Project 2025 is a set of policy recommendations for the next administration from over 100 conservative organizations and led by the Heritage Foundation. If enacted, the plan would have significant implications for public health and equity as it seeks to restructure federal agencies including the Centers for Disease Control and Prevention (CDC); roll back diversity and LGBTQ+ protections; restrict access to reproductive healthcare; limit mandates and allow more exemptions for public health services including vaccinations; reduce climate change prevention efforts and more.
Project 2025 proposes significant changes to the federal workforce, advocating for the replacement of current civil servants with individuals aligned with the administration's priorities. It calls for a rollback of civil service protections and proposes that federal employees should be more easily fired and replaced by political appointees who share the administration's ideology.
Perhaps most concerning for the health and well-being of the public, Project 2025 suggests overhauling the Department of Health and Human Services (HHS) based on the belief that HHS has “lost its way” during the past four years. This includes a proposal to split the CDC into two agencies, one for data collection and one for policy recommendations, suggesting that CDC is not equipped to make policy decisions. If carried out, this would slow down emergency responses and take away the already limited authority for CDC to provide public health guidance. The document criticizes the National Institutes for Health (NIH) for its “inappropriate industry ties” and calls for term limits for leaders and block granting research budgets to states. The Project recommends reforming the Food and Drug Administration’s drug approval process, advocating for the reversal of the approval of abortion medication and an end to “mail-order abortions." The document also criticizes the FDA for the use of vaccines developed using fetal cell lines and lab-grown cells used in life-saving treatments.
Key areas of concern in Project 2025 include:
- CDC guidance and authority: The proposal recommends prohibiting the CDC from issuing prescriptive guidance on vaccines and masks, leaving such decisions entirely to parents and medical providers (p. 454). It also advocates for limiting the CDC's role to evaluating only health-related costs and benefits of interventions, without considering any social impacts (p. 453).
- Reproductive health: The plan advocates a strict anti-abortion agenda, urging HHS to combat "abortion tourism" by cutting funds and mandating detailed abortion reporting by states (p. 455). It would also limit access to drugs like Mifepristone.
- LGBTQ+ protections: Project 2025 calls for CDC to stop collecting data on gender identity, as it claims this supports "unscientific" beliefs (p. 462), focuses on limiting gender-affirming care and proposes a ban on transgender individuals serving in the military (p. 104).
- Census and Data Collection: Project 2025 would extend political ideology into the Census, which provides much of the data for federal decisionmaking processes, by appointing “strong political leadership” (p.679), making the wording of race and ethnicity questions less inclusive, and adding a citizenship question.
- DEIA: The report calls for efforts to retool HHS for “reversing the Diversity, Equity and Inclusion Revolution” (p. 582) and close various departments’ offices of equity, diversity and inclusion.
- Education: Project 2025 calls for the U.S. Department of Education to be eliminated entirely (p. 319); seeks to "phase out existing income-driven repayment plans" for student loans (p. 337) and the Public Service Loan Forgiveness program (p. 340) and restrict or ban educating students on topics like race, gender identity and sexual orientation.
- Vaccines and research: The blueprint advocates for limiting vaccine mandates, referring to them as "irrational, destructive, un-American" (p. 283).
- Medicaid access: The plan proposes adding work requirements and capping benefits from Medicaid, disproportionately affecting those with chronic conditions or disabilities (p. 468).
- Climate change: The plan calls to end "government interference" in energy decisions and encourages the use of oil and natural gas (p. 365) which would increase the negative public health effects of climate change.
While Project 2025 is aimed at the executive branch and intended as guidance for the next administration, many members of the U.S. House and Senate and those in state government support many of the policies proposed in Project 2025, and they are looking for ways to implement its provisions through means including legislation or executive order. To protect and promote the public’s health, we need to work together to #speakforhealth, identify new partners and new champions, and prevent the enactment of health or equity-limiting Project 2025 provisions.
You can make a difference:
- Sign up for APHA action alerts, legislative updates and more
- View our Legislative Update page and stay informed about important federal legislative activity and notable state legislative activity.
- Check out our partnerships and identifying champions
- Watch a webinar on distinguishing between advocacy, lobbying and education, highlighting what advocates are allowed to do.
- Tell us what resources or assistance you need to communicate about the value of public health, share evidence-based policies and practices, and Speak for Health!
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