The results of the 2024 election will likely bring a seismic shift for reproductive justice in the United States. Project 2025, crafted by the conservative Heritage Foundation and over 100 aligned organizations, is poised to guide the new administration’s policies.
The new vision is sweeping, targeting nearly every facet of American life, with reproductive rights caught squarely in its crosshairs. From revoking FDA approval for abortion medications to reinstating the Comstock Act, this agenda threatens to reverse decades of progress.
In a forum held a month before the election, I joined forces with Israel Cook of the Center for Reproductive Rights and Mackenzie Brennan from the Arizona Proactive Reproductive Justice Alliance to break down what this means for all of us. Our goal was to understand how Project 2025 might be implemented and the impact it could have on patients and providers.
Together, we walked through the dense 900-page manual behind this agenda, tracing its potential pathways to reshape federal agencies and undermine critical protections for bodily autonomy.
I’ve already seen the ripple effects of restrictive policies: patients are confused, frightened, and struggling to access care. With Project 2025 poised to consolidate executive power further, its reach could expand dramatically, dismantling key safeguards in healthcare, data privacy, and education.
As I told the audience that evening, understanding what’s at stake is the first step toward action.
What Is Project 2025?
Project 2025 lays out detailed plans to centralize executive power, dismantle federal protections, and enforce a restrictive agenda across American life. The document explicitly rejects the notion that abortion is healthcare, targeting reproductive rights with alarming precision.
Among its key objectives:
- Revoking FDA approval for mifepristone: This medication, used safely for decades as part of a two-drug regimen for medication abortion, is central to over half of abortions in the United States. By revoking its approval, Project 2025 aims to eliminate a critical option for reproductive care.
- Reinstating in-person dispensing requirements: During the pandemic, medication abortion access expanded through telehealth and mail-order options. As I said in the forum, Project 2025 seeks to roll back these advancements, creating additional hurdles for patients seeking care.
- Reviving the Comstock Act: This 19th-century law criminalized mailing any material considered “obscene,” including abortion medications. Its enforcement today could effectively ban medication abortion by mail, a vital service for those in restrictive states.
Project 2025 doesn’t stop at abortion. It also seeks to codify federal funding restrictions, such as the Hyde Amendment, limiting resources for low-income individuals seeking care. Moreover, its call to reframe the Department of Health and Human Services as the “Department of Life” signals a broader strategy to redefine public health through an anti-abortion lens.
Taken together, these initiatives are part of a calculated strategy to criminalize care, stigmatize patients, and silence providers. Project 2025 seeks to reshape the day-to-day lives of people who rely on these healthcare services.
How Will Project 2025 Affect Us?
The implementation of Project 2025 would drastically alter the landscape of reproductive healthcare, with profound consequences for both patients and providers. I expect it to create chilling effects on the medical community and expand surveillance and criminalization.
For Patients
Imagine a patient in a state like Arizona already navigating restrictive abortion laws. Under Project 2025, they might face:
- Loss of medication abortion options: Without mifepristone, patients would have fewer choices, forcing many into undesired surgical procedures or less safe alternatives.
- Increased confusion and fear: The revival of the Comstock Act and the criminalization of abortion medication distribution could leave patients unclear about what care is legal or accessible, deterring them from seeking help.
- Surveillance and criminalization: Pregnant individuals, particularly those in marginalized communities, would face heightened scrutiny over their healthcare decisions, risking prosecution for outcomes like miscarriage or self-managed abortion.
For Providers
Healthcare providers would face mounting pressure as Project 2025 unfolds:
- Legal risks: Providers could be targeted under revived laws like the Comstock Act, facing prosecution for offering care or even sharing information about abortion options.
- Loss of funding and resources: Due to expanded “gag rules” and funding restrictions, clinics relying on Title X funding might be forced to close or significantly reduce services.
- Chilling effects on practice: Providers might withdraw from offering abortion or gender-affirming care altogether, fearing the legal and professional repercussions of criminalization.
Broader Impacts
These measures ripple across all aspects of reproductive healthcare. Marginalized groups, including low-income individuals, people of color, and LGBTQ+ communities, would bear the brunt of these policies. Pregnancy criminalization would heighten existing inequities, further disenfranchising the very people who need care the most.
As I shared in the forum, these impacts are not hypothetical. Patients are already experiencing fears due to the erosion of Roe v. Wade. Project 2025’s implementation would only deepen these challenges, turning a growing crisis into an outright emergency.
Deeper Implications
Project 2025 would also dismantle protections that intersect with racial justice, LGBTQ+ rights, and economic equity. By using reproductive healthcare as a wedge, the plan expands into broader realms, threatening the well-being of already marginalized communities.
Racial and Economic Justice
Communities of color and low-income individuals are disproportionately impacted by policies outlined in Project 2025.
- Healthcare access barriers: The erosion of Medicaid, Medicare, and Title X funding will disproportionately affect Black, Indigenous, and other people of color, further widening existing health disparities.
- Criminalization and surveillance: Black and brown people, already over-policed and disproportionately incarcerated, would face intensified scrutiny under pregnancy criminalization laws, with outcomes such as miscarriages or stillbirths weaponized against them.
LGBTQ+ Rights
Project 2025 directly attacks LGBTQ+ rights, specifically targeting gender-affirming care and anti-discrimination protections:
- Eliminating healthcare protections: The plan proposes removing gender-affirming care from Medicaid and Medicare coverage, effectively barring access for many transgender individuals.
- Increasing stigma and discrimination: By dismantling federal anti-discrimination protections, Project 2025 would embolden state-level attacks on LGBTQ+ communities, creating a hostile healthcare environment.
Global Impacts
The reach of Project 2025 extends beyond U.S. borders, with proposed expansions of the Global Gag Rule:
- Restricting international aid: Organizations receiving U.S. humanitarian aid would be barred from providing or even discussing abortion care, cutting off critical resources for vulnerable populations globally.
- Undermining comprehensive care: These restrictions would dismantle international programs supporting reproductive and sexual health, exacerbating global health inequities.
A Broader Framework for Oppression
As I shared during the forum, these attacks are not isolated. Coupled with its rollbacks on labor protections, education access, and voting rights, these policies would entrench systemic inequities. For many, the policies threaten not just autonomy over their own bodies but also their ability to live free from oppression.
This intersectional lens reveals Project 2025’s stakes: power, control, and the silencing of marginalized voices.
Turn Understanding into Action
If its policies are implemented, Project 2025 will affect clinics like mine, as well as homes and communities all over the country. It seeks to criminalize care, curtail freedoms, and worsen inequities.
But understanding what’s at stake is only the first step. Knowledge must be paired with action. We can’t let a policy manual define this country’s future of healthcare and justice. Here’s what you can do today:
- Support Local Providers and Advocacy Groups: Independent clinics and abortion funds are lifelines for people navigating restrictive policies. Donate, volunteer, or organize fundraisers to sustain their work.
- Stay Informed and Educate Others: Share what you’ve learned about Project 2025 with your networks. Combat misinformation with facts, and encourage your community to get involved.
- Vote and Mobilize: We have a midterm election in just two years. Check your voter registration and engage in efforts to increase turnout in your area. Policy change begins at the ballot box.
The fight for reproductive justice is deeply personal for me, and I hope it is for you, too. Together, we can push back against policies that strip away autonomy and rights, creating a future where everyone can access equitable care and make their own healthcare decisions.
The path forward exists, but it requires all of us to walk it together.
