In the first weeks of his administration, few voters hoped President Donald Trump would cut billions of dollars from the country’s best federal cancer research institutions.
However, funding cuts to the National Institutes of Health (NIH) were booked in Project 2025’s “Leadership Delegation.” This is a conservative plan of governance that Trump said he knew nothing during his campaign. Now his administration is accepting it.
The 922-page playbook, edited by Washington’s conservative research group, Heritage Foundation, states that “NIH monopoly on research supervision should be broken,” concludes its payments to universities and their hospitals that “helps reduce federal taxpayer subsidies on the left agenda.”
University currently facing drastic cuts in agency grants covering these overhead costs say that policies will destroy ongoing and future biomedical sciences. A federal judge temporarily suspended cuts in medical research on February 10 after drawing legal challenges from medical institutions and 22 states.
Project 2025 as a prologue
The rapid adoption of many of the Project 2025 goals shows that Trump’s supporters (many of his contributors were veterans in his first term and joined his second administration) have quietly laid the foundations for disrupting the National Health System over the years. That goes against Trump’s claims about the campaign path that he is ignorant of documents after Democrats put Project 2025 into a strong offensive line.
“I don’t know what Project 2025 is,” Trump told a rally on October 31, 2024 in Albuquerque, New Mexico. “I’ve never read it, and I’ll never.”
But because his administration is so closely driven by the playbook that compiled the Heritage Foundation, opposition groups and Democrat leaders in some states say they can act quickly to counter Trump’s moves in court.
They are currently preparing Trump to act on some of the nation’s largest and most important health programs, including Medicaid and Medicare, as well as the recommendations of Project 2025 for federal health agencies.
“There were many plans on the litigation side to challenge executive orders and other early actions from many different organizations,” said Noah Bookbinder, president of the Citizens for Washington’s responsibility and ethics at WatchDog Group. “Project 2025 has allowed some preparation.”
For example, the plan calls for state flexibility to impose some beneficiaries, labor requirements, and lifetime caps or time limits, calling for limits on Medicaid coverage for some enrollees in the program for low-income and disabled Americans, which could lead to a surge in uninsured numbers after the Biden administration widens program coverage.
“We’re excited to announce that we’re a health policy vice president for Kaiser Family Foundation (KFF), a health information nonprofit that includes KFF Health News,” said Larry Levitt, vice president of health policy at Kaiser Family Foundation (KFF), a health information nonprofit that includes KFF Health News. “Setting barriers to those who register with Medicaid, such as documenting premiums and job status, will result in coverage rationing through complexity and ability to pay.”
Congressional Republicans are thinking of a budget plan that could potentially trim hundreds of billions of dollars from Medicaid over a decade.
Project 2025 called for increased access to health plans that do not comply with the most powerful consumer protections of the Affordable Care Act. It could reduce buyer choice and monthly premiums more, but unfamiliar consumers could face potentially huge out-of-pocket costs due to care that the plan doesn’t cover.
Project 2025 also called for the suspension of Medicaid funding for parent-child parties in the Plan. A key healthcare provider for women across the country, the organization has earned around $700 million a year from Medicaid and other government programs, based on a report from 2022-23. Abortions account for about 4% of the services the organization has provided to patients, the report said.
The administration’s procedures to scrub words such as “fair” from federal documents erase international medical aid, which is part of all of the Project 2025 wish list, and procedures to reduce international medical aid have already been cleaned, hobsing to international programs aimed at preventing illness and improving maternal health outcomes.
For example, under a memorandum issued in January, Trump reinstated and expanded the federal funding ban on global organisations providing legal information about abortions.
Research shows that the ban, known as the “Global Gag Rules” or “Mexico City Policy,” stripped millions of dollars from foreign aid groups that failed to comply with it. It also had a calm effect. In Zambia, a group deleted information in a birth control pamphlet, and in Torkie, they stopped talking to patients about menstrual regulations as a form of family planning.
Project 2025 called on the next president to revive the GAG rules, saying “it needs to be drafted widely to apply to all foreign aid.”
Trump has also signed an executive order that reiterates transgender rights by banning federal funds for transition-related care for people under the age of 19. The order he signed instructed only to recognize two genders, male and female, and to use the term “sex” instead of “gender.”
The Project 2025 document calls for removing the term “gender identity” from federal rules, regulations and grants, and unlocking policies and procedures that authors say will be used to advance “radical redefine gender.” It also states that the Department of Health and Human Services programs should “protect the mind and body of children.”
“Extreme actors within and outside the government are promoting harmful identity politics that replace biological gender with subjective concepts of “gender identity,” reads the Project 2025 roadmap.
The data will disappear
Health researchers say that as a result of Trump’s order on gender identity, the Centers for Disease Control and Prevention (CDC) has deleted online information on transgender health and deleted data on LGBTQ+ health. On February 11, a federal judge ordered much of the information to be restored. The administration has added notifications to several web pages that have been labelled “very inaccurate” and claimed that it “doesn’t reflect biological reality.”
The CDC also delayed the release of information and findings on avian influenza in weekly reports of institutional morbidity and mortality. Additionally, federal workers have been told to withdraw papers that contain terms such as “non-binary” and “transgender.” Additionally, some hospitals have stopped gender maintenance care, including hormone therapy and adolescent blockers for young people.
Advocacy groups say the order discriminates and poses barriers to medically necessary care, and transgender children and their families have filed numerous court assignments.
Lawyers, advocates and researchers say the implementation of many of the health policy goals for Project 2025 poses a threat.
“This playbook presents an anti-science, anti-industrial and anti-medicine agenda,” according to an article last year by a researcher at Boston University in the JAMA Journal.
Project 2025 Blueprint sets goals to curb access to medication abortion, restructure public health agencies, and undermine protections against gender-based discrimination. By privatizing health programs for seniors, you can register by default with Medicare Advantage plans run by commercial insurance companies. And, insurance experts say, they are asking people to eliminate the coverage requirements for affordable care law plans that they buy without federal subsidies.
“That’s on the Trump administration’s agenda,” said Robert Weissman, co-chairman of Civils, a progressive consumer rights advocacy group. “It’s minimizing access to care by rolling back consumer protection and subsidies in Medicaid’s strict work requirements, Medicare privatization, and Affordable Care Act.”
The White House did not respond to a message seeking comment. Conservatives say the implementation of the project’s proposal will curb the waste and fraud of the free health system from the federal health program and the clutches of the radical “wake” agenda.
“Americans are tired of their government being used against them,” lawyer and former director of Project 2025 Paul Dance said in a 2024 statement. “The administrative state is at best not in full contact with Americans and at worst weaponized against them.”
DANS did not reply to a message asking for comment on this article.
The Heritage Foundation has attempted to separate 2025 from Trump’s executive order and other health initiatives.
“This is not a recommendation for Project 2025. It’s something we’ve done for over 40 years. It’s about President Trump offering his promise to make America safer, stronger and better than ever, and he and his team deserve credit,” Heritage spokesman Ellen Keenan said in a statement.
Versions of the document have been created about every four years since the 1980s and have influenced other GOP presidents. Former President Ronald Reagan adopted about two-thirds of the recommendations from his previous heritage guide, the group said.
In some cases, the Trump administration has not only followed Project 2025 proposals, but has surpassed them.
The document called on the next president to “deradicalise” the United States Organization for International Development (USAID), an independent federal agency that provides foreign aid and support, including many international health programs.
The administration has not only reduced USAID. Trump’s advisor Elon Musk boasted on his social media platform X. His “government efficiency” boasted that he provided agents to “woodchipper,” physically closing offices, funding for the program, and putting almost all of its staff on administrative leave, spreading misinformation about them.
However, if the administration adopts the project’s goal of overturning US healthcare and health policies, it risks eroding public support. Almost 60% of voters said they felt negative about Project 2025 in a September poll by NBC News.
“Project 2025 was by no means a thought exercise. Ally Bogun, spokesman for Reproductive Freedom for All, an abortion rights organization, said: “We’ve only been in the past few weeks since his presidency. It’s even more foundational.”
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