Where you should actually be looking for Trump's health priorities (hint: not Project 2025)

Democrats have done their very best lately to tie former President Trump to Heritage Foundation-created policy recommendations on various issues, including health care. Project 2025, as the effort is called, is the left's new favorite bogeyman.

The problem is, nobody's really taking it seriously among GOP health care circles — even people who weighed in on its creation. I reached out to leading Republican health care experts who also served in the Trump administration and heard a resounding shoulder shrug. Many hadn't even read the document. (It is more than 900 pages long, to be fair.)

What the people who had actually worked with Trump told me was that the only reliable indicator for Trump's priorities are the words that have come out of his mouth. So STAT dug up campaign videos of Trump himself detailing his policy priorities as part of a series called "Agenda47." They're more detailed than the Republican platform, and illuminate his stance on issues like gender-affirming care, abortion, drug pricing, investigating chronic illness rates, and addressing the overdose crisis.

We pooled the talents and expertise of six reporters across our newsroom to explain and contextualize Trump's proposals, and we're excited to finally bring you our magnum opus on what a Trump administration could mean for health care.

on the campaign trail

Walz previews health care freedom message

Minnesota Gov. Tim Walz is leaning into the latest Democratic critique of GOP health care stances — that they are attacking individual freedoms — with a Midwestern flair. "In Minnesota, we respect our neighbors and the personal choices that they make, even if we wouldn't make the same choice for ourselves. There's a golden rule: Mind your own damn business," he told Philadelphia rally goers Tuesday night.

Walz has been a staunch advocate for abortion rights and gender-affirming care access, positions Republicans have used to paint Harris-Walz as a "far-left" ticket, my co-author Sarah Owermohle writes. On Tuesday, Walz went on the offensive, like the former football coach he is, warning that Trump would take the country "backwards," repeal Obamacare, and "gut" Social Security and Medicare.

In some ways, Walz's run for VP will revive 2020 battles between the governor and then-President Trump. In the early months of the Covid-19 pandemic, Trump lamented the state's extensive shutdown policies, calling to "LIBERATE MINNESOTA!" Conservative groups eventually sued over Walz's mask mandate, though the state Supreme Court sided with the governor earlier this year.

And a bonus backstory with a Minneapolis dateline: Walz has sterling progressive credentials on health care issues, but agreed to water down legislation addressing health care affordability and when Mayo Clinic threatened to direct billions in planned investments to other states. Bob Herman and Tara Bannow joined me in speaking with experts based in Minnesota about the negotiations and how some hospitals wield political power.

science

Cognitive experts weigh in on why Trump trails off

JIM WATSON/AFP VIA GETTY IMAGES

Back in 2017, the great Sharon Begley tackled a tough question for STAT: Were changes in Trump's speaking style a sign of cognitive decline? Now that Trump is running again, Olivia Goldhill revisited that question seven years later.

Experts who reviewed four clips of recent Trump speeches noticed that since his first term, Trump speaks in more short sentences, confuses word order, repeats himself, and digresses more than he used to.

A detailed analysis of Trump's speeches since 2021 also found that there was an increase in what experts call "all-or-nothing thinking" and is more focused on the past. Read the full details of the findings here.

business

CVS talks PBM lobbying

On an earnings call this morning, CVS Health CEO Karen Lynch said the company has taken "a very aggressive approach to educating Congress on the role of the PBM" as lawmakers eye some sort of PBM reform bill in December, my colleague Bob Herman flagged.

Lynch said that the company has proven that PBMs save money, and that the Federal Trade Commission's report on the industry didn't incorporate holistic data.

She's not too worried about whatever lawmakers could pass: "As you can see, nothing has happened in Congress because there's a lot of discussion going on around the PBMs. I do think that if anything ever does happen, it will be on transparency." We'll see!

On a separate matter, Lynch said CVS has taken Medicare up on its offer of additional premium-stabilization subsidies for stand-alone Part D drug plans.

Aaaand on that note…

drug pricing

Not so fast, Medicare

Republicans are attacking the Biden administration for using government subsidies to lower some seniors' Medicare Part D premiums next year ahead of changes to coverage due to the passage of the Inflation Reduction Act, John Wilkerson writes. Seniors' annual Part D out-of-pocket costs will be capped at $2,000 next year, and for the first time the private insurers that offer Medicare drug coverage will have to pay for the brunt of seniors' drug costs above that amount.

It's a familiar scenario. Medicare officials are allowed to pilot test policies. At times, that authority has been used to smooth over insurance-market transitions in the guise of a so-called demonstration project, such as when Medicare temporarily gave performance bonuses to the vast majority of Medicare Advantage plans to offset MA pay cuts following the passage of the Affordable Care Act. At the time, Republicans raised a stink, saying the demonstration covered up flaws in Obamacare, and the Government Accountability Office determined the demonstration didn't test much of anything at a cost of $8 billion.

Now Republicans are complaining about the premium-subsidy demonstration, and they're again asking the GAO to estimate the cost of the program and determine whether it tests anything. As with the ACA, Republicans also are using the demonstration as a cudgel against the Inflation Reduction Act.

More around STAT

Check out more exclusive coverage with a STAT+ subscription

Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

How UnitedHealth turned a questionable artery-screening program into a gold mine, STAT
Pharma industry ramps up legal fight of state drug discount laws, Bloomberg Law
FDA scolds Bristol Myers over a misleading website for a cancer treatment, STAT