Editor's Note: This series examines the Heritage Foundation's effort to transform the government through a process called Project 2025. Lean to the Left writers CJ Waldron and V. Susan Hutchinson explore how allies of Donald Trump hope to increase the power of the presidency, eliminate career government positions, and cede regulatory responsibility to the individual states. Although Trump has criticized Project 2025 prompting its director, Paul Dans, to resign, it's critical for voters to understand key parts of this manifesto, in context with current and future GOP proposals. The statements in Project 2025 are, at best, misleading with outright lies, twisted interpretations of the Constitution, and personal opinions sprinkled throughout, and much of the document has been incorporated into the GOP Platform, virtually word for word. So, beware.
The American healthcare system is and has, for a long time, been a for profit business. The average annual salary across the country is $59,428 and Americans pay on average $13,493 per person per year for their healthcare, which is twice what other wealthy countries spend.
With the rising cost for housing, gas, food, and utilities a lot of American families need two incomes to cover basic living expenses. Heaven help those with a chronic illness, children with cancer or are also caretakers for elderly parents.
On the other side of the coin are the insurance companies who care nothing for families, especially those who already find it hard to pay premiums, co-pays, and exorbitant prescription costs. Fourth quarter earnings for 2023 show United Healthcare raking in $22.4 billion in profits, up 11.2 percent over 2022. Even though Humana was down 11.3 percent from 2022 they still managed to make $2.5 billion.
Project 2025 lays out a plan for healthcare companies to make even bigger profits every year. All while saying they want patients to be their focus.
Understanding Project 2025
Five Goals for Reforming the Department of Health and Human Services
In the introduction to the section on the Department of Health and Human Services (HHS), author Roger Severino makes a very true statement that “HHS activities personally impact the lives of more Americans than do those of any other federal agency.” He then devolves into outrageous lies about the Trump and Biden administrations and claims HHS has “lost its way” and lays out five goals for the department.
Not surprisingly Goal #1 is “Protecting Life, Conscience, and Bodily Integrity.” There is one sentence that is the key take-away: “The Secretary must ensure that all HHS programs and activities are rooted in deep respect for innocent life from day one until natural death: Abortion and euthanasia are not healthcare.”
Since the Supreme Court overturned Roe v Wade fourteen states have put abortion bans in place, some with no exception for rape or incest.
Let’s put this in the perspective of healthcare costs.
The increased number of children born means increased healthcare, as well as childcare costs for women who may or may not have a second income to rely on or even a job that provides insurance. As for making end-of-life decisions when quality of life is unachievable and suffering is all that is left, the conservative right believes no one has the right to end their own life. Prolonged suffering means increased healthcare costs and more profit for corporations and insurance companies.
Goal #2 “Empowering Patient Choices and Provider Autonomy” applies the economic principle of supply and demand to healthcare costs. It states “costs tend to decrease and quality and options tend to increase when there is robust and free competition in the provision of goods and services.”
The claim is that healthcare is not an exception to this rule; however, a web search to better understand the supply and demand principle reveals “Demand for basic necessities is relatively inelastic. It’s less responsive to changes in their price.” Applying economics to healthcare is a win-win for the provider or insurance companies, but not for the consumer.
This goal continues by saying providers should be free to address patient needs, but states should regulate the medical profession. They also want to reduce “burdens of regulatory compliance.” We have seen this before in other parts of this document; move everything to the state level with no federal oversight to level the playing field from state to state and strip down regulations that are intended to protect the American people.
Goal #3 is basically an attack on the LGBTQ+ community and single parent households.
Project 2025 wants to remove transgender and non-binary people from existence, at least as far as giving them equality in healthcare. Their statement that “HHS should prioritize married father engagement in its messaging, health, and welfare policies” means their focus will further marginalize those in poor communities and all those children who will be forced to have babies that are a result of rape and incest.
Goal #4 wants to redefine when a pandemic becomes a real healthcare emergency. We all remember COVID-19 and how Trump and the GOP were more concerned with the economy than people. Since the virus appeared in the U.S. there were over one million deaths through May 2023. The Project 2025 plan for the next pandemic may very well triple that amount when the next healthcare crisis appears. Those most at risk will be poor communities and minorities.
The last goal is all about dismantling the National Institutes of Health, Centers for Disease Control and Prevention and the Food and Drug Administration. They call for these critical healthcare offices to get their funding only from the government “with robust congressional oversight.”
Project 2025 wants to take science-based decisions out of the hands of scientists. An ultra-conservative Congress who believes in “natural death” will now be deciding when and if a vaccine will be produced for the next viral pandemic and make it optional in schools where those children they forced to be born are now at risk of dying.
Political agendas and even more misinformation would now drive the next crisis.
Centers for Medicare and Medicaid Services (CMS)
Project 2025 refers to Medicare and Medicaid as “runaway entitlements that stifle medical innovation, encourage fraud and impede cost containments.” The term entitlement is commonly used when it comes to social programs that workers have paid into so they have something for retirement. They imply an entitlement is a free give away of federal money.
One of the goals for Medicare is to “Increase Medicare beneficiaries’ control of their health care.” It is clear in this section that Project 2025 knows absolutely nothing about how Medicare works. Their claim that they can make it so beneficiaries have more choices in doctors, hospitals, and insurance plans is ludicrous. We already have all these things with Medicare Parts A and B plus supplemental insurance. What they really want is for private insurance to take complete control of Medicare.
More than half of Medicare recipients participate in the Medicare Part C (Medicare Advantage) plan. Project 2025 wants to make Medicare Part C the “default enrollment option.” They not only want everyone covered by for-profit insurance companies, but also to “remove burdensome policies that micromanage MA plans.”
Medicare Part C is already a bad idea for people who want or need flexibility in their healthcare providers. It may entice you with the term “all inclusive” or hearing aids and dental are covered, but beneficiaries need to read the fine print and do their homework before signing up. These plans usually have a network where they pay all or almost all costs incurred, such as hospital or doctor visits. If you are out of network, good luck.
When you hear the term “$0 monthly premium” it means your co-pays are high and your annual out of pocket could be $15,000 or more.
The Affordable Care Act (ACA) currently prohibits insurance companies from denying coverage to those with “pre-existing conditions.” With Project 2025 this policy will no longer apply and when private insurance controls Medicare they may not deny coverage, but will make premiums almost out of reach for some seniors.
You better have a very large 401(k) portfolio if Project 2025 starts fiddling with Medicare.
Medicare Part D, the prescription drug plan is required if patients opt for traditional Medicare Parts A and B. Drugs are included under a Part C plan. Since the Inflation Reduction Act (IRA) was signed by President Joe Biden, insulin has been capped at $35 per month, Medicare will be allowed to negotiate drug prices and in 2025 annual out of pocket costs will be capped at $2,000.
Project 2025 calls for a repeal of the IRA. It seems Project 2025 wants to give beneficiaries choices while doing nothing to control rising costs which come into play when making those choices.
Under the conservative plan, millions of seniors across America will be making the choice of whether to live or die a potentially painful “natural death” because they can’t afford treatment or essential drugs.
Regarding Medicaid, Project 2025 does not want expansion and South Carolina’s governor Henry McMaster says it is a non-starter in his state. Project 2025 feels that reforms, such as work incentives for those who can work and increasing premiums for those with higher incomes is the answer. None of their so-called solutions do anything for nursing home residents who rely on Medicaid for end-of-life care.
The Affordable Care Act and Private Health Insurance
It is no secret that the Republican Party has tried to repeal the Affordable Care Act (ACA) since it first came into being. If it wasn’t for the late Sen. John McCain (R-AZ), this critical program would not be available today and 21.3 million people would have no access to affordable healthcare insurance.
The Project 2025 claim that the ACA “has made insurance more expensive and less competitive” is questionable at best. With insurance companies making multi-billion dollar profits every year, it is safe to say that any increased cost is most likely due to corporate greed with the ACA as the scapegoat.
Although the plan does not specifically call for repealing the ACA, it does want to separate the non-subsidized from subsidized market and get rid of regulations for the non-subsidized one. Regulations like the one mentioned above about pre-existing conditions.
Here we are again with taking away regulations to protect Americans across every state and allowing corporations the freedom to do whatever they want. This is a common theme across this manifesto for everything in the federal government.
What Can We Do to Stop This?
Implementing the Project 2025 plan will have a detrimental effect on everyone who is struggling even on two incomes and those in poorer communities. Health insurance companies will see even larger profits when they have little or no regulations. Americans on Medicare will be forced into a plan that limits what they currently have under the traditional plans and at higher costs.
The Affordable Care Act, even though it is not really on the chopping block, will be slowly dismantled before being eliminated and leaving millions of people without affordable insurance options.
Trump and the Republicans claimed in 2016 they would replace the ACA with something better. Their plan was just a lot of empty promises, but now with the guidelines from Project 2025 they have a blueprint to work from and it is far from better.
The only way to stop this threat to America’s healthcare system is to get out and vote November 5. Kamala Harris and a united Democratic party will always be on the side of all Americans to protect their right to affordable and quality healthcare. Understanding Project 2025 is essential when it comes time to vote.
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