In an unexpected turn of events, President Donald Trump made significant budget cuts to the country’s leading federal cancer research agency in his early days in office. These cuts, affecting the National Institutes of Health (NIH), were foreshadowed in the “Leadership Mandate” of Project 2025, a conservative governance plan that Trump claimed to be unaware of during his campaign but is now closely following.
Crafted by the Heritage Foundation, a conservative research group in Washington, this 922-page manual advocates for breaking the NIH’s monopoly on research direction and calls for limiting payments to universities and their hospitals to reduce federal taxpayer funding for leftist agendas. Universities are now facing drastic cuts in grants covering general costs, leading to concerns about the destruction of current and future biomedical science.
On February 10th, a federal judge temporarily halted the cuts to medical research after 22 medical institutions and 22 states challenged the reductions in court. This swift adoption of Project 2025 objectives suggests that Trump’s followers have long planned steps to disrupt the national healthcare system, despite his previous claims of ignorance regarding the plan.
The implementation of Project 2025 goals could impact major health programs in the country, including Medicaid and Medicare, as well as federal health agencies. Organizations are preparing to challenge Trump’s actions in court, as the manual’s recommendations are being strictly adhered to by his administration.
Challenges Ahead
One of the key elements of Project 2025 is to increase access to health plans that do not meet the Affordable Care Act’s (ACA) consumer protections. While this may offer more choices and lower monthly premiums for buyers, it could lead to substantial out-of-pocket expenses for services not covered by the plans, potentially causing confusion among consumers.
Additionally, the plan calls for cutting off Medicaid funding to Planned Parenthood affiliates, a significant healthcare provider for women nationwide. This move could impact the availability of essential healthcare services for women, affecting millions of patients who rely on these facilities for a range of health needs.
The administration’s efforts to remove terms like “equity” from federal documents, erase transgender identifiers, and restrict international medical aid—all part of Project 2025’s wishlist—have already had significant repercussions. These actions have hindered healthcare access and dismantled international programs aimed at disease prevention and improving maternal health outcomes.
Unpacking the Impact
Health researchers warn that the implementation of Project 2025’s policies poses serious threats to public health and medical care in the country. The agenda outlined in the manual is deemed anti-science, anti-data, and anti-medicine by experts, potentially limiting access to essential healthcare services and weakening protections against sex-based discrimination.
For instance, the plan aims to reshape public health agencies, limit access to medication abortions, and privatize Medicare by enrolling seniors directly in Medicare Advantage plans managed by commercial insurers. It also seeks to eliminate coverage requirements for ACA plans purchased without federal subsidies, which experts fear could leave many individuals underinsured.
As these policies unfold, advocacy groups are raising concerns about discrimination and barriers to medically necessary care, particularly for transgender individuals. The removal of critical health information online and delays in publishing key findings further exacerbate the challenges faced by marginalized communities seeking healthcare services.
With a significant portion of the public expressing negative views on Project 2025, the Trump administration risks losing public support if it continues to push for radical changes to the country’s healthcare and health policy. As the debate unfolds, the impact of these policy decisions on the nation’s health landscape remains a topic of intense scrutiny and concern.
In a statement, a spokesperson for the Heritage Foundation sought to distance the organization from the administration’s actions, emphasizing that the recommendations put forth in Project 2025 have been a longstanding part of their work. However, as the administration moves forward with these policies, the implications for healthcare access and quality of care continue to raise questions and spark debate among various stakeholders.
