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Project 2025 and healthcare

- October 18, 2024

Kamala Harris is committed to building on the Affordable Care Act; Trump has stated plan, but Project 2025 does outline how it would recommend handling healthcare.

By Jay Brock
COLUMNIST

The vast majority of Americans understand how dysfunctional our health insurance system is. After all, across the nation three-fourths of Americans worry whether they’ll be able to afford to pay their medical bills if they get sick.

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As we are now in the final stages of a presidential campaign, let’s take a look at what the candidates are saying about this issue.

Democratic nominee Kamala Harris is recommending building on the Affordable Care Act (Obamacare), a popular program that has significantly increased the number of Americans with health insurance. She is in favor of lowering medication costs to seniors by negotiating lower prices with America’s politically powerful pharmaceutical industry, with the hope to extend the same benefit to all Americans. She has also just come out with a proposal to have Medicare pay for long term home care, something that would greatly benefit tens of millions of senior and disabled Americans covered under Medicare.

The Republican nominee, Donald Trump, has said he has “the concept” of a plan on how to proceed regarding healthcare and health insurance. Unfortunately, there are no details available. So far, his main effort on healthcare has been to repeal the ACA.

Given that policy vacuum, attention has naturally shifted to a recent major proposal from the Heritage Foundation, the conservative think tank influential with many Republicans.

It’s called Project 2025, and it’s a 900-page proposition on how they think the government should be run under a second Trump Administration. It includes several recommendations regarding healthcare.  

Project 2025 is very controversial: among other suggestions, it recommends eviscerating much of the currently non-political civil service and replacing it with employees who would be loyal to Donald Trump, not the American people.

It’s so controversial that Donald Trump, although a number of those contributing to the report have been close to him, his campaign, or his Administration, is attempting to distance himself from it and its recommendations by vociferously denying any knowledge of it.

We can leave the determination as to whether his protestations of ignorance of the Heritage Foundation ideas are valid or not to the reader, but it might be worthwhile to look at some of its recommendations regarding healthcare.

  1. Project 2025 would remove protections for preexisting conditions from certain types of plans under the ACA. As many as half of non-senior Americans (as many as 129 million) have a pre-existing medical condition. If these  protections can be removed from these plans, why not remove them from any other type of plan—and then the nation ends up as it did before the ACA took effect, where people with preexisting conditions could either be priced out of the marketplace or refused insurance altogether. Who benefits? The health insurance industry, which doesn’t have to cover sick patients.
  2. Project 2025 would prevent Uncle Sam from negotiating lower medication prices. Americans, who already spend more for their medications than any other advanced nation, would continue to be overcharged more than $100 billion/year for their medications. Who benefits? The pharmaceutical industry and their stockholders. For most Americans, not so much.
  3. Private, for-profit so-called “Advantage” plans would become the default option for future Medicare enrollees. This is a terrible idea. Although these plans might look attractive to many, remember that these for-profit companies are in business to make sure their profit—and not your healthcare—comes first. Thus, restricted networks of providers, delays of care due to the bureaucracy of “prior authorizations”, and outright denials of care your physician deems necessary are features, not bugs, of this plan. And studies claim these plans overcharge Uncle Sam—i.e., you and me—by $100 billion/year or more. Who benefits? The insurance company.
  4. Project 2025 allows inferior health insurance plans to be sold. Some of these are “junk plans” that don’t cover much, or contain very high deductibles. Buying health insurance can be difficult enough (just ask any senior about “open enrollment”); having mediocre plans in the mix will lead to inevitable disappointment for too many people. Who benefits? The insurance company.

Republicans and Democrats have very different ideas on how to deal with the many problems of our current health insurance system, which is based largely on the for-profit health insurance industry, but also designed to protect the immense profits of the pharmaceutical industry.

One Party plans to make care more obtainable and affordable.

The other seems to be making things even better for the health insurance and pharmaceutical industries.

Given that unaffordable healthcare is such an important issue to so many Americans—remember the three-fourths of us who worry about being able to afford to pay their medical bills if they get sick—it will be up to those voters to decide where their best healthcare interests lie.

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