By Jack Bernard
Georgia Recorder, Oct. 10, 2024
“Cultural institutions like…public health agencies are only as ‘independent’ from public accountability as elected officials and voters permit.” – Project 2025
Constructed by the Heritage Foundation conservative thinktank, Project 2025 is a radical plan put forth as the basis for an incoming Trump administration. Former President Donald Trump saying, “I know nothing about Project 2025” is disingenuous. Authors include 140 former officials of Trump’s first administration.
It covers many areas, including health care. As someone with decades of health policy experience, implementation of Project 2025 would be a disaster for Georgia, which has the nation’s worst health care. Classifying public health departments as “cultural” …. versus scientifically based institutions… opens them up to raw politics. Politicization and ideological federal funding reductions would cripple already inadequately funded functions such as mental, physical and environmental health.
The problem isn’t just Trump. Gov. Brian Kemp emphasizes Georgia’s positives, but continually ignores negatives, like health care access.
Georgia has the nation’s third largest number of uninsured. Kemp enacted Georgia’s Affordable Care Act Medicaid “waiver.” Pathways. Pathways costs Georgia a lot, while producing little. Kemp said it would cover 100,000-200,000 Georgians. But only 4,300 have enrolled so far.
More than 400,000 uninsured would get coverage if we had normal Medicaid expansion. Further, 90% of the cost would be paid for by the federal government. Under Pathways, the feds pay two-thirds.
Georgia’s maternal and infant mortality rates are disastrous. Under Kemp, the situation has deteriorated. The death rate increased nearly a third between 2018 and 2021.
Conservatives believe Georgia’s six-week abortion rule is too liberal – and advocate banning abortions, no exceptions. Project 2025 indicates Trump “should…enact the most robust protections for the unborn that Congress will support while deploying existing federal powers to protect innocent life.” Further, Project 2025 says the “FDA should…reverse its approval of chemical abortion drugs.” This document also promotes restricting abortion access for veterans.
A Fulton County judge recently ruled Georgia’s six-week abortion ban unconstitutional (a decision subsequently overturned by the Georgia Supreme Court). Kemp’s spokesperson responded, saying: “Once again, the will of Georgians and their representatives has been overruled by the personal beliefs of one judge”
This statement is hypocrisy at its worst. There was no statewide referendum on abortion. The General Assembly refused to allow a vote on it.
“The deficit is a Medicare and Medicaid problem.” Traditional Medicare would be gutted, making private Medicare Advantage PPOs and HMOs the “the default enrollment option.” Private insurance has 12% administrative and marketing overhead versus 2% for traditional Medicare.
Removing regulatory agency “burdensome policies,” such as regulations protecting patients, opens Medicare Advantage programs to increased financial mismanagement. Questionable Medicare Advantage plan diagnoses already cost taxpayers $50 billion.
During the debate between Trump and Vice President Kamala Harris, he stated that he has the “concepts of a plan” to replace the ACA, often called Obamacare. He’s probably referring to Project 2025.
Millions would lose ACA health insurance. Trump proposed state block grants in his 2020 “A BUDGET FOR A Better America.” Millions would lose insurance in states where coverage is a lower priority.
Nationally, under Project 2025 Medicaid expansion would be limited by adding “work requirements.” Known as the Pathways waiver in Georgia, this approach has failed.
Georgia projected 100,000-200,000 new people would be covered via Pathways.
However, only 4,500 received coverage and administrative costs are high. If current national Medicaid expansion reverts to Georgia’s ineffective model, tens of millions will lose coverage.
Project 2025 undercuts public health and pollution control regulations. It ignores science, stating, “incentives here are no different from those of global elites insulating policy decisions—over the climate, trade, public health.” Instead, it encourages vague, questionable free-market healthcare “solutions.”
It states there should be no government “pricing control” and “alternative insurance coverage options.” Project 2025 would eliminate drug price reductions for Georgia’s Medicare beneficiaries, ending “taxes on drug manufacturers to compel them to comply with Medicare price controls.”
In conclusion, neither Kemp or Trump have a reasonable plan to improve the health of Georgians or Americans. Both are alike in that for political gain, they want to run against Democrats and Washington.
Kemp should be alleviating Georgia’s shortcomings versus crowing about being No. 1 for business. Partly due to Kemp’s policies, Georgia’s health care is failing. And Project 2025 will just make it worse.
Jack Bernard, formerly Director of Health Planning for Georgia and a corporate SVP, is currently Chairman of the Board of Health in Fayette County and on the Executive Board of the Georgia Public Health Association. He is also on the steering committee for the Georgia Chapter of Physicians for a National Healthcare Program.