Trump's Project 2025 Threatens Full Privatization of Medicare

A Death Sentence for Millions

Diljeet Singh

Once you’ve been told you have cancer, waiting is the last thing you want to do. As a practicing Gynecologic Oncologist, I know patients with so-called “Medicare Advantage” plans will be waiting—waiting to find a specialist like me within their network, waiting to get pre-authorization for the tests they need so we can discuss their diagnosis and possible treatments and, ultimately, waiting to get approval for their surgery and treatments.

Unfortunately, Project 2025 would make this already difficult process even worse. By fully privatizing Medicare, this Heritage Foundation plan would shift even more power into the hands of corporate insurers, who prioritize profits over patient care. 

The result would be even narrower provider networks, more restrictive approvals for tests and treatments, and a system designed to delay or deny care to those who need it most. For patients, that means critical time lost—time that may mean more pain, more symptoms, and a decreased chance of being cured.

Under Project 2025, the burden of navigating these hurdles would fall not just on patients, but on physicians and health care workers who are already stretched thin. Physicians for a National Health Program estimates that doctors and their teams would spend up to 43 million hours annually dealing with prior authorizations alone. 

This clinically meaningless administrative burden steals time that should be spent caring for patients, wastes resources that we can’t afford to lose, and is a source of burnout and moral distress for healthcare professionals.

I feel helpless to overcome the negative impact that delays in care have on patients’ chances of being cured. But delayed care is often the best-case scenario for seniors in “Advantage” plans, because there is a high potential that the best cancer center in their area is outside of their narrow network and that treatments will be denied.

Research shows seniors with corporate “Advantage” plans have lower access to the high-volume hospitals that most successfully care for uncommon cancers. For example, people with stomach, pancreatic, and liver cancer requiring surgery were shown to have a higher likelihood of dying when compared to seniors with real Medicare.

Despite the overwhelming evidence showing that privatized Medicare does not serve our seniors’ best interests and wastes money, Project 2025 wants to take over all of Medicare by automatically enrolling seniors in corporate insurance plans without their full consent.

This will be catastrophic for people on Medicare, who will face increasing financial burdens and decreased access to care. An estimated 24 million seniors in corporate “Advantag

e” plans would face limited provider networks that exclude up to 70% of the doctors in their regions. And more than 15 million people would be considered underinsured due to the reduced benefits available under privatized plans. Without the choice of sticking with real Medicare, our seniors would all be threatened by the health impacts of delayed and denied care.

Corporate insurance plans are designed to make profits, not take care of patients, and so they use shady techniques such as upcoding, which boost payment rates by making patients seem sicker than they are. In 2024, so-called “Advantage” plans overcharged the American people by as much as 140 billion dollars—and provided less care with worse health outcomes. If this system of skimming funds were extended to all seniors, the Medicare trust fund would immediately begin deficit spending, leading to insolvency within five years. It would cost $1.5 trillion more than real Medicare over 10 years.

Congress must take a stand to protect American seniors and the Medicare Trust Fund by rejecting Project 2025’s dangerous push to privatize Medicare.

Instead of funneling money into the hands of corporate insurers, we should be cracking down on overcharging and using those savings to strengthen Medicare. For example, a cap on out-of-pocket spending is crucial to ensure seniors receive the financial protection they deserve. We should also invest in much-needed dental, vision, and hearing coverage for everybody on Medicare.

It’s time to give all seniors access to the best care possible and stop wasting our healthcare dollars on corporate profits.

Dr Diljeet Singh is a women’s health advocate, an integrative gynecologic oncologist, and the president-elect of Physicians for a National Health Program.