Project 2025 HHS

Project 2025 on Health and Human Services

The opening paragraph of the Health and Human Services (HHS) section of Project 2025 states, “For good or ill, HHS activities personally impact the lives of more Americans than do those of any other federal agency.” (Ref. 1, page 449)

Christian fundamentalism is rampant throughout this portion of the Project in which the department would “maintain a biblically-based…definition of marriage.” (Ref. 1, page 481)

Additionally, Project 2025 would recommend:

Restricting access to birth control
Privatizing Medicare – “By making Medicare Advantage – privatized Medicare – the default option for all Medicare enrolled, Project 2025’s plan would lead to a multibillion-dollar giveaway to corporations that would limit older Americans’ health care choices while putting Medicare’s future at risk.” Ref. 2)
Prohibiting the CDC from prescribing public health requirements
Eliminating any program that doesn’t respect conscience rights, undermines family formation, and doesn’t promote natural family planning methods.
Repealing ability of Medicare to negotiate lower prices for drugs
Eliminating the Head Start program for low-income preschoolers
Abolishing the DEI office of the NIH and halt its efforts to understand gender identity
Weakening/repealing the ACA
Eliminating any mention of LGBTQ+ and race protections by blacklisting the following terms in legislation and on every federal document: Sexual orientation and sexual identity (SOGI), gender, gender equality, gender awareness, and gender-sensitive
Transfering CDC programs related to vaccine safety to the FDA

References

Mandate for Leadership, The Conservative Promise, Project 2025, Presidential Transition Project; https://static.project2025.org/2025_MandateForLeadership_FULL.pdf
The Center for American Progress article, “Project 2025’s Medicare Changes Would Restrict Older Americans’ Access to Care an Imperil the Program’s Financial Health”, by Brian Keyser and Andrea Ducas, August 15, 2024; https://www.americanprogress.org/article/project-2025s-medicare-changes-would-restrict-older-americans-access-to-care-and-imperil-the-programs-financial-health/

Note: The restrictions and regulations regarding reproductive health from this section of Mandate for Leadership: The Conservative Promise were covered in an earlierAlert. Please refer to Reproductive Healthcare (https://indivisiblehocomd.org/project-2025/project-2025-reproductive-healthcare/) for that coverage.

OVERVIEW

“If the U.S. Department of Health and Human Services (HHS) were a separate country, its approximately $1.6 trillion budget would rank as the world’s fifth-largest national budget. For good or ill, HHS activities personally impact the lives of more Americans than do those of any other federal agency. Under President Trump, HHS was dedicated to serving “all Americans from conception to natural death, including those individuals and families who face…economic and social well-being challenges.” Under President Biden, the mission has shifted to “promoting equity in everything we do” for the sake of “populations sharing a particular characteristic” including race, sexuality, gender identification, ethnicity, and a host of other categories.” (Ref. 1, page 449)

“From the moment of conception, every human being possesses inherent dignity and worth, and our humanity does not depend on our age, stage of development, race, or abilities. The Secretary must ensure that all HHS programs and activities are rooted in a deep respect for innocent human life from day one until natural death: Abortion and euthanasia are not healthcare.” (Ref. 1, page 450)

“Families comprised of a married mother, father, and their children are the foundation of a well-ordered nation and healthy society. Unfortunately, family policies and programs under President Biden’s HHS are fraught with agenda items focusing on “LGBTQ+ equity,” subsidizing single-motherhood, disincentivizing work, and penalizing marriage. These policies should be repealed and replaced by policies that support the formation of stable, married, nuclear families.

Working fathers are essential to the well-being and development of their children, but the United States is experiencing a crisis of fatherlessness that is ruining our children’s futures. In the overwhelming number of cases, fathers insulate children from physical and sexual abuse, financial difficulty or poverty, incarceration, teen pregnancy, poor educational outcomes, high school failure, and a host of behavioral and psychological problems. By contrast, homes with non-related “boyfriends” present are among the most dangerous place for a child to be. HHS should prioritize married father engagement in its messaging, health, and welfare policies. In the context of current and emerging reproductive technologies, HHS policies should never place the desires of adults over the right of children to be raised by the biological fathers and mothers who conceive them. In cases involving biological parents who are found by a court to be unfit because of abuse or neglect, the process of adoption should be speedy, certain, and supported generously by HHS.“ (Ref. 1, page 451)

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)

“The CDC can and should make assessments as to the health costs and benefits of health interventions, but it has limited to no capacity to measure the social costs or benefits they may entail. For example, how much risk mitigation is worth the price of shutting down churches on the holiest day of the Christian calendar and far beyond as happened in 2020? What is the proper balance of lives saved versus souls saved?” (Ref. 1, page 453)

“By statute or regulation, CDC guidance must be prohibited from taking on a prescriptive character. For example, never again should CDC officials be allowed to say in their official capacity that school children “should be” masked or vaccinated (through a schedule or otherwise) or prohibited from learning in a school building.” (Ref. 1, page 454)

“The CDC operates several programs related to vaccine safety including the Vaccine Adverse Event Reporting System (VAERS); Vaccine Safety Datalink (VSD); and Clinical Immunization Safety Assessment (CISA) Project. Those functions and their associated funding should be transferred to the FDA, which is responsible for post-market surveillance and evaluation of all other drugs and biological products.“ (Ref. 1, page 454)

“Respect for Life and Conscience. The CDC should eliminate programs and projects that do not respect human life and conscience rights and that undermine the Department of Health and Human Services family formation. It should ensure that it is not promoting abortion as health care. It should fund studies into the risks and complications of abortion and ensure that it corrects and does not promote misinformation regarding the comparative health and psychological benefits of childbirth versus the health and psychological risks of intentionally taking a human life through abortion.

The CDC oversaw and funded the development and testing of the COVID-19 vaccines with aborted fetal cell lines, insensitive to the consciences of tens of thousands to hundreds of thousands of people who objected to taking a vaccine with such a link to abortion….CDC should update its public messaging about the unsurpassed effectiveness of modern fertility awareness–based methods (FABMs) of family planning and stop publishing communications that conflate such methods with the long-eclipsed “rhythm” or “calendar” methods. CDC should fund studies exploring the evidence-based methods used in cutting-edge fertility awareness.” (Ref. 1, page 454-455)

“Data Collection.

…HHS should use every available tool, including the cutting of funds, to ensure that every state reports exactly how many abortions take place within its borders, at what gestational age of the child, for what reason, the mother’s state of residence, and by what method. It should also ensure that statistics are separated by category: spontaneous miscarriage; treatments that incidentally result in the death of a child (such as chemotherapy); stillbirths; and induced abortion.” (Ref. 1, page 455)

“The CDC should immediately end its collection of data on gender identity, which legitimizes the unscientific notion that men can become women (and vice versa) and encourages the phenomenon of ever-multiplying subjective identities.“ (Ref. 1, page 456)

NATIONAL INSTITUTES OF HEALTH (NIH).

“HHS should create and promote a research agenda that supports pro-life policies and explores the harms, both mental and physical, that abortion has wrought on women and girls.“ (Ref. 1, page 461)

“NIH has been at the forefront in pushing junk gender science. Instead, it should fund studies into the short-term and long-term negative effects of cross-sex interventions, including “affirmation,” puberty blockers, cross-sex hormones and surgeries, and the likelihood of desistence [sic] if young people are given counseling that does not include medical or social interventions.” (Ref. 1, page 462

CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS)

“HHS needs to restore and enhance conscience protection regulations that allow medical practitioners to participate in federal health care programs without being compelled to provide sex changes or similar services.” (Ref. 1, page 464)

“Make Medicare Advantage the default enrollment option.” (Ref. 1, page 465)

“Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication.

This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in the catastrophic tier, and requiring manufacturers to bear a larger share.” (Ref. 1, page 465-466)

“CMS should also:

Clarify that states have the ability to adopt work incentives for able-bodied individuals (similar to what is required in other welfare programs) and the ability to broaden the application of targeted premiums and cost sharing to higher-income enrollees.
Add targeted time limits or lifetime caps on benefits to disincentivize permanent dependence.“ (Ref. 1, page 468)

AFFORDABLE CARE ACT AND PRIVATE HEALTH INSURANCE

“Allow private health insurance. Congress should allow states the option of contributing to a private insurance benefit for all members of the family in a flexible account that rewards healthy behaviors. This reform should also allow catastrophic coverage combined with an account similar to a health savings account (HSA) for the direct purchase of health care and payment of

cost sharing for most of the population.“ (Ref. 1, page 468)

“Separate the subsidized ACA exchange market from the non-subsidized insurance market. The Affordable Care Act has made insurance more expensive and less competitive, and the ACA subsidy scheme simply masks these impacts. To make health insurance coverage more affordable for those who are without government subsidies, CMS should develop a plan to separate the non-subsidized insurance market from the subsidized market, giving the non-subsidized market regulatory relief from the costly ACA regulatory mandates.“ (Ref. 1, pages 469 – 470)

LIFE, CONSCIENCE, AND BODILY INTEGRITY

“Reissue a stronger transgender national coverage determination. CMS should repromulgate its 2016 decision that CMS could not issue a National Coverage Determination (NCD) regarding “gender reassignment surgery” for Medicare beneficiaries. In doing so, CMS should acknowledge the growing body of evidence that such interventions are dangerous and acknowledge that there is insufficient scientific evidence to support such coverage in state plans.“ (Ref. 1, page 474)

“Radical Redefinition of Sex. On August 4, 2022, HHS published a proposed rule entitled “Nondiscrimination in Health Programs and Activities.” This rule addresses nondiscrimination provisions of the Affordable Care Act, known as Section 1557, which is enforced by the Office for Civil Rights and the Centers for Medicare and Medicaid Services. Section 1557 prohibits discrimination on the basis of race, color, national origin, age, disability, and sex in covered health programs or activities. Under the proposed rule, sex is redefined: “Discrimination on the basis of sex includes, but is not limited to, discrimination on the basis of sex stereotypes; sex

characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; and gender identity.” In other words, the department proposes to interpret Section 1557 as if it created special privileges for new classes of people, defined in ways that are highly ideological and unscientific. The redefinition of sex to cover gender identity and sexual orientation and

pregnancy to cover abortion should be reversed in all HHS and CMS programs as was done under the Trump Administration. This includes the Children’s Health Insurance Program (CHIP). Low-income families who rely on CHIP should not be coerced, pressured, or otherwise encouraged to embrace this ideologically motivated sexualization of their children.“ (Ref. 1, page 475)

“CMS should:

Announce nonenforcement of the Biden Administration’s COVID-19 vaccination mandate on Medicaid and Medicare hospitals.
Revoke corresponding guidance and regulations.
Refrain from imposing general COVID-19 mask mandates on health care facilities or personnel.
Pay damages to all medical professionals who were dismissed directly because of the CMS vaccine mandate.“ (Ref. 1, page 475-476)

ADMINISTRATION FOR CHILDREN AND FAMILIES (ACF)

“Teen Pregnancy Prevention (TPP) and Personal Responsibility Education Program (PREP)…certain provisions should be employed so that these programs do not serve as advocacy tools to promote sex, promote prostitution, or provide a funnel effect for abortion facilities and school field trips to clinics, or for similar purposes. Parent involvement and parent–child communication should be encouraged and be a part of any funded project. Risk avoidance should be prioritized, and any program that submits a proposal that promotes risk rather than health should not be eligible for funding.” (Ref. 1, page 477)

Healthy Marriage and Relationship Education (HMRE) Program

“The following policies should be implemented…

the positive role of faith-based programs should be protected and prioritized so that these programs do not receive undue scrutiny or pressure to conform to nonreligious definitions of marriage and family as put forward by the recently enacted Respect for Marriage Act.
Protect faith-based grant recipients from religious liberty violations and maintain a biblically based, social science–reinforced definition of marriage and family.

Social science reports that assess the objective outcomes for children raised in homes aside from a heterosexual, intact marriage are clear: All other family forms involve higher levels of instability (the average length of same-sex marriages is half that of heterosexual marriages); financial stress or poverty; and poor behavioral, psychological, or educational outcomes.For the sake of child well-being, programs should affirm that children require and deserve both the love and nurturing of a mother and the play and protection of a father. Despite recent congressional bills like the Respect for Marriage Act that “redefine marriage to be the union between any two individuals, HMRE program grants should be available to faith-based recipients who affirm that marriage is between not just any two adults, but one man and one unrelated woman.” (Ref. 1, page 479 – 481)

ADMINISTRATION ON CHILDREN, YOUTH, AND FAMILIES (ACYF)

“Allocate funding to strategy programs promoting father involvement or terminate parental rights quickly.“ (Ref. 1, page 482)

OFFICE OF HEAD START (OHS)

“Eliminate the Head Start program. ” (Ref. 1, page 482)

ADMINISTRATION FOR COMMUNITY LIVING (ACL)

“Physician-assisted suicide (PAS) is legal in 10 states and the District of Columbia. Legalizing PAS is a grave mistake that endangers the weak and vulnerable, corrupts the practice of medicine and the doctor–patient relationship, compromises the family and intergenerational commitments, and betrays human dignity and equality before the law. Instead of embracing PAS, policymakers should focus on the benefits of palliative care, which works to improve a patient’s quality of life by alleviating pain and other distressing symptoms of a serious illness. HHS ACL should survey their programs to ensure that they are supporting vulnerable persons of age or disability and are not facilitating or encouraging participation in PAS.“ (Ref. 1, page 482)

HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA)

“Restore Trump religious and moral exemptions to the contraceptive mandate (also a CMS rule).” (Ref. 1, page 483)

“Withdraw Ryan White guidance allowing funds to pay for cross-sex transition support. HRSA should withdraw all guidance encouraging Ryan White HIV/AIDS Program service providers to provide controversial “gender transition” procedures or “gender-affirming care,” which cause irreversible physical and mental harm to those who receive them.“ (Ref. 1, page 485)

“Ensure that training for medical professionals (doctors, nurses, etc.) and doulas is not being used for abortion training. HHS should ensure that training programs for medical professionals—including doctors, nurses, and doulas—are in full compliance with restrictions on abortion funding and conscience-protection laws.” (Ref. 1, page 485)

OFFICE OF THE SECRETARY

“Restrict HHS’s ability to declare indefinite public health emergencies (PHEs). Currently, HHS is merely required to notify Congress of such a declaration within 48 hours. Congress should establish a set time frame for any PHE, placing on the Secretary the burden of proof as to why an extension of the PHE is necessary.
Reinstate the HHS SUNSET (Securing Updated and Necessary Statutory Evaluations Timely) rule. Congress should codify the now-reversed Trump Administration rule that required all HHS agencies to review regulations retrospectively and publish results; without such a review, regulations expire.
Investigate, expose, and remediate any instances in which HHS violated people’s rights by:

Colluding with Big Tech to censor dissenting opinions during COVID.
Colluding with abortion advocates and LGBT advocates to violate conscience-protection laws and the Hyde Amendment.“ (Ref. 1, page 488-489)

“The Life Agenda. The Office of the Secretary should eliminate the HHS Reproductive Healthcare Access Task Force and install a pro-life task force to ensure that all of the department’s divisions seek to use their authority to promote the life and health of women and their unborn children. Additionally, HHS should return to being known as the Department of Life by explicitly rejecting the notion that abortion is health care and by restoring its mission statement under the Strategic Plan and elsewhere to include furthering the health and well-being of all Americans ‘from conception to natural death’.” (Ref. 1, page 489)

“The Family Agenda. The Secretary’s anti-discrimination policy statements should never conflate sex with gender identity or sexual orientation. Rather, the Secretary should proudly state that men and women are biological realities that are crucial to the advancement of life sciences and medical care and that married men and women are the ideal, natural family structure because all children have a right to be raised by the men and women who conceived them.“ (Ref.1, page 489)

OFFICE OF THE ASSISTANT SECRETARY FOR HEALTH (OASH) / OFFICE OF THE SURGEON GENERAL (OSG)

“Promoting Life and Family. Strong leadership is needed in the Office of Science and Medicine to drive investigative review of literature for a variety of issues including the effect of abortion on prematurity and breast cancer; lack of evidence for so-called gender-affirming care; and physical and emotional damage following cross-sex treatments, especially on children. The OASH should withdraw all recommendations of and support for cross-sex medical interventions and ‘gender-affirming care’.“ (Ref. 1, page 490-491)

“Title X. The Title X family planning program should be reframed with a focus on better education around fertility awareness and holistic family planning and a Deputy Assistant Secretary for Population Affairs that understands the program and is able to work within its legislative framework (ideally, an MD). In addition, the Office of Population Affairs should eliminate religious discrimination in grant selections and guarantee the right of conscience and religious freedom of health care workers and participants in the Title X program.“ (Ref. 1, page 491)

“Congress should complement these efforts by passing legislation such as the Title X Abortion Provider Prohibition Act,78 which would prohibit family planning grants from going to entities that perform abortions or provide funding to other entities that perform abortions. This would help to protect the integrity of the Title X program even under an abortion-friendly Administration.“ (Ref. 1, page 491)

OFFICE OF GENERAL COUNSEL (OGC)

“Rescind efforts to curtail OCR (Office for Civil Rights) authority over conscience and religious freedom. All OGC memos and Federal Register notices of organization or delegations of authority moving any OCR conscience and religious freedom enforcement to OGC, including Religious Freedom Restoration Act RFRA, should be rescinded, and independent authority over these matters should be restored to OCR.“ (Ref. 1, page 492)

“Rescind legal analysis that authorized HHS to impose a moratorium on rental evictions during COVID.“ (Ref. 1, page 492)

OFFICE OF GLOBAL AFFAIRS (OGA)

“OGA should have a clear and consistent voice for the Administration’s pro-life and pro-family priorities in all international engagements.” (Ref. 1, page 493)

OFFICE FOR CIVIL RIGHTS (OCR)

“HHS should reestablish waivers for state and child welfare agencies for religious exemptions, especially for faith-based adoption and foster care agencies.” (Ref. 1, page 494)

“HHS should restore OCR authority to review requests for and render opinions on the application of RFRA to requests for religious accommodation of people, families, and doctors who cannot in good conscience take or administer vaccines, including those made or tested with aborted fetal cell lines.” (Ref. 1, page 495)

“Remove all guidance issued under the Biden Administration concerning sexual orientation and gender identity.” (Ref. 1, page 495)

“Issue a general statement of policy specifying that it will not enforce any prohibition on sexual orientation and gender identity discrimination.” (Ref. 1, page 495)

“Issue a proposed rule to restore the Trump regulations under Section 1557, explicitly interpreting the law not to include sexual orientation and gender identity discrimination based on the textual approach to male and female biology taken by Congress in the ACA, the need to recognize biological distinctions as part of the sound practice of health care, and the need to ensure protections of medical judgment and Conscience.” (Ref. 1, page 496)

“Issue and finalize the Trump-era draft disability rights regulations concerning crisis standards of care and use of Quality of Life Adjusted Years (QALYs), and reissue and finalize a disability regulation (withdrawn by the Biden Administration) that prohibited discriminatory application of assisted suicide and denial of life-saving treatments for disabled newborns.” (Ref. 1, page 496)

References

Mandate for Leadership, The Conservative Promise, Project 2025, Presidential Transition Project; https://static.project2025.org/2025_MandateForLeadership_FULL.pdf
The Center for American Progress article, “Project 2025’s Medicare Changes Would Restrict Older Americans’ Access to Care an Imperil the Program’s Financial Health”, by Brian Keyser and Andrea Ducas, August 15, 2024; https://www.americanprogress.org/article/project-2025s-medicare-changes-would-restrict-older-americans-access-to-care-and-imperil-the-programs-financial-health/