July 19, 2024

Dear Interested Readers,

 

It Has Been A Very Strange Week

 

We never know what unexpected event the next day or even the next hour might bring to us. What were you doing late last Saturday afternoon while Biden was in a contentious meeting with Democratic members of Congress who were trying to convince him to withdraw from the presidential race, and a young shooter was climbing up on a roof where he might have a clear shot at former President Trump? Neither event settled anything, but one did result in the tragic loss of life for one father. I hope the calls to “turn down the heat” on the rhetoric will have an impact that has a half-life of more than a week or so.

 

I should interject here that I will continue to comment frequently on the evolving presidential campaign because both Democracy and the Triple Aim are on the ballot. Can you imagine any improvement in the Social Determinants of Health over another four years of a Trump presidency? Candidate Trump is evasive about the plans for healthcare if he is elected to a second term. As I noted last week, there is very little about healthcare or healthcare policy in the recently published Republican Platform For 2024. A more ominous and potentially important document than the Republican Platform is the 900-page blueprint for his next term developed by the conservative “think tank,” The Heritage Foundation. Candidate Trump has disavowed “Project 2025.” He has gone so far as to imply that he has had nothing to do with it. That is not the same as saying that it will not be a factor in his next administration if he is reelected. Some of the more frightening things he has said in his rallies and in his acceptance speech last night seem like they are right out of the document. 

 

The link above about Trump claiming to have no connection to Project 2025 is to a recent article from The New York Times by Simon J. Levien. In the article, Mr. Levien writes:

 

What does Project 2025 propose?

Much of the plan’s nearly 900 pages detail extreme executive-branch overhauls. Among many recommendations, Project 2025 lays out plans for criminalizing pornography, disbanding the Commerce and Education departments, rejecting the idea of abortion as health care and shredding climate protections.

It calls out the National Oceanic and Atmospheric Administration, which includes the National Weather Service, as “one of the main drivers of the climate change alarm industry.” And it backs deploying the military “to assist in arrest operations” along the U.S.-Mexico border.

Beyond the policy proposals, something else comes up over and over again in the document — Mr. Trump and the Trump administration, which are mentioned hundreds of times…

 

If you are concerned about the possibility of a second Trump term as the beginning of an autocratic government, you are not paranoid. Project 2025 is a road map to that destination written by a think tank whose vision extends far beyond the four years of a second Trump term but is consistent with the vision of Republican politicians who are even further “Right,” well-funded, more politically sophisticated, and perhaps more intelligent, though less flamboyant then Mr. Trump. J.D. Vance would definitely be the kind of guy who could animate the 900 pages of the plan. 

 

I was surprised to find that Wikipedia has done an admirable job of summarizing the 900 pages of Project 2025. To summarize the plan in one sentence, it represents a vast expansion of the president’s executive powers. If you are like me, you have heard of Project 2025, but you haven’t examined what it entails. But, you have witnessed the successes of conservatives successfully pursuing their causes through the Supreme Court, through judicial appointments like Judge Eileen Cannon who this week threw out the “Documents Case” against Trump, and their success at the state level in passing many laws undermining women’s reproductive rights, LGBTQ+ rights, what is taught in schools, and negating attempts to promote improve diversity, equality, and inclusion. Throughout Project 2025 there is the oder of Christian Nationalism. I shuddered with the frequent suggestions in the speeches at the Republican Convention that Donald Trump is an instrument of God and that he was saved from the assassin’s bullet as an act of God. 

 

It seems to me that the Supreme Court’s recent ruling giving presidents immunity from prosecution for official acts could be a catalyst for a more regressive political and cultural swing to the right and authoritarian control of the country not unlike Margaret Atwood described in A Handmaiden’s Tale. The link is to a 2017 essay in The New York Times by Atwood entitled: “Margaret Atwood on What ‘The Handmaid’s Tale’ Means in the Age of Trump.” In the essay, she writes:

 

Having been born in 1939 and come to consciousness during World War II, I knew that established orders could vanish overnight. Change could also be as fast as lightning. “It can’t happen here” could not be depended on: Anything could happen anywhere, given the circumstances.

 

Such a change that is “as fast as lightning” could occur this fall with a sweeping Republican victory that gives the Trump-controlled Republican Party the presidency and control of both Houses of Congress to augment the control they now have over the Supreme Court. If that outcome occurs, it will be difficult to resist the implementation of Project 2025. It behooves us to understand Project 2025.

 

The Wikipedia summary is worth your perusal. Below, I have lifted and annotated the points that are made to describe what is in the 900-page Project 2025 document. If you listened closely to the acceptance speech of J.D. Vance and the rambling stream-of-consciousness presentation of former President Trump at this week’s Republican Convention and compare what you heard to what Project 2025 advocates, you will realize that six months from now we could be living in a very different America that may never be “great again.” What follows are the high points of the lengthy review of Project 2025 in Wikipedia. I have bolded some things like the sections that impact healthcare.

 

The 2025 Presidential Transition Project,[3] also known as Project 2025, is an initiative organized by the Heritage Foundation with the aim of promoting a collection of conservative and right-wing policy proposals to reshape the United States federal government and consolidate executive power should Donald Trump win the 2024 presidential election.[4][5] The Project asserts that the entire executive branch is under the direct control of the president under Article II of the U.S. Constitution and the unitary executive theory.[6][7] It proposes reclassifying tens of thousands of federal civil service workers as political appointees, in order to replace them with loyalists more willing to enable Trump’s policies.[8][9] In doing so, proponents argue that the change would dismantle what they view as a vast, unaccountable, and mostly liberal government bureaucracy.[10] The Project seeks to infuse the government and society with Christian values.[11][12] Critics have characterized Project 2025 as an authoritarian, Christian nationalist plan to steer the U.S. toward autocracy.[11][13] Many legal experts have said it would undermine the rule of law,[14] the separation of powers,[5] the separation of church and state,[15] and civil liberties.[5][14][16]

 

That introduction should give you “the shivers” but the details that follow should terrify you. The Project was written by Trump enthusiasts and former officials of Trump’s first term.

 

…The project’s authors acknowledge that most of the proposals would require the Republican Party to control both the U.S. House of Representatives and the U.S. Senate.[10] …Although Project 2025 cannot legally promote a specific presidential candidate, many contributors are associated with Donald Trump and his 2024 presidential campaign.[43][44][45] The Heritage Foundation employs numerous people closely aligned with Trump,[46][47][48] and coordinates the initiative with various conservative groups run by Trump allies.[49] 

Heritage president Kevin Roberts sees the organization’s current role as “institutionalizing Trumpism.”[72] 

Philosophical outlook

The main Project 2025 document, Mandate for Leadership: The Conservative Promise, outlines four main aims: restoring the family as the centerpiece of American life; dismantling the administrative state; defending the nation’s sovereignty and borders; and securing God-given individual rights to live freely.[119] In the Mandate’s foreword, Heritage Foundation president Kevin Roberts writes, “The long march of cultural Marxism through our institutions has come to pass. The federal government is a behemoth, weaponized against American citizens and conservative values, with freedom and liberty under siege as never before.[120]

Policies

The Economist summarizes the plan as containing some predictable culture war issues, along with others more sweeping in scope that break with past Republican orthodoxy, expanding deficits and the national debt.[129]

Census citizenship question

The project seeks to revive a Trump administration effort to include in the decennial U.S. census the question whether the person being counted is a U.S. citizen. The census is used to apportion congressional seats and the Electoral CollegeThe Fourteenth Amendment to the U.S. Constitution says the congressional apportionment figures must include the “whole number of persons in each state”, not “citizens”.[131]

Christian nationalism

As the leader of the Center for Renewing America, Project 2025 contributor Russell Vought has spearheaded an effort to instill precepts of Christian nationalism into government and public life should Trump win a second term. 

Climate change mitigation

Project 2025 advises a future Republican president to go further than merely nullifying President Biden’s executive orders on climate change.[74] It proposes abandoning strategies for reducing greenhouse gas emissions responsible for climate change

The blueprint declares that the federal government has an “obligation to develop vast oil and gas and coal resources” and supports Arctic drilling.[40][121] 

Economy

…It is critical of the Federal Reserve, which it blames for the business cycle, and proposes abolishing it.[145] …the Project seeks to extend the Tax Cuts and Jobs Act of 2017 (TCJA).[18] ,,, The proposal would likely increase taxes significantly for millions of low- and middle-income households.[149]

…The project declares that “God ordained the Sabbath as a day of rest” and recommends legislation requiring that Americans be paid more for working on Sunday.[121] It also aims to institute work requirements for people reliant on the Supplemental Nutrition Assistance Program, which issues food stamps.[16]

Education and research

A major concern of Project 2025 is what it calls “woke propaganda” in public schools.[146] In response, it envisions a dramatic reduction of the federal government’s role in education, and the elevation of school choice and parents’ rights.[20] For Project 2025, education should be left to the states.[16] To achieve that goal, it proposes eliminating the Department of Education, and allowing states to opt out of federal programs or standards… The federal government would no longer investigate schools for signs of disparate impacts of disciplinary measures on the basis of race or ethnicity…

Cuts would be made to the funding for free school meals. The Head Start program that provides services to children of low-income families would be eliminated.[21][155] For the project’s backers, education is a private rather than a public good.[20] Project 2025 criticizes any programs to forgive student loans.[156]

Expansion of presidential powers

Project 2025 seeks to place the federal government’s entire executive branch under direct presidential control, eliminating the independence of the DOJ, the FBI, the Federal Communications Commission, the Federal Trade Commission, and other agencies.[4] The plan is based on an interpretation of the unitary executive theory, arguing that Article Two of the U.S. Constitution vests executive power solely in the president.[70][121][44][157]

Project 2025 proposes that all Department of State employees in leadership roles should be dismissed by the end of January 20, 2025. It calls for installing senior State Department leaders in “acting” roles that do not require Senate confirmation.[158][The Project considers] most State Department employees too [be] left-wing and wants them replaced by those more loyal to a conservative president… Trump, the presumptive 2024 Republican presidential nominee, said in 2019 that Article Two of the U.S. Constitution grants him the “right to do whatever as president”, a common claim among supporters of the unitary executive theory. 

Personnel change

Project 2025 proposes reclassifying tens of thousands of federal civil service workers as political appointees in order to replace them with Trump loyalists, who would be willing to bend or break protocol, or in some cases violate laws, to achieve his goals.[5][169] It established a personnel database shaped by Trump’s ideology. The project uses a questionnaire to screen potential recruits for their adherence to the project’s agenda.[2][170]

Foreign affairs

Project 2025 favors neither interventionism nor isolationism. Instead, it emphasizes that all decisions related to foreign policy must prioritize national interests.[183]

Nuclear policy

The Mandate argues that the U.S. should maintain its nuclear umbrella only for member nations of the North Atlantic Treaty Organization (NATO), and that these countries should be responsible for deploying their own conventional forces to deter Russian aggression.[121] …More specifically, the plan calls for a speech shortly after inauguration to “make the case to the American people that nuclear weapons are the ultimate guarantor of their freedom and prosperity.” 

Healthcare and public health

Project 2025 accuses the Biden administration of undermining the traditional nuclear family, and wants to reform the Department of Health and Human Services (DHHS) to promote this household structure.[24] According to Project 2025, the federal government should prohibit Medicare from negotiating drug prices[24] and promote the Medicare Advantage program, which consists of private insurance plans.[124]: 464–65  Federal healthcare providers should deny gender-affirming care to transgender people and eliminate insurance coverage of the morning-after pill Ella, as required by the Affordable Care Act (Obamacare).[24]

Project 2025 suggests a number of ways to cut funding for Medicaid,[25] such as caps on federal funding,[25] limits on lifetime benefits per capita,[25] and letting state governments impose stricter work requirements for beneficiaries of the program.[32] Other proposals include limiting state use of provider taxes,[25] eliminating preexisting federal beneficiary protections and requirements,[25] increasing eligibility determinations and asset test determinations to make it harder to enroll in, apply for and renew Medicaid,[25] providing an option to turn Medicaid into a voucher program,[25] and eliminating federal oversight of state medicaid programs.[25]

Project 2025 aims to dramatically reform the National Institutes of Health (NIH) by making it easier to fire employees and to remove DEI programs. Conservatives consider the NIH corrupt and politically biased.[23]

Project 2025 accuses social media networks—directly naming Facebook, Instagram, Twitter, and TikTok—of jeopardizing young Americans’ mental health and social ties by creating a form of addiction. “Federal policy cannot allow this to continue,” it says.[124]: 5–6 [non-primary source needed]

Immigration reforms

The Mandate of Leadership suggests abolishing the Department of Homeland Security (DHS) and replacing it with an immigration agency that incorporates Customs and Border Protection (CBP), the Transportation Security Administration (TSA), Immigration and Customs Enforcement (ICE), the U.S. Citizenship and Immigration Services (USCIS), and elements of the departments of Health and Human Services and Justice.[121][186] Other tasks could be privatized.[186] The admission of refugees would be curtailed, and processing fees for asylum seekers would increase, something the Project deems “an opportunity for a significant influx of money”.[121] Immigrants who wish to have their applications fast-tracked would have to pay even more.[146]

…Project 2025 policy includes “arresting, detaining, and removing immigration violators anywhere in the United States.”[154]

 

If you had the stomach to listen to Trump’s acceptance speech, you know that his comments about immigration are totally aligned with the verbiage in the Project 2025 document.

 

…Project 2025 encourages the president to withhold federal disaster relief funds granted by the Federal Emergency Management Agency (FEMA) should state or local governments refuse to abide by federal immigration laws, by, for example, not sharing information with law enforcement.[186]

Issues of identity

Project 2025 attacks what it calls the “radical gender ideology”[156] and advocates that the government “maintain a biblically based, social-science-reinforced definition of marriage and family.”[121] To achieve this, it proposes ending same-sex marriage, removing protections against discrimination on the basis of sexual or gender identity, and eliminating provisions pertaining to diversity, equity, and inclusion (DEI)—which it calls “state-sanctioned racism”—from federal legislation.[30][31][188] Federal employees who have participated in DEI programs or any initiatives involving critical race theory might be fired.[121]

Journalism

Project 2025 proposes reconsidering the accommodations given to journalists who are members of the White House Press Corps.[5] It proposes defunding the Corporation for Public Broadcasting, a private, nonprofit corporation that provides funding for the Public Broadcasting System and National Public Radio, as “good policy and good politics”.[189]

Law enforcement

In the view of Project 2025, the Department of Justice (DOJ) has become “a bloated bureaucracy with a critical core of personnel who are infatuated with the perpetuation of a radical liberal agenda” and has “forfeited the trust” of the American people due to its role in the investigation of alleged Trump–Russia collusion. It must therefore be thoroughly reformed and closely overseen by the White House, and the director of the Federal Bureau of Investigation (FBI) must be personally accountable to the president.[121]

A DOJ reformed per Project 2025’s recommendations would combat “affirmative discrimination” or “anti-white racism“, citing the Civil Rights Act of 1964

National security

Project 2025 would require the Pentagon to abolish its DEI programs and immediately reinstate all service members discharged for not getting vaccinated against COVID-19.[5] The United States Armed Forces would not be authorized to take climate change into account in evaluating national security threats.[22]

Project 2025 identifies China as the leading threat to U.S. national security.[128][183] It also expresses concern over China’s influence on American society, and recommends banning the social network TikTok (which it accuses of espionage),,, The Project also expresses concern over Chinese intellectual property theft and accuses Big Tech of acting on the behalf of the Chinese Communist Party to undermine the U.S.[128][124]: 9–13 American pension funds would be encouraged to avoid Chinese investments and American companies seeking to invest in sensitive sectors in China would face restrictions or denial of permission.[128]

Pornography and adult content

…recommends the criminal prosecution of people and companies producing pornography, which he compares to addictive drugs.[30] Previously, the Supreme Court has ruled against attempts to ban pornography on First Amendment grounds.[191]

Women’s reproductive health

Project 2025’s proponents maintain that life begins at conception.[24] The Mandate says that the Department of Health and Human Services (HHS) should “return to being known as the Department of Life”, as Trump HHS secretary Alex Azar nicknamed it in January 2020, voicing his pride in being “part of the most pro-life administration in this country’s history”. Project 2025 says it would reposition department policies “by explicitly rejecting the notion that abortion is health care and by restoring its mission statement under the [Trump HHS] Strategic Plan and elsewhere to include furthering the health and well-being of all Americans ‘from conception to natural death’.”[26][194][195]

…Project 2025 encourages the next president “to enact the most robust protections for the unborn that Congress will support”.[121]

The project opposes any initiatives that, in its view, subsidize single parenthood.[11] Project 2025 encourages the next administration to rescind some of the provisions of the Family Planning Services and Population Research Act of 1970, enacted as Title X of Public Health Service Act, which offers reproductive healthcare services, and to require participating clinics to emphasize the importance of marriage to potential parents.[196]

…[The Project leadership contends that] the Food and Drug Administration is “ethically and legally obliged to revisit and withdraw its initial approval” of the abortion pills mifepristone and misoprostol.[124][non-primary source needed] He also recommends that the Centers for Disease Control and Prevention “update its public messaging about the unsurpassed effectiveness of modern fertility awareness-based methods” of contraception,[124][non-primary source needed] such as smartphone applications that track a woman’s menstrual cycle.[196] \

…The project seeks to restore Trump-era “religious and moral exemptions” to contraceptive requirements under the Affordable Care Act, including emergency contraception (Plan B), which it deems an abortifacient,[197][24] to defund the Planned Parenthood program,[11] and to remove protection of medical records involving abortions from criminal investigations if the owners of said records cross state lines.[24] 

Transportation infrastructure

Project 2025 recommends curtailing the Bipartisan Infrastructure Law of 2021, which authorizes funding for de-carbonizing transportation infrastructure.[200] It views the Federal Transit Administration (FTA) unfavorably, calling it a waste of money. It suggests cutting federal funding for transit agencies nationwide in the form of the Capital Investment Grants (CIG) program. It wants the FTA to conduct “rigorous cost–benefit analysis” even though the agency already scrutinizes projects before allocating funding.[201]

 

If you are surprised by the far-right reach of many of the proposals in Project 2025, you are not alone. Given the origin of the proposals and the potential transformational impact that they would have on the lives of most Americans, it would be irresponsible not to consider what the impact would be on our Democracy which is what the next section of the article covers.

 

Reactions and responses

Allegations of authoritarianism

Democracy experts, political scholars, and other commentators have described the project as dangerous,[204] risking authoritarianism,[205] and apocalyptic.[206][207] Many legal experts have said it would undermine the rule of law,[14] the separation of powers,[5] the separation of church and state,[15] and civil liberties.[5][14][16] Snopes cites “people across the political spectrum” worried that the plan is a precursor to authoritarianism.[208]

Ruth Ben-Ghiat, a scholar of fascism and authoritarian leaders at New York University, wrote in May 2024 that Project 2025 “is a plan for an authoritarian takeover of the United States that goes by a deceptively neutral name.” She said the project’s intent to abolish federal departments and agencies “is to destroy the legal and governance cultures of liberal democracy and create new bureaucratic structures, staffed by new politically vetted cadres, to support autocratic rule.” …

 

The Wikipedia review ends with pages and pages of scholarly reactions to Project 2025. Toward the end we read a good summary written by historian Emma Shortis she writes:

 

The Mandate’s veneer of exhausting technocratic detail, focused mostly on the federal bureaucracy, sits easily alongside a Trumpian project of revenge and retribution…[plans] more broadly aim for nothing less than the total dismantling and restructure of both American life and the world as we know it….The Mandate doesn’t specify who the next conservative president might be, but it is clearly written with Trump in mind…Project 2025’s Mandate is iconoclastic and dystopian, offering a dark vision of a highly militaristic and unapologetically aggressive America ascendant in ‘a world on fire’. Those who wish to understand Trump and the movement behind him, and the active threat they pose to American democracy, are obliged to take it seriously.”[226]

 

Is Project 2025 really a threat to the nation? Can we risk blowing it off? Can you believe that Trump, as he claims, knows nothing of it? Can you believe anything he says? I reject thinking about any solution to the problem of Donald Trump other than the ballot box or perhaps, at some time long after the 2024 election, through the courts. What I do assert is that if you care about the health of the nation, the health of the disadvantaged, any modicum of health equity, or any chance of moving on from profit being the primary driver of healthcare delivery then you need to vote in a way that contributes to a Congress and a president that believes in the separation of powers, the rule of law, and effective accessible healthcare as an expectation, even a right, of everyone in our society. Donald Trump and J.D. Vance have said enough, done enough, and accepted the support of enough money from those who don’t share your vision of America as a society that tries to be inclusive for you to know that we are vulnerable to a dystopian future. 

 

My Wife, Son, Joe, and Me

 

The header for this letter shows beautiful clouds and a very blue sky. It is the scene I enjoy most days on my swim since about half of the time I am doing a backstroke. On my daily swims, I use different backstrokes, the breaststroke, and the crawl (freestyle). For the past two weeks, it has been unusually hot and humid which was why I was not surprised that my energy level was low and my swim took more out of me. I also thought I had a “summer cold” with a little bit of a headache, sore throat, and a cough with scant sputum. It never occurred to me that I might have COVID for the second time.

 

On Wednesday my California son called to say he had COVID. My wife had just developed a terrible headache, a cough, and a raw throat. She had a strongly positive COVID test. By then, I was feeling better, and I was surprised when I also scored a positive test. It may be that our family cluster was precipitated by the visit of my Florida son who had very mild URI symptoms after flying up from Miami. My Miami son has noticed an article in the Boston Globe that reported a significant increase in COVID across the country, especially in New England. As we all know, the last problem that President Biden needed to confront was several days of isolation with COVID. 

 

President Biden has gotten no breaks since his difficulties at the debate on June 27. I greatly appreciate his successes and leadership over the last three and a half years, but I am concerned that his continued candidacy will only increase Donald Trump’s chances of being elected to a second disastrous term when Project 2025 might become a reality. As I said at the beginning of this letter, we live in a time of unexpected events. While I am doing my backstrokes and looking at the clouds, I am wondering what new surprise is about to happen.

 

I hope there are no surprises ahead for you this weekend. The heat and the humidity have passed here. I hope that it will be cool and dry and COVID-free wherever you are this weekend. 

Be well

Gene

 

P.S.: I think the problems of with gmail have been resolved. Readers who do not use gmail got two notices last Friday. Gmail readers finally got their notice at about 4:15 last Friday. I hope that this week’s notifications will be back to normal for everyone.