President Donald Trump unexpectedly cut billions of dollars from the nation’s premier federal cancer research agency in the early weeks of his administration, which surprised many voters.
The funding cuts to the National Institutes of Health were part of Project 2025’s “Mandate for Leadership,” a conservative plan that Trump claimed he knew nothing about during his campaign but has now embraced.
The Heritage Foundation, a conservative research group in Washington, compiled the 922-page playbook titled “Mandate for Leadership”, which proposes breaking the NIH monopoly on directing research and capping payments to universities and hospitals. These cuts have drawn legal challenges from medical institutions and 22 states, prompting a federal judge to temporarily halt them in February.
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Universities, now facing significant cuts in agency grants covering overhead costs, warn that the policy will harm ongoing and future biomedical science. The rapid adoption of Project 2025’s objectives by the Trump administration suggests a long-term effort from his administration to disrupt the national health system, despite Trump’s claims of ignorance about the document during his campaign.
Trump’s administration closely following the Heritage Foundation-compiled playbook has prompted opposition groups and state Democratic leaders to swiftly act against Trump’s moves in court. Project 2025 recommendations, including proposals for Medicaid, Medicare, and federal health agencies, are expected to be implemented next.
Various policies proposed in Project 2025, such as Medicaid funding to Planned Parenthood affiliates and healthcare access restrictions, have already had significant impacts. Additionally, the administration’s actions aligning with Project 2025’s objectives on issues like transgender rights have raised concerns and legal challenges from advocacy groups.
Health researchers have pointed out the harmful effects of the administration’s actions on transgender health data, bird flu information, and LGBTQ+ health data, resulting from directives to censor certain terms and topics.
Versions of Project 2025 have been influential over the years and have shaped health policies under previous GOP presidents. The Trump administration’s implementation of the plan, however, faces public disapproval according to recent polls.
The White House has not provided any comment on these actions, and conservatives defending the administration’s choices claim they are aimed at curbing waste and fraud in federal health programs while countering what they see as a radical agenda.
The Heritage Foundation has tried to distance itself from Trump’s executive orders and health initiatives, stating that they are intended to fulfill Trump’s promises rather than following the recommendations in Project 2025.
Concerns persist over the potential impact of Project 2025’s health policy goals, with advocates warning of discrimination and barriers to essential care. The administration faces challenges in implementing these goals amid public backlash and legal battles.
The administration’s alignment with Project 2025’s proposals has raised alarms among various groups, who see it as a dangerous shift in U.S. health care and health policy.
“Project 2025 was never a thought exercise; it was always a blueprint,” said a spokesperson for Reproductive Freedom for All. “We’re only a few weeks into his presidency, and it’s setting the groundwork for even more.”
KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom dedicated to in-depth journalism about health issues and is a core operating program at KFF — the independent source for health policy research, polling, and journalism.
