--- description: The agenda would set back decades of progress in medicine and public health, writes Dr. Suhas Gondi. title: How Project 2025 Would Jeopardize Americans' Health image: https://static.time.com/v3/assets/bltea6093859af6183b/bltbd9504a052228b1b/698a5a449862f59f1189614e/donald-trump-2025.jpg?branch=production&width=3840&quality=75&auto=webp&crop=16:9 ---  * [Ideas](/section/ideas/) ## Ideas Update your preferences in [Account Settings](/account/preferences/) Close * [health](/tag/health/) ## health Update your preferences in [Account Settings](/account/preferences/) Close # How Project 2025 Would Jeopardize Americans' Health by [Suhas Gondi](/author/suhas-gondi/) ## Suhas Gondi Update your preferences in [Account Settings](/account/preferences/) Close Aug 27, 2024 3:02 PM CUT  Former President Donald Trump during a campaign event in Wilkes-Barre Township, Pa., on Aug. 17, 2024. Former President Donald Trump during a campaign event in Wilkes-Barre Township, Pa., on Aug. 17, 2024.Heather Khalifa—Bloomberg/Getty Images by [Suhas Gondi](/author/suhas-gondi/) ## Suhas Gondi Update your preferences in [Account Settings](/account/preferences/) Close Aug 27, 2024 3:02 PM CUT With fewer than 70 days to the election, Americans are starting to learn about the distinct visions that Vice President Kamala Harris and former President Donald Trump have for our country’s future. Nowhere is the divide between the two candidates wider than in [health care](https://www.kff.org/compare-2024-candidates-health-care-policy/ "undefined"). Though health care has frequently played a pivotal role in presidential contests, this November’s election may be among the most consequential for our patients. While Harris and Governor Tim Walz will work to build on the successes of the Biden-Harris administration over the past four years—continuing efforts to [lower prescription drug costs](https://www.npr.org/2024/08/18/nx-s1-5008844/democratic-national-convention-harris-policy "undefined") and [address medical debt](https://www.statnews.com/2024/08/16/kamala-harris-healthcare-platform-medical-debt-relief-lower-drug-prices/ "undefined"), for instance—Trump and his running mate J.D. Vance have said relatively little about their health policy agenda. But Project 2025 offers a glimpse of what it could look like. Sponsored by the right-wing think tank, the Heritage Foundation, the Project 2025 policy agenda was written by more than 400 conservative experts and published in a [book](https://www.project2025.org/policy/ "undefined") titled _Mandate for Leadership: The Conservative Promise_. While Trump has publicly [disavowed](https://www.c-span.org/video/?c5124900/donald-trump-disavows-project-2025 "undefined") the initiative, he has endorsed (and even tried to implement) [many](https://www.cbsnews.com/news/project-2025-proposals-trump-policies/ "undefined") of its core proposals, several of which were penned by his former staffers. Here are a few examples of how the Project 2025 agenda would leave my patients—and those of clinicians across the country—worse off. ## Making medications more expensive I’ve taken care of countless patients who rely on insulin to control their diabetes. When these patients don’t take their insulin, they’re at risk of not just worsened diabetes (which increases the risk of heart attacks and strokes) but also life-threatening medical emergencies from dangerously high blood-sugar levels. In the decades preceding the Biden-Harris administration, the [out-of-pocket cost](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646207 "undefined") of insulin [steadily](https://www.kff.org/medicare/issue-brief/insulin-out-of-pocket-costs-in-medicare-part-d/ "undefined") [grew](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857611/ "undefined"), forcing many patients to [cut back](https://www.rand.org/pubs/articles/2021/the-astronomical-price-of-insulin-hurts-american-families.html "undefined") elsewhere to afford their insulin and others to [forgo](https://diabetesjournals.org/care/article/45/3/594/139257/Cost-Related-Medication-Nonadherence-in-Adults "undefined") it altogether. **Read More**: [_How Simple Monitors Can Prevent Air Pollution-Related Illness_](https://time.com/7013463/air-pollution-monitors-health/ "undefined") The [Inflation Reduction Act](https://www.congress.gov/bill/117th-congress/house-bill/5376 "undefined") (IRA)—signed into law by President Biden two years ago—capped insulin costs at $35 per month for people on Medicare. The data show that this cap [increased](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10366947/ "undefined") the number of insulin prescriptions that were filled, ensuring more patients with diabetes got what they needed to stay healthy. The IRA will also cap annual out-of-pocket spending on prescription drugs (not just insulin) for seniors starting next year. And despite aggressive lobbying and [legal](https://www.nytimes.com/2023/07/23/us/politics/medicare-drug-price-negotiations-lawsuits.html "undefined") [challenges](https://www.fiercepharma.com/pharma/boehringer-ruling-industry-extends-legal-losing-streak-against-medicare-price-negotiations "undefined") from drugmakers, the law empowered Medicare to negotiate prices with Big Pharma for the first time in history, achieving significant [discounts](https://www.whitehouse.gov/briefing-room/statements-releases/2024/08/15/fact-sheet-biden-harris-administration-announces-new-lower-prices-for-first-ten-drugs-selected-for-medicare-price-negotiation-to-lower-costs-for-millions-of-americans/ "undefined") and saving [billions](https://www.brookings.edu/articles/impact-of-federal-negotiation-of-prescription-drug-prices/ "undefined"). These are just a few of the many reasons more than 500 health professionals [recently signed](https://www.nbcnews.com/politics/2024-election/live-blog/trump-harris-president-election-live-updates-rcna165967#rcrd52285 "undefined") an [open letter](https://www.documentcloud.org/documents/25047904-open-letter-from-american-health-care-professionals%5F-we-must-protect-the-inflation-reduction-act-by-electing-vice-president-harris-and-governor-walz "undefined") to protect the IRA. Yet at a time when a [third](https://today.yougov.com/health/articles/45388-americans-have-not-filled-prescription-price-poll "undefined") of Americans report not filling a prescription due to [cost](https://www.goodrx.com/healthcare-access/research/third-of-americans-dont-fill-prescriptions-due-to-cost# "undefined"), Project 2025 calls for these life-saving provisions to be rolled back. IRA repeal, [supported](https://democrats.org/news/on-inflation-reduction-act-anniversary-trump-vance-ticket-is-pursuing-a-project-2025-agenda-to-gut-landmark-legislation/ "undefined") by Trump and Vance, would make drugs like insulin more expensive and force patients to shoulder more of the costs of the medications we prescribe them, forcing impossible choices between health and livelihood. ## Decreasing access to Medicaid Project 2025 doesn’t just try to scale back recent successes in making care more affordable for people on Medicare. It also seeks to weaken Medicaid, which more than 70 million low-income Americans rely on for health care. The authors propose instituting lifetime caps on benefits and adding work requirements as a condition for coverage, creating administrative hurdles that make life harder for people who have the least. Together, these provisions could cause millions of people—including those who are currently [working](https://www.commonwealthfund.org/publications/explainer/2024/apr/work-requirements-medicaid-enrollees "undefined")—to lose coverage. These policies punish patients for being poor, and in one of the harshest ways: by denying them health care. **Read More**: [_7 Metrics Everyone Should Know About Their Own Health_](https://time.com/7010448/health-metrics-everyone-should-know/ "undefined") ## Restricting reproductive health care And at a time when reproductive rights are under attack in so many states, Project 2025 would not only further [restrict abortion](https://www.washingtonpost.com/politics/2024/08/22/project-2025-would-recast-hhs-federal-department-life/ "undefined") at the [national level](https://reproductivefreedomforall.org/resources/gutting-abortion-access-under-project-2025/ "undefined") but also eliminate no-cost coverage for some contraception, erecting more barriers to evidence-based care for patients of reproductive age. ## Endangering childrens’ health Finally, Project 2025 takes particular aim at the well-being of children. The authors seek to prevent public health agencies from requiring vaccination in school children, which could cause more outbreaks of preventable diseases like [measles](https://www.pbs.org/newshour/health/measles-cases-are-rising-in-the-u-s-heres-why-misinformation-about-the-vaccine-persists-today "undefined"). They also propose invalidating state laws intended to stem gun violence, a [leading](https://www.kff.org/mental-health/issue-brief/the-impact-of-gun-violence-on-children-and-adolescents/ "undefined") cause of death for children in the U.S. Project 2025 would even eliminate Head Start, a [critical program](https://www.americanprogress.org/article/project-2025-would-eliminate-head-start-severely-restricting-access-to-child-care-in-rural-america/ "undefined") for early childhood development, especially in low-income and rural communities. If elected, Trump might not adopt all of these proposals. But if he institutes even some of these plans, it would set back decades of progress in medicine and public health. As doctors, we know that progress on these issues did not come easily. The Affordable Care Act was hotly contested and survived multiple partisan efforts to dismantle it—including by Trump during his first term. For more than ten years, Medicaid expansion has been a fierce and ongoing state-by-state battle. The pharmaceutical industry fought tooth-and-nail against drug-price negotiation. At every step of the way, countless doctors have stood up for their patients, advocating for greater access to affordable medical care. The prospect of these hard-fought victories being reversed—and the suffering it would cause our patients—is worth another fight. ```json [{"@context":"https://schema.org","@type":"OpinionNewsArticle","@id":"https://time.com/7014947/project-2025-health-trump/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/7014947/project-2025-health-trump/"},"headline":"How Project 2025 Would Jeopardize Americans' Health","datePublished":"2024-08-27T15:02:06.000Z","dateModified":"2026-02-24T18:12:33.264Z","description":"The agenda would set back decades of progress in medicine and public health, writes Dr. Suhas Gondi.","url":"https://time.com/7014947/project-2025-health-trump/","keywords":["health","healthscienceclimate"],"thumbnailUrl":"https://static.time.com/v3/assets/bltea6093859af6183b/bltbd9504a052228b1b/698a5a449862f59f1189614e/donald-trump-2025.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","author":[{"@type":"Person","name":"Suhas Gondi","jobTitle":null,"url":"https://time.com/author/suhas-gondi/"}],"articleSection":"Ideas","image":[{"@type":"ImageObject","url":"https://static.time.com/v3/assets/bltea6093859af6183b/bltbd9504a052228b1b/698a5a449862f59f1189614e/donald-trump-2025.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","width":1200,"height":675,"headline":"Donald Trump Holds Rally In Pennsylvania","caption":"Donald Trump Holds Rally In Pennsylvania","creditText":"Heather Khalifa—Bloomberg/Getty Images","representativeOfPage":true}],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/section/ideas/","name":"Ideas"}},{"@type":"ListItem","position":2,"item":{"@id":"/tag/health/","name":"health"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/7014947/project-2025-health-trump/","name":"How Project 2025 Would Jeopardize Americans' Health"}}]},{"@context":"https://schema.org","@type":"VideoObject","name":"What Kamala Harris and Donald Trump Have Said About Project 2025","description":"Vice President Kamala Harris this week compared her and President Biden's policies with those of Donald Trump and the Heritage Foundation's Project 2025, a far-right proposed plan for a second Trump term. 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