Editor’s note: On August 15, CHN hosted a webinar, Project 2025’s Threat to Human Needs Programs. This is the third of a three-part series that examines the issues that were raised during the discussion. You can read the first two parts here and here. 

Millions of Medicaid and Medicare recipients will be harmed. Newly won prescription drug negotiations will be stopped and costs will once again spiral, as will the cost of vaccinations. And in part by causing untold damage to the Environmental Protection Agency, millions more will suffer adverse health effects. 

During a recent webinar, three experts with the Center on American Progress (CAP) discussed the potential impact Project 2025 would have on health policy. Their diagnosis: not good. 

Project 2025 is a project that created a 900-plus page radical blueprint called Mandate for Leadership, outlining what an extreme right wing administration might look like. Although the Trump campaign has distanced itself from the effort, observers note that many aides to the former president, including high-ranking aides, have been linked to the project and have written many sections. 

Natasha Murphy, CAP Health Policy Director, said Project 2025 proposes converting federal Medicaid funding to block grants, imposing targeted time limits or lifetime caps on Medicaid benefits, and allowing states to mandate work reporting requirements, among other restrictions. She said this would result in “tens of millions of Americans becoming under-uninsured or uninsured completely.” 

She added that Project 2025 calls for repeal of the Inflation Reduction Act, which includes Medicare drug price negotiations and provisions that help lower out-of-pocket drug costs for Medicare enrollees. 

“Recognizing that drug affordability is at an all-time low in this country and so many individuals…report having difficulty affording their prescription drugs, and many fail to take their medicine as prescribed because they cannot afford it, Project 2025 certainly poses a threat for America’s seniors,” Murphy said. 

Marquisha Johns, CAP Associate Director of Public Health, added that the IRA included a provision for cost-sharing for Medicare prescription drug coverage (Part D) enrollees, allowing recipients to save. 

“As we all know, vaccines are very critical and effective for protecting health and preventing diseases,” she said. “And we know that cost can be a real barrier to people deciding whether to be vaccinated.” 

Johns said that the IRA most recently provided more than 52 million beneficiaries with access to free vaccines. “And last year 10.3 million of those beneficiaries actually used that benefit,” she said. 

“Because of the IRA, beneficiaries ended up saving over $400 million in out-of-pocket costs last year,” she said. “So upending that through Project 2025’s plan to repeal the IRA would end up costing patients a lot more money.” 

Jill Rosenthal, CAP Director of Public Health Policy, focused on what she termed Project 2025’s plans to dismantle the Environmental Protection Agency (EPA). 

“This is an area where we could see a lot of damage, from wiping out the EPA and replacing career civil servants with loyalists to the Trump Administration, to Project 2025,” she said. 

She said Project 2025 calls for reducing the EPA’s powers, instituting a “pause and review” on major rules that protect public health and the environment, and reversing progress in protecting Americans from lead, PFAs, soot, and other hazards. 

All of this, she said, would “increase suffering from asthma, cancer, heart disease, reproductive health harms, child development delays, and other health conditions.” 

“We’re highlighting Project 2025’s impact on drastically reducing the EPA’s powers and hamstringing the EPA’s ability to safeguard public health, and dissolving unprecedented U.S. climate, clean energy, and environmental investments,” Rosenthal said. “The ultimate impact of these actions would be eroding our fundamental freedom to breathe clean air and drink safe water, and would significantly increase the number of Americans who suffer from a whole host of health conditions.”