Health care in America is often a tale of two nations. For many Americans—particularly white and wealthy ones—the U.S. can offer some of the best, most groundbreaking care in the world.
But for people of color, the LGBTQ+ community, rural populations, and low-income neighborhoods, health outcome disparities can be jarring. Higher uninsured rates, language and cultural barriers to care, economic and educational background, and greater exposure to pollution are just a few of the factors that threaten these groups.
Despite the gains we’ve made as a nation since passing the Affordable Care Act (ACA), race, ethnicity, and background often still determine whether our fellow Americans can find high-quality, reliable health care.
Stickers tying J.D.Vance to Project 2025 are seen on the street outside the CBS broadcast center in Manhattan on Oct. 1, in New York City.
Roy Rochlin/Getty Images for DNC
How are elected officials planning to fix that? There are two distinctly different visions.
Republicans have Trump’s Project 2025, a 900-page agenda from the Trump-aligned and Republican-aligned Heritage Foundation for a future Republican administration. It’s a power grab that’s bad for everyone, but especially for marginalized groups and people of color whose health will suffer dramatically with its implementation.
The Project 2025 health care agenda is the Trump healthcare agenda. Trump claims he has “no idea who’s behind” Project 2025 but more than 140 Trump political appointees are involved in it. Six Trump Cabinet officials, Trump’s chief of staff, and senior advisors like Stephen Miller helped write the plans or led groups that advised Project 2025. His own choice for vice president, Sen. JD Vance (R-OH) wrote the foreword to a book about the Project 2025 agenda.
Listen to Trump himself. In 2022, Trump said of the Heritage Foundation’s plans: “They’re going to lay the groundwork and detail plans for exactly what our movement will do.”
So, what’s inside Trump’s plan that Republicans want to implement?
Most of us view Medicare as a crucial part of our retirement plans that we’ve contributed to all our lives, but Project 2025 labels it a “runaway entitlement” and endorses efforts to push seniors into privatized health plans. It would repeal the Inflation Reduction Act, ending prescription drug price negotiation and lifting the $2,000 annual cap on prescription drug copays for Medicare recipients. That would drive drug costs up and help Big Pharma at the expense of seniors on a fixed budget.
Project 2025 would end all public-private partnerships with the NIH, including those working to cure devastating diseases or develop new medicines to address all kinds of illnesses and conditions—including diabetes, cancer, hepatitis, or HIV—that disproportionately have an impact on communities of color.
The last time Republicans controlled Washington, they tried unsuccessfully to repeal the ACA. That would kick at least 20 million Americans off their health insurance, end protections for people with pre-existing conditions, and end Medicaid coverage for millions, devastating the low-income Americans and people of color who rely on the program for lifesaving healthcare.
And finally, make no mistake: the Project 2025 agenda would further restrict women’s reproductive freedom after the reversal of Roe v. Wade by ending FDA approval for medication abortion, limiting access to abortion drugs by mail or telehealth, and starting invasive investigations into abortion providers and medicine manufacturers.
Thankfully, there’s another path forward, and that’s our Health Equity and Accountability Act, or HEAA.
If signed into law, this legislation would build on the ACA and Inflation Reduction Act. HEAA would bring us closer to a just health care system for all Americans—no matter their race, ethnicity, gender, or language—by advancing culturally and linguistically appropriate health care, improving data reporting, addressing diseases that disproportionately harm certain communities, diversifying our health care workforce, expanding equitable reproductive care, and so much more.
Introduced in every Congress since 2003 by the Tri-Caucus, made up of the Congressional Asian Pacific American Caucus, Congressional Black Caucus, and Congressional Hispanic Caucus, HEAA is the only comprehensive legislation that directly addresses the intersections of health inequities and race and ethnicity. This Congress, Rep. Barbara Lee (D-CA) and Sen. Mazie Hirono (D-HI) led the introduction.
Parts of HEAA have already been signed into law as part of landmark legislation like the ACA, which increased community health clinic funding and culturally sensitive care. It helped codify the Office of Minority Health within the Department of Health and Human Services. But there is so much left to be done.
The American people deserve leaders who will be honest about their plans for our health care. Every one of us will face illness or need care at some point in our lives. Elected officials have a responsibility to be straightforward about what we will do to improve care and reduce costs. That’s what HEAA aims to do. The attempt by Trump and his Republican allies in Congress to run away from Project 2025’s unpopular healthcare agenda will backfire.
Americans of all races, ethnicities, and backgrounds know that we cannot trust them to protect our care.
Rep. Judy Chu was elected to the U.S. House of Representatives in 2009 and represents the 28th congressional district of California. She is the first Chinese American woman to serve in
Congress and is the chair of the Congressional Asian Pacific American Caucus.
Rep. Nanette Barragán was elected to the U.S. House of Representatives in November 2016, becoming the first Latina ever to represent California’s 44th Congressional district. She serves as chair of the Congressional Hispanic Caucus.
Rep. Steven Horsford represents the 4th congressional district of Nevada in the U.S. House of Representatives. He is the first African American to represent Nevada in Congress and serves as the chair of the Congressional Black Caucus.
The views expressed in this article are the writers’ own.
