The politics of health and culture in the United States have rarely been more fraught than in the wake of Project 2025, a sweeping policy blueprint championed by the Heritage Foundation and implemented in key ways by President Donald Trump’s administration. As outlined in the foreword of Project 2025, titled "A Promise to America," Heritage Foundation President Kevin Roberts set forth an agenda with four sweeping promises, the first of which was to "restore the family as the centerpiece of American life and protect our children." According to FactCheck.org, Roberts’s "pro-family promises" specifically targeted reproductive rights, transgender protections, critical race theory, and diversity, equity, and inclusion (DEI) initiatives. He called for the deletion of terms like sexual orientation and gender identity (SOGI), DEI, reproductive rights, and similar language from every federal rule, agency regulation, contract, grant, and piece of legislation.
These proposals quickly found their way into the machinery of government. In his second term, President Trump signed executive orders that ended protections for transgender individuals and eliminated DEI programs, policies, and offices. The Department of Government Efficiency, a new agency under Trump, reduced the federal workforce by placing all employees in federal agencies who worked on DEI on administrative leave, as reported by Government Executive. The Department of Defense also ended the service of transgender military members, a move that drew both praise from some conservative circles and fierce criticism from advocates for LGBTQ rights.
But the culture wars didn’t stop there. On the issue of abortion, Trump embraced many of Project 2025’s proposals, including an attempt—so far unsuccessful—to defund Planned Parenthood. However, he has hesitated to move on some of the more restrictive recommendations, such as reversing approval of or restricting access to abortion pills. Shortly after winning the election, Trump stated it was "very unlikely" he would restrict access to pills used in medication abortion. Yet, abortion rights advocates remain wary, especially after the Food and Drug Administration, on September 30, 2025, approved a new generic version of the abortion pill mifepristone, while Health and Human Services Secretary Robert F. Kennedy Jr. announced his department was conducting a review "relating to the safety and efficacy" of the drug.
According to Human Rights Watch, the Trump administration’s approach to health policy has raised serious concerns about the politicization of health information and the undermining of evidence-based medical guidance. On September 22, 2025, both President Trump and Secretary Kennedy publicly advised pregnant women to avoid acetaminophen, a common over-the-counter medication for pain and fever. This advice, which runs counter to established medical consensus, generated considerable controversy and was only the latest in a series of actions that critics say reflect an ideological, rather than evidence-based, approach to public health.
"If the administration’s goal is to help make America healthy, it has to stop making it harder for people to make informed choices about health care," Matt McConnell, an economic justice and rights researcher at Human Rights Watch, told the press. "Respect for people’s right to health requires health policy driven by evidence, not ideology or the personal beliefs of government officials."
In line with this ideological shift, the administration removed thousands of Health and Human Services (HHS) web pages and datasets related to sexual orientation, gender identity, reproductive rights, contraception, HIV, maternal health, and mental health, following a day-one executive order. These removals included research articles, federal guidelines, and educational materials vital for public health. While court cases brought by physicians and public health officials led to the restoration of many resources, some remained offline for significant periods—including the Centers for Disease Control and Prevention’s (CDC) Mpox vaccination recommendations during an ongoing global outbreak. Others are still inaccessible, according to Human Rights Watch.
Layoffs at HHS and its constituent agencies further reduced the production and availability of health information resources. The CDC’s reproductive health division was particularly hard-hit, with significant cuts to programs that offer guidance on safe contraception use and publish data about the drivers behind the United States’ alarmingly high rate of maternal mortality among Black women. The administration also eliminated several advisory committees of independent experts, which had previously provided evidence-based guidance on healthcare access and infection prevention.
Perhaps most controversially, in June 2025, Secretary Kennedy removed all existing members of the Advisory Committee on Immunization Practices (ACIP), a move that drew immediate condemnation from the American Medical Association, the nation’s largest professional association for physicians and medical students. On September 18 and 19, Kennedy’s handpicked replacements for ACIP voted to reverse the CDC’s universal recommendation on Covid-19 vaccination and to remove the combined vaccine for measles, mumps, rubella, and varicella (MMRV) from the recommended schedule for children under age four.
The ACIP’s recommendations have a direct influence on vaccine availability and insurance coverage across the United States. Once adopted by the CDC, these recommendations determine which vaccines should be available to the public, and many state policies and insurance programs are closely tied to their findings. If adopted, the changes would restrict parents’ access to the combined MMRV vaccine for young children—a move at odds with public health strategies that depend on broad vaccine coverage.
The turmoil didn’t end there. In August 2025, Secretary Kennedy abruptly fired CDC director Susan Monarez, prompting a wave of resignations from top public health officials and widespread condemnation from medical associations. In subsequent public comments and an opinion article, Monarez claimed she was fired in part for refusing to prematurely approve ACIP’s new vaccine recommendations. Kennedy has denied those claims.
As a result of these changes, several states have banded together in regional blocs to issue their own vaccine recommendations, following the advice of private medical associations rather than ACIP. In contrast, Florida moved in September to end all state-mandated vaccine and immunization requirements for public school attendance, with other states reportedly considering similar steps.
"This fragmentation is a worrying sign that it is becoming much harder for the public to access consistent, reliable information about health care," McConnell of Human Rights Watch said. "US authorities should ensure that federal healthcare resources are grounded in evidence and accessible to all, and should take steps to bolster the public’s trust in those resources."
The debate over Project 2025 and its implementation by the Trump administration has exposed deep rifts in American society over the role of government in health and culture. Supporters argue that the changes restore traditional values and protect children, while critics contend that they undermine public health, restrict access to vital information, and erode trust in scientific expertise. As the nation grapples with these challenges, the future of health policy—and the very fabric of American civil society—hangs in the balance.
