Are you over 65 and on Medicare? Or LGBTQIA+, or living with HIV? Or a woman seeking reproductive health services? Getting insurance from Obamacare – the Affordable Care Act? Or someone who’s lost a job or isn’t working, or is getting federal benefits such as Medicare, Medicaid, or SNAP food stamps? If you are, Project 2025 will negatively – and possibly drastically – impact your health care access. But it also impacts all Americans – and a global public – because it calls for radical policy changes to impose a conservative Christian agenda on all sectors of the federal government, including foreign aid (see related global health brief).

In a nutshell, Project 2025 proposes to drastically cut the US health safety net for the poorest and most vulnerable Americans, cutting benefits programs like those listed above, while overhauling the key federal health departments and scientific agencies that conservatives view as run by “woke” officials. Where possible, Project 2025 favors outsourcing health programs to the private sector including Christian groups and cutting Obamacare to expand private insurance.

One rare positive policy reform is Project 2025’s call to boost generic drug access and require Big Pharma to stop delaying access to generic drugs once brand name drug patents have expired.

Project 2025’s chapter on the Department of Health and Human Services (HHS) is written by Roger Severino, a militant Catholic activist and reported member of Opus Dei (see our Special Report, Follow the Dark Money) who backs a federal ban on abortion, limits to birth control and fertility methods (see related briefs on Reproductive Rights, and Sex and Gender) and elimination of care services to transgender individuals (see brief on LGBTQIA+).

Imposing a radical pro-life health agenda

Project 2025 proposes to rename HHS as “the Department of Life,” to be run by a new pro-life Secretary and pro-life Task Force to ensure that its mission “furthers the health and well-being of all Americans from conception to natural death.” The CDC, FDA, NIH would be similarly restructured to reflect a conservative Christian anti-choice, antigay agenda. So would USAID, which oversees foreign aid dollars. Vaccine and mask mandates would no longer be part of Covid-19 public health policy, while scientific research would be scrubbed of any support for abortion. Overall, Project 2025 eliminates gender identity from federal protections, and criminalizes transgender identity. In short, no federal money can support LGBTQIA+ programs.

Main health proposals and impacts:

• Guts the US federal health safety net and threatens health access and insurance under the ACA for the most vulnerable Americans, and those living with HIV

• Turns Medicare into a free market program; repeals Medicare drug pricing negotiations passed by Biden 

• Establishes a work requirement for Medicaid; makes Medicaid recipients pay for some care; puts a lifetime cap on benefits

• Establishes a work requirement for SNAP; tightens eligibility for food stamps, Thrifty food, and WIC; also K-12 school lunch programs (see our chapter on Dept. of Education)

• Expands private insurance and outsources health services to private sector contractors 

• Calls for expansion of private sector health care options for Native Americans

• Turns HHS into a pro-life agency run by a pro-life Secretary and Task Force and eliminates abortion services, restricts birth control, seeks limits on fertility methods

• Promotes marriage and abstinence in STD and pregnancy prevention

• Radically restructures the HHS, FDA, CDC, NIH; replaces Biden administration officials

• Eliminates federal services to LGBTQ+ people

• Eliminates federal funding for gender-affirming care. Criminalizes transgender and nonbinary identity and criminalizes providers of gender-affirming care

• Reestablishes waivers for state and child welfare agencies for religious exemptions, especially for faith-based adoption and foster care agencies

• Removes vaccine mandates; cuts CDC vaccine research and preparedness. This would put the US public at increased risk for eradicated diseases like polio and new pathogens

• Opposes physician-assisted suicide; promotes palliative care as alternative  

• Requires that development of all drugs and biologics be free of fetal cell lines

• Globally, requires any group getting US foreign aid to be aligned with a pro-life, anti-gay policy or lose USG funding, preventing funding for services to LGBTQIA+, for abortion

• Calls for a review and hold on reauthorization of the successful U.S. President’s Emergency Plan For AIDS Relief (PEPFAR) contingent on adoption of a pro-life agenda

• Reinstates the Biden-rescinded “Mexico City” policy (global gag rule) that would ban US funding of foreign nonprofits who provide abortion services; extends ban globally

• Opposes US boycotts or criticism of foreign governments who pass harsh antigay laws 

• Expands federal grants and support for Christian and private sector providers abroad