Let's take a look at Donald Trump's #Project2025 Medicaid Agenda, shall we?
Before I get started, I want to be clear about two things.
First, what exactly is "Project 2025?"
Project 2025, also known as the Presidential Transition Project, is a collection of conservative and right-wing policy proposals from the Heritage Foundation to reshape the United States federal government and consolidate executive power should the Republican Party candidate win the 2024 presidential election.
It proposes reclassifying tens of thousands of merit-based federal civil service workers as political appointees in order to replace them with those who will be more willing to enact the wishes of the next Republican president.
It asserts that the president has absolute power over the executive branch.
Critics of Project 2025 have characterized it as an authoritarian, Christian nationalist plan to transform the United States into an autocracy.
Many legal experts have asserted it would undermine the rule of law, the separation of powers, the separation of church and state, and civil liberties.
Heritage Foundation president Kevin Roberts said in July 2024 that "we are in the process of the second American Revolution, which will remain bloodless if the left allows it to be."
Paul Dans, the project's director, said in April 2023 that Project 2025 is "systematically preparing to march into office and bring a new army, [of] aligned, trained, and essentially weaponized conservatives ready to do battle against the deep state."
Second: Despite his claim earlier today that he "knows nothing about Project 2025" and that he "has no idea who's behind it," it absolutely is Donald Trump's policy platform:
Trump campaign chooses Project 2025 leader Russ Vought to co-lead the RNC’s Platform Committee. Last year, Vought wrote that he was “proud to work with William Wolfe on scoping out a sound Christian Nationalism.”
Trump’s Press Secretary is literally starring in recruitment ads for Project 2025
"Here is Trump Senior Advisor and former appointee John McEntee, who helped draft Project 2025, explaining to Steve Bannon last July how Trump plans to implement the plan immediately after taking office. But Trump doesn’t know these people or anything about it."
OK, now that we have that out of the way, I thought it would be a good idea to delve into just what Donald Trump has in mind for U.S. Healthcare policy if he ends up returning to office a little over 6 months from now.
Trump's entire Project 2025 Policy Agenda is huge--over 900 pages as I understand it--but given the nature of my website, I'm going to restrict myself to discussing the healthcare policy section, which is thankfully "only" 54 pages long.
Since there's so much to wade through here, I'll be breaking this into several individual posts.
First up, according to Edwin Park, Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families, here's how Project 2025 would impact MEDICAID:
- It would convert federal Medicaid funding into BLOCK GRANTS (a set amount of money which would remain the same regardless of increased healthcare cost growth, enrollment growth, unexpected additional costs from recessions, disasters, another global pandemic, etc.
- It would require states to pay a much larger share of Medicaid costs
- It would eliminate states ability to use provider taxes, which states use to pay part of their share
- This in turn would prevent states from being able to access even the already-reduced federal revenue
- It would eliminate many Medicaid protections & requirements, including adding coverage time limits and lifetime benefit caps
- It would allow states to increase premiums & cost sharing for enrollees and add them to children and pregnant women
- It would allow states to drop coverage of nursing home care and long-term services
- States would no longer have to coverage non-elderly non-disabled parents
- It would add more red tape & make it more difficult for people to apply for, enroll in and renew their coverage
- It would let states add work reporting requirements, which have proven to be a disaster in the handful of states that it's been allowed for to date
- It would push for Medicaid vouchers for less affordable & far less comprehensive private coverage
- It would remove most federal oversight of state Medicaid programs...except for abortion & reproductive healthcare, where it would crack down with draconian federal requirements including prohibiting Planned Parenthood from receiving federal funding, prohibiting coverage of travel to get an abortion and eliminating Medicaid funding for states which require abortion coverage in private policies*
*Note: As of 2022, that included California, Illinois, Maine, Maryland, New York, Oregon and Washington.
Overall, Park estimates that Project 2025 would slash federal Medicaid funding by more than 50% over the next decade.