--- title: How Project 2025 Would Jeopardize Americans' Health description: The agenda would set back decades of progress in medicine and public health, writes Dr. Suhas Gondi. canonical: https://time.com/7014947/project-2025-health-trump/ author: Suhas Gondi article:opinion: true article:content_tier: free article:published_time: 2024-08-27T15:02:06.000Z article:modified_time: 2026-08-04T07:50:18.522Z article:section: Ideas og:title: How Project 2025 Would Jeopardize Americans' Health og:description: The agenda would set back decades of progress in medicine and public health, writes Dr. Suhas Gondi. og:url: https://time.com/7014947/project-2025-health-trump/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltbd9504a052228b1b/698a5a449862f59f1189614e/donald-trump-2025.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2400 og:image:height: 1350 og:image:alt: Donald Trump Holds Rally In Pennsylvania og:type: article twitter:card: summary_large_image twitter:title: How Project 2025 Would Jeopardize Americans' Health twitter:description: The agenda would set back decades of progress in medicine and public health, writes Dr. Suhas Gondi. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltbd9504a052228b1b/698a5a449862f59f1189614e/donald-trump-2025.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # How Project 2025 Would Jeopardize Americans' Health > Sponsored content. 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Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ## Video: What Kamala Harris and Donald Trump Have Said About Project 2025 [Watch (HLS stream): What Kamala Harris and Donald Trump Have Said About Project 2025](https://cdn.jwplayer.com/manifests/uPVIlsSZ.m3u8) (1:53)  _Published 2024-07-25. 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. The previous weekend, Trump had once again denied involvement with the "extreme" Project 2025 at a campaign rally in Grand Rapids, Michigan, and claimed "he took a bullet for democracy."_ by [Suhas Gondi](https://time.com/author/suhas-gondi/) ## Suhas Gondi Aug 27, 2024 3:02 PM UTC  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](https://time.com/author/suhas-gondi/) ## Suhas Gondi Aug 27, 2024 3:02 PM UTC 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/). 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) and [address medical debt](https://www.statnews.com/2024/08/16/kamala-harris-healthcare-platform-medical-debt-relief-lower-drug-prices/), 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/) titled _Mandate for Leadership: The Conservative Promise_. While Trump has publicly [disavowed](https://www.c-span.org/video/?c5124900/donald-trump-disavows-project-2025) the initiative, he has endorsed (and even tried to implement) [many](https://www.cbsnews.com/news/project-2025-proposals-trump-policies/) 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) of insulin [steadily](https://www.kff.org/medicare/issue-brief/insulin-out-of-pocket-costs-in-medicare-part-d/) [grew](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857611/), forcing many patients to [cut back](https://www.rand.org/pubs/articles/2021/the-astronomical-price-of-insulin-hurts-american-families.html) elsewhere to afford their insulin and others to [forgo](https://diabetesjournals.org/care/article/45/3/594/139257/Cost-Related-Medication-Nonadherence-in-Adults) it altogether. **Read More**: [_How Simple Monitors Can Prevent Air Pollution-Related Illness_](https://time.com/7013463/air-pollution-monitors-health/) The [Inflation Reduction Act](https://www.congress.gov/bill/117th-congress/house-bill/5376) (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/) 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) [challenges](https://www.fiercepharma.com/pharma/boehringer-ruling-industry-extends-legal-losing-streak-against-medicare-price-negotiations) 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/) and saving [billions](https://www.brookings.edu/articles/impact-of-federal-negotiation-of-prescription-drug-prices/). 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) 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) 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) 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#), 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/) 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)—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/) ## 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/) at the [national level](https://reproductivefreedomforall.org/resources/gutting-abortion-access-under-project-2025/) 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). 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/) 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/) 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. ## Transcript Project 2025 is a plan to return America to a dark past. Donald Trump and his extreme allies want to take our nation back to failed trickle down economic policies. Back to Union busting, Back to tax breaks for billionaires. Donald Trump and his allies want to cut Medicare and Social Security to stop student loan forgiveness for teachers and other public servants. And I say to AFT, they even want to eliminate the Department of Education. And end head start, which, of course, would take away preschool from hundreds of thousands of our children. He intends to give tax breaks to billionaires and big corporations and make working families foot the bill. And he intends to end the Affordable Care Act. You know, America has tried these failed economic policies before. But we are not going back. We are not going back. And they come up with this I don't know what the hell it is. It's Project 25. He's involved in project. And then they read some of the things and they are extreme. I mean, they're seriously extreme. But I don't know anything about it. I don't want to know anything about it. But what they do is misinformation and disinformation. And they keep saying, He's a threat to democracy. I'm saying, What the hell did I do for democracy? Last week, I took a bullet for democracy. 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