Tag: Project 2025

The Art of Political Jiu-Jitsu: Project 2025 and Donald Trump

Sep 13, 2024

By MIKE MAGEE

Funny think about that Project 2025’s “Mandate for Leadership.” Trump declared in this week’s debate, “I know nothing about it.” But in addition to the vast majority of authors and editors of the document having served in the prior Trump administration, the former President’s name is mentioned in the 887 page document over 300 times.

Described by Pulitzer Prize winning economics columnist, Carlos Lozada, the work itself is an “off-the-shelf governing plan.” It’s packed with conservative fan favorites, not simply “militarizing the southern border” and reversing what they call “climate fanaticism”, but especially placing DEI (diversity, equity, inclusion) efforts in the waste bin, banning abortion nationally, and pushing deregulation and tax cuts for the richy rich.

None of that is surprising if you’ve run into these characters on K street and beyond. This is who they are, and largely who they have always been. Over the years, I’ve bumped elbows with them in Washington and in corporate C-suites galore. What makes this effort a bit unique is, of course, the presence of a cooperative headliner who will clearly endorse “the elevation of religious beliefs in government affairs” and actively diminish “the powers of Congress and the Judiciary.”

This is political jiu-jitsu practiced at its highest level. Rather than dismantling the “deep state,” these operators are fast at work “capturing the administrative state” for their own self-serving purposes.

Understanding jiu-jitsu takes one a long way toward understanding the Heritage Foundation and Freedom Institute’s puppet masters. The word “Jū” means “gentle, soft, supple, flexible, pliable, or yielding.” It’s companion, “jutsu” is the “art or technique.” Combine the two, and you have the ”yielding-art.” The intent in bodily (or political) combat is to harness an opponent’s power against himself, rather that confronting him directly.

Political jiu-jitsu may be deceptive and confusing in the absence of visible weaponry, but it is anything but gentle. In the physical version, you are instructed in joint locks and chokeholds of course, but also biting, hair pulling, and gouging. Kevin Roberts, the President of the Heritage Foundation and editor of Project 2025, is a master of the political version. While he and Trump outwardly employed a “nothing to see here” stance, demographic realities were cued up in the document. The solution to the growing minority status for Republicans? “Voter efficiency” and a rigged census. Or in the Project’s words: “Strong political leadership is needed to increase efficiency and align the Census Bureau’s mission with conservative principles.”

Robert’s language is soft, but its impact hard indeed. In the introduction he suggests that the Declaration of Independence’s words “pursuit of happiness” were better understood to be “the pursuit of blessedness” while providing corporations a market free hand “to flourish.” Career civil servants are recast as “holdovers” without “moral legitimacy.” And the Justice Department suffers this put-down – “a bloated bureaucracy with a critical core of personnel who are infatuated with the perpetuation of a radical liberal agenda.”

Majority rules and demographic changes being what they may, alternative facts and voter suppression have been added to the tools of “political jiu-jitsu” artists. But Kelly Anne Conway was nowhere to be seen this week, and their headliner was long-winded, boring, and tired. As for voter integrity, the Democrats are fully funded and lawyered up. Finally, good Republicans everywhere have begun to recognize that towing the MAGA line much further puts their down-ballot hopes in the direct line of fire. Those 300 mentions are beginning to look like a liability instead of an asset.

Mike Magee MD is a Medical Historian and a regular THCB contributor. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex. (Grove/2020)

What the Health System Can Expect from a Second Trump Term

Aug 5, 2024

By JEFF GOLDSMITH

Though the results of the November election are by no means a foregone conclusion, it is worth thinking about how a second Trump administration might affect the nation’s $4.7 trillion health system. People were not the problem with the first Trump term; his healthcare team was strong and capable: Alex Azar, Scott Gottlieb, Seema Verma,. Bret Giroir, Brad Smith etc.

After the embarrassing political failure of Repealing and Replacing ObamaCare in 2017 (for which blame look to his White House staff), his healthcare team settled in to a quiet and unremarkable term until the COVID wave broke over them and helped drive them out of office. It was not merely ironic but deeply disturbing that MAGA politics prevented Trump from claiming credit for the Operation Warp Speed vaccine miracle his team produced.

A second Trump term would likely be very different- both more ideologically driven but also fiscally constrained. The people part is completely unreadable at this early hour. But health policy will almost certainly be a second tier priority because trade and tariffs, conflicts with our traditional allies and trading partners, and inflamed social issues like illegal immigration, wokeness, and abortion will crowd out changes in health coverage, costs and payment policy.

Show Me the Money!

However, fiscal pressures will force a second Trump administration to confront federal health spending and set him on a collision course with the hospital and pharmaceutical industries, two of the three largest organized actors in healthcare. Trump inherits a 2024 $5 trillion federal budget with a $1.7 trillion deficit, an anomalous degree of fiscal stimulus at the height of an economic boom. That deficit is also a major driver of the inflation Trump has promised to conquer.

Trump is committed to reauthorizing the individual tax cuts from his 2017 Tax Cuts and Jobs Act which are scheduled to expire in 2025, which would add $3.3 trillion to the deficit over the next ten years. He also wants to reduce the corporate tax rate from 21% to 15%. If Trump does nothing meaningful about federal spending, his FY 26 budget, due shortly after he arrives in the White House, would harbor immense out year deficits and completely gross out both the bond and currency markets–a “Liz Truss” moment for the new regime. The promise of immediately reducing inflation which Trump made in his RNC acceptance speech goes sailing out the window.

Savaging Medicaid Spending (or Trying to)

Trump has tied his budgetary hands by committing to not cutting a single penny from Medicare and Social Security, which are forty percent (!) of the federal budget. This commitment appears both in the Republican platform and in Agenda47, which is the Trump campaign’s compilation of commitments made in his speeches. Trump has also committed to not reducing the $850 billion spent on Defense.

Ringfencing Social Security, Medicare and Defense leaves the more than trillion dollar Medicaid program (state and federal combined) as the largest single potential source of potential budgetary savings to avoid inflationary blow-out growth in the federal deficit. At its peak in March of 2023, Medicaid/CHIP enrolled 94 million people, or 28% of the US population. Expect an incoming Trump administration to attack Medicaid spending, both by accelerating the decline in enrollment that began in 2023 with the expiration of the COVID Public Health Emergency and by cutting rates and payments to Medicaid Managed Care providers. Some 24 million Medicaid beneficiaries have been “redetermined” and over 15 million have lost coverage. KFF says present Medicaid enrollment is about 80 million in mid-2024 but that number is certainly moving down

While Trump has distanced himself from the Heritage Foundation’s Project 2025, that policy blueprint characterized the ObamaCare Medicaid expansion as “inappropriate” and the program itself as a “cumbersome, complicated and unaffordable burden on nearly every state”. It advocated ending what it called “financing loopholes” (e.g. provider taxes that have trued up Medicaid rates to hospitals and physicians vs. Medicare), tightening Medicaid eligibility, and imposing both work requirements and cost sharing, “reforming” disproportionate share payments, time limits and lifetime caps on Medicaid benefits and ending coverage for “middle and upper income beneficiaries”! We can certainly expect inflammatory publicity from a Trump White House on states that have expanded Medicaid eligibility to “undocumented aliens”, followed by pressure on Congress to prohibit this coverage by statute.

When former Trump press secretary and present Arkansas Governor Sarah Huckabee Sanders, announced her removal of 400 thousand Arkansans from Medicaid enrollment, she said she was “liberating them from dependency”. It is likely that that millions more Americans will be “liberated from dependency” on Medicaid during the first two years of a second Trump Administration. There will be work requirements (with politically damaging pressure on the 11 million very poor or disabled “dual eligibles” eg. Medicare plus Medicaid) population), as well as cost sharing and an voucher option to purchase private insurance (!?) for Medicaid beneficiaries. An aggressive effort to “re-welfare-ize” the Medicaid program will raise numerous bureaucratic barriers to Medicaid enrollment, scaring off a lot of otherwise eligible beneficiaries.

Don’t Limp. Crush the “Trump Reich.”

Jul 8, 2024

By MIKE MAGEE

I have always felt a kinship with EJ Dionne. We are both Boomers, though I am 4 years his senior. We share similar politics, religious origins, early Catholic school educations, fathers in health care and mothers who were teachers, deep New England roots, addiction to the written word, blessings with long marriages and children (they 3, we 4), and deep revulsion with Trump and his enablers and everything they represent.

Viewing him as measured and wise, I took special care in reading his Washington Post column yesterday, “The words about Joe Biden I never wanted to write.”

For twelve days since that first debate, I have worked to remain officially neutral on “what next to do,” and stayed focused on how to ensure a decisive (message-sending) defeat not only of Trump but Republicans up and down the ticket, so that there is no confusion that the whole cabal – Project 2025, Leonard Leo et al, the Supreme Court’s “Doomed Crusade”, Bannon-led MAGA insurrectionists – is sufficiently devastated that it cannot remerge from the cinders.

There is no doubt that Biden’s physical and mental decline was on full view for over 50 million Americans two weeks ago. And you don’t have to be a medical historian or a prize winning journalist to recognize that the degenerative processes that are responsible for his decline are progressive (albeit possibly slowly progressive). That is to say, his decline will continue, as predictably as did Ronald Reagan’s.

But as E.J. makes clear in his opinion piece this week, “Biden’s capacity to do a ‘good job’ is not ‘what this is about.’ Donald Trump’s threat to democracy is the overriding question before the country…”

While Dionne is right that this is not “about Biden,” he understates the problem when he suggests instead that it is about Trump alone. That is no more true than to suggest that WWII was only about Hitler, Mussolini, and Hirohito, when in fact the challenge was far greater than that.

Stated simply, the human species in the Axis societies had gone off the rails, and channeled themselves into a death spiral. “Breaking the spell” required unprecedented force and ultimately the use of atomic bombs, followed by multi-decade investments through the Marshall Plan to reestablish civilized human societies.

President Biden limping to the finish line and repeating slight margin victories in seven swing states will not solve America’s current problem. We are too far along. As with Hitler’s Germany in the 30’s, the enemy’s course trajectory is by now visible for all to see, and it will achieve its’ Project 2025 goals and objectives if allowed. These determined radicalized leaders are more than halfway there, fueled with a religious fervor that cannot be modified by honest debate or calm logic.

Success breeds success as well for evil as for good. So far, with Biden still in power, political arsonists have achieved an immune Executive branch; a biased Judiciary with no Code of Ethics; a House of Representatives directed from Mar-a-Lago; and 14 state houses with absolute control over their citizens reproductive rights.

Clearly the problem is bigger than Trump. Project 2025’s declaration leaves little room for confusion. It states: “It is not enough for conservatives to win elections. If we are going to rescue the country from the grip of the radical Left, we need both a governing agenda and the right people in place, ready to carry this agenda out on Day One of the next conservative Administration.”

There will be no Pearl Harbor to wake us from our sleep, or galvanize our clear majorities that know in their hearts that something has gone very, very wrong. That Presidential debate was our final warning. Time’s up. As Sen. Chris Murphy (D-Conn.) said this weekend “This is a really critical week. I do think the clock is ticking.”

What then is the formula for an overwhelming defeat of the Trump Reich? Three pillars: Energy, Enthusiasm, Women-Led.

Mike Magee MD is a Medical Historian and regular THCB contributor. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex (Grove/2020)