With Donald Trump as the official GOP presidential nominee, health care is once again on the chopping block. Donald Trump has renewed calls to “terminate” the Affordable Care Act (ACA). MAGA allies at the Heritage Foundation released Project 2025, a dangerous policy roadmap designed to give more tax breaks to big corporations and the wealthiest Americans by decimating the middle class and stripping away our health care. The GOP plan for health care is clear: repeal the Inflation Reduction Act and ACA, slash Medicaid and Medicare funding, repeal protections for pre-existing conditions, raise prescription drug and premium costs, and strip away health care from millions of Americans all while giving tax breaks to billionaires, CEOs, and corporations. If Trump and MAGA Republicans get their way, it would be disastrous for tens of millions across the nation. Here is a quick look at the health care policies proposed in Project 2025:
Hike Health Care Costs and Rip Away Protections For Pre-Existing Conditions
Project 2025 calls for repealing the Inflation Reduction Act. This means it would end enhanced premium tax credits that lower insurance costs for Americans purchasing coverage on their own through the ACA. Getting rid of these premium tax credits would make health care more expensive, threatening coverage and well being for millions of Americans.
In addition, a core piece of the Project 2025 plan would codify rules put forth by the Trump administration that expanded junk health insurance plans known as association health plans. These plans charge people who have pre-existing conditions more and deny coverage for essential services like prescription drugs and maternity care, leaving people with unexpected medical bills.
If Project 2025’s proposals are enacted:
- GONE: Lower health care premiums for the over 20 million who buy their own coverage through the Marketplace. Ending the tax credits would mean a typical 60-year-old couple making $80,000 per year would see their premiums triple to over $24,000 per year and premiums for a family of four making $125,000 would increase by $7,676.
- GONE: Protections against catastrophic surprise hospital bills through total repeal of the No Surprises Act. Nearly 9 million people avoided surprise bills in 2022 alone.
- GONE: The Medicaid Drug Rebate Program which gives low income Americans lower costs and allows states to expand drug coverage while maintaining savings.
Increase Prescription Drug Costs
Project 2025’s plan to fully repeal the Inflation Reduction Act would eliminate the lifesaving insulin cost cap and Medicare’s power to negotiate lower drug prices. As a result, health care costs will skyrocket for families while drug and insurance companies and their CEOs are allowed to charge Americans whatever they want and get billions in tax breaks.
If Project 2025’s proposals are enacted:
- GONE: $35 cap on monthly insulin costs for people with Medicare
- GONE: Medicare’s power to negotiate lower prices for the most popular and expensive prescription drugs. Nearly 9 million people take the first ten drugs that were selected for Medicare negotiation, which account for 20 percent of Medicare Part D yearly spending.
- GONE: Prescription drug savings for people on Medicare, including a new $2,000 annual out-of-pocket cap and protections from drug company price hikes through inflation rebates. Nearly 19 million American seniors are expected to save an average of $400 per year.
- GONE: Free vaccines for 52 million people on Medicare, including for shingles and pneumonia.
- GONE: Prescription drug savings for 4 million low-income seniors through the Medicare Part D Extra Help program.
Changing and Cutting Medicare
Project 2025 proposes stripping Medicare coverage from seniors, increasing prescription drug prices, increasing fraud throughout the system, and forcing seniors to pay more for their health care. This plan puts essential coverage for our nation’s seniors in jeopardy.
If Project 2025’s proposals are enacted:
- GONE: The Medicare Shared Savings Program which saves CMS over $2.5 billion annually and impacts nearly 11 million people with Medicare.
- GONE: Rural hospitals as Medicare Advantage plans continue to systemically underpay rural providers and deny coverage to rural Americans.
- GONE: Medicare’s inflation rebate which has lowered costs for 203 drugs, 64 of which just this past quarter were subject to the rebate, used by around hundreds of thousands of Medicare beneficiaries annually since the program began.
- GONE: The Medicare plans for 33 million seniors who would be forced over into a Medicare Advantage plan.
Slashing Medicaid
Project 2025 repeatedly refers to Medicaid and its expansion under the ACA to low-income adults as “failing” and too expensive to maintain. Project 2025 proposes overhauling Medicaid expansion and imposing onerous work requirements, time limits, and lifetime caps, eliminating mandatory benefits, and funneling Medicaid funding toward vouchers for private insurance, whose plans will be far less affordable and provide fewer benefits. Their plan for Medicaid is simple: throw people off of their coverage and raise health care costs across the board.
If Project 2025’s proposals are enacted:
- GONE: Coverage for 21 million people because of the GOP’s onerous work reporting requirements.
- GONE: Protections and health care for up to half of the 38 million children currently covered through Medicaid and CHIP.
- GONE: Essential federal funding for states like Mississippi, whose population makes less than the federal average income, to support their Medicaid programs so that working-class Americans can continue to receive quality and affordable health care.
- GONE: Federal funding for Medicaid expansion, putting coverage for about 24 million Americans at risk.
- GONE: Billions in state funding for Medicaid, as Republicans plan to eliminate provider taxes to cut taxes for the rich at the expense of Americans’ health care.
Restricting Reproductive Rights
Project 2025 calls for a national abortion ban and a reverse of the FDA’s approval of Mifepristone; the safe, effective, and most common medication prescribed for an abortion regimen. Project 2025 would also limit access to contraception and IVF for millions of Americans.
If Project 2025’s proposals are enacted:
- GONE: Access to abortion care if a state wants to maintain federal funding for its Medicaid programs.
- GONE: The ACA’s requirements that employers cover contraceptives, potentially increasing a woman’s out-of-pocket costs for contraception by more than $584 annually.
- GONE: The ability to seek a life-saving abortion at a Medicare-funded hospital as doctors could face up to 5 years in prison.
- GONE: All funding to Planned Parenthood which in just 2023 had over 2 million patients and performed nearly 10 million services including cancer screenings, STI tests, etc.
- GONE: No-cost emergency contraception currently available to 47.8 million Americans.