The administration followed the federal judge’s orders on February 11 to restore a significant portion of the information, adding notices to some websites that claimed they don’t “reflect biological reality” and said they are “extremely inaccurate.”
Additionally, the CDC slowed down the agency’s Morbidity and Mortality Weekly Report’s release of information and findings regarding bird flu. In addition, federal workers have said they were told to retract papers that contain words such as “nonbinary” or “transgender”. Additionally, some hospitals stopped providing gender-affirming services for young people, such as hormone therapy and puberty-busting medications.
Transgender children and their families have filed a number of court challenges, and advocacy groups claim the orders discriminate and impede medically necessary care.
Lawyers, advocates, and researchers say implementation of many of Project 2025’s health policy goals poses a threat.
“The playbook presents an anti-science, anti-data, and anti-medicine agenda”, according to a piece last year by Boston University researchers in the JAMA journal.
The Project 2025 blueprint sets out goals to curb access to medication , abortion, restructure public health agencies, and weaken protections against sex-based discrimination. Seniors would be required to enroll in Medicare Advantage plans that are administered by private insurers, privatizing the older Americans’ health system in essence. Additionally, it calls for eliminating the Affordable Care Act coverage requirements for individuals who purchase without federal subsidies, which insurance experts fear poses a risk of leaving people uninsured.
“It’s the agenda of the Trump administration”, said Robert Weissman, a co-president of Public Citizen, a progressive consumer rights advocacy group. “It’s to minimize access to care under the guise of strict work requirements in Medicaid, privatizing Medicare, and rolling back consumer protections and subsidies in the Affordable Care Act,” the statement reads.
The White House didn’t respond to a message seeking comment. According to conservatism, the project’s recommendations would help to free federal health systems from the clutches of a radical “woke” agenda and reduce waste and fraud in federal health programs.
“Americans are tired of their government being used against them”, Paul Dans, a lawyer and former director of Project 2025,  , said in a 2024 statement. “The administrative state is, at best, completely out of touch with the American people and, at worst, is weaponised against them”.
Dans did not respond to messages asking for comment on this article.
The Heritage Foundation has attempted to break up Trump’s executive orders and other health initiatives with Project 2025.
“This isn’t about our recommendations in Project 2025 – something we’ve been doing for more than 40 years. This is about President Trump delivering on his promises to make America safer, stronger, and better than ever before, and he and his team deserve the credit”, Ellen Keenan, a spokesperson for Heritage, said in a statement.
Versions of the document , have been produced roughly every four years since the 1980s and have influenced other GOP presidents. According to the group, former president Ronald Reagan incorporated the recommendations from a previous Heritage guide into about two-thirds of the recommendations.
In some instances, the Trump administration hasn’t just followed Project 2025’s proposals but gone beyond them.
The US Agency for International Development (USAID), an independent federal agency that provides foreign aid and assistance, including for many international health programmes, was ordered by the document’s next president to “deradicate” it.
The administration hasn’t just scaled back USAID. Elon Musk, a Trump aide, claimed on his social media platform, X, that his “Department of Government Efficiency” physically closed its offices, took almost all of its employees on administrative leave, cut funding for its programs, and spread false information about them.
If the administration decides to change US healthcare and policy, the public may start to lose support. In a NBC News poll conducted in September, almost 60% of voters questioned Project 2025.
Source: Aljazeera
Leave a Reply