Project 2025 is Unraveling Decades of Public Health Progress

by Mandy Morgan February 21, 2025

The early days of President Donald Trump’s administration have seen rapid implementation of policies rooted in Project 2025, a comprehensive conservative playbook developed by the Heritage Foundation. While Trump has publicly denied knowledge of the 922-page “Mandate for Leadership,” his administration’s actions tell a different story—one with profound implications for public health, biomedical research, and healthcare access in the United States.

Let’s take stock of where we are as of February 21, 2025

NIH Cuts Threaten Medical Research

One of the most controversial moves has been slashing billions of dollars from the National Institutes of Health (NIH). The administration’s new policy caps indirect grant funding at 15%, a drastic reduction that threatens university budgets and ongoing research. The consequences are stark: Researchers like Dr. Rick Huganir at Johns Hopkins University fear they may have to abandon or delay critical clinical trials, impacting treatment development for rare disorders like SYNGAP1 mutations in children.

Restructuring Medicaid and Medicare

Project 2025’s proposals also target major federal health programs. The blueprint calls for Medicaid work requirements, lifetime caps, and state flexibility to introduce premiums—measures that could reduce coverage for low-income and disabled Americans. For Medicare, the plan aims to default seniors into Medicare Advantage plans, effectively privatizing the program. Critics warn this could increase out-of-pocket costs for vulnerable populations.

Attacks on Public Health Agencies

Under the new administration, public health agencies such as the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are undergoing significant changes. The confirmation of Robert F. Kennedy Jr., a known purveyor of vaccine misinformation, as Secretary of Health and Human Services (HHS) has only fueled concerns. The chaos at these agencies—staff cuts, paused grants, and halted research—risks undermining decades of scientific progress.

Limiting Access and Erasing Data

Project 2025 extends beyond budget cuts. The administration has reinstated the “global gag rule,” limiting international medical aid, and issued orders to roll back transgender rights and erase terms like “gender identity” from federal documents. Health researchers report that LGBTQ+ health data has been removed from CDC websites, and hospitals have halted gender-affirming care for youth.

Growing Pushback from the Public

Resistance to Project 2025’s initiatives is gaining momentum. Rep. Rich McCormick (R-Ga.) recently faced intense criticism from his constituents during a town hall in Roswell, Georgia. Voters voiced frustration over his support for the Trump administration’s aggressive budget cuts, with boos and jeers filling the room. Critics questioned the administration’s “chainsaw approach” to cutting federal jobs and slashing healthcare funding. The event highlighted a growing divide, even in districts where Trump received strong support, signaling that the public’s patience with drastic healthcare reforms is wearing thin.

What’s Next for Public Health?

With legal challenges underway, the future of Project 2025’s policies remains uncertain. However, public health professionals face a critical challenge: bridging the growing divide between science and politics. Experts suggest that more grassroots organizing, community engagement, and public education are essential to defending public health infrastructure and advancing equitable healthcare policies.

That can seem trite, but it so critical. In coming days we’ll have more columns on direct and indirect actions you can take. It starts by contacting your congressional representatives.

Here’s a form email to use

Dear [Representative’s Name],

I am writing to express my deep concern and profound disappointment regarding the recent policies being implemented. These changes—including drastic cuts to the National Institutes of Health (NIH), and the erosion of public health agency integrity—pose a severe threat to the health and well-being of all Americans.

The administration’s decision to cap NIH grant funding and restructure critical health programs will undoubtedly hinder medical research, reduce healthcare access, and disproportionately affect vulnerable communities. The rollback of protections for marginalized groups and the suppression of science-based public health guidance only deepen my alarm.

As your constituent, I urge you to oppose these dangerous policies and advocate for evidence-based, equitable healthcare solutions. Our public health system must be strengthened, not dismantled. I hope you will take immediate action to protect our healthcare infrastructure, support scientific research, and ensure that public health policies are guided by data and compassion—not political agendas.

Thank you for your attention to this urgent matter.

I just sent this to good old Lloyd Smucker. You can find your rep here. https://www.usa.gov/elected-officials

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