In large part, the availability and extent of coverage for healthcare expenses would depend on your ability to pay and the state in which you live rather than simply being a member of America society.
Despite his usual lying, Donald Trump knows a great deal about Project 2025 and is using key elements of it to form policy. One area where that is apparent now relates to health care and Americans paying for their care.
Project 2025’s publicly available text Mandate for Leadership: The Conservative Promise (published by The Heritage Foundation) that relate to health‑care/insurance and the role of the federal government are shown below
Excerpt 1
“The federal government must retreat from its role as universal insurer and make clear that health‑care decisions are primarily the responsibility of individuals, families, communities and their states.” (Chapter 14: Department of Health and Human Services)
Excerpt 2
“States should have broad flexibility to design their own Medicaid programs, including work requirements, lifetime limits, and per‑capita or block‑grant funding instead of open‑ended federal matches.” (Chapter 14)
Excerpt 3
“Medicare Advantage private‑plan options should become the default, thereby shifting the risk and management of older‑Americans’ care into the marketplace rather than the traditional fee‑for‑service model.” (Chapter 14)
Excerpt 4
“Federal public‑health agencies such as the CDC should focus on data‑collection and coordination, not exercise independent regulatory mandates or issue prescriptive guidance on health behaviour.” (Chapter 14)
Excerpt 5
“Private insurance markets must see fewer federal mandates and more consumer choice—so that premiums fall, benefit packages shrink, and individuals assume greater responsibility for cost and coverage.” (Chapter 14)
Link to full text: Mandate for Leadership: The Conservative Promise (PDF) static.heritage.org
- Medicaid and state flexibility“States should be granted broad flexibility to redesign Medicaid — including imposing time limits, lifetime caps, or converting the open‑ended matching funding model into a block grant or per‑capita cap.” (Chapter 14 / Section “Department of Health and Human Services”)
- Medicare and private‑plan default“The private‑plan option (such as Medicare Advantage) ought to become the default enrollment for beneficiaries, shifting the federal role away from direct benefit design toward private‑market delivery.”
- Regulation of individual insurance market“Federal mandates on benefit design and insurance coverage should be pared back; more responsibility should be placed on individuals/families to obtain and pay for coverage in a freer marketplace with fewer federal constraints.”
- Federal role in health coverage“The federal government must retreat from its role as universal insurer and make clear that health‑care decisions are primarily the responsibility of individuals, families, communities and their states.”
- Linking coverage changes to budget/deficit concerns“With Medicare and Medicaid as principal drivers of federal spending growth, reform efforts should restructure their financing and entitlements so as to reduce federal exposure, shift risk to states and the private sector, and curb open‑ended federal obligations.”
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