Project 2025: A Looming Threat to Chicago’s Health Equity Progress

As Chicago grapples with one of the nation’s most severe racial health disparities, a controversial conservative policy agenda known as Project 2025 threatens to undermine crucial health equity initiatives in the city. Public health experts and healthcare providers warn the proposed policies could reverse years of progress in addressing Chicago’s stark life expectancy gap. 

The Stakes for Chicago

The Chicago Department of Public Health’s latest data reveals a sobering reality: an 11.4-year life expectancy gap between Black and non-Black residents. In some West Side neighborhoods, the disparity is even more stark – West Garfield Park residents face a life expectancy of just 62.0 years, nearly 20 years lower than their counterparts in more affluent areas.

The Illinois Department of Human Resources released a 2024 report on health disparities that identified nine barriers to equitable healthcare across the state, including “a lack of access to healthcare and social support services,” the “prohibitively high cost of care” and “not centering the community voice in decisions.” 

These disparities represent real lives and communities that have historically been underserved by our healthcare system. Project 2025’s proposals could make these inequities substantially worse.

Dismantling Critical Healthcare Programs

Project 2025’s proposed restructuring of essential healthcare programs could hit Chicago’s vulnerable communities particularly hard.

The plan calls for eliminating Medicare drug price negotiations and imposing lifetime caps on Medicaid benefits – programs that more than 3 millions Illinoisans rely on for basic healthcare access.

One of the biggest programs at stake is the 340B Drug Pricing Program, which enables healthcare organizations serving low-income patients to buy outpatient drugs, like HIV medication and cancer treatment drugs, from pharmaceutical companies at significantly reduced prices. The program has operated for more than 30 years, and allows hospitals to “stretch scarce resources as far as possible, reaching more eligible patients,” according to a Health Resources and Services Administration review.  

 Project 2025’s proposed restructuring would severely limit these hospital’s ability to offer affordable medications and essential services to those who need them most.

Impact on Chicago’s Strategic Health Initiatives

The timing of Project 2025 could hardly be worse for Chicago’s public health efforts. The city’s Healthy Chicago 2025 Strategic Plan, aimed at reducing the racial life expectancy gap, focuses on seven key areas including chronic disease management, mental health services, and substance use treatment and targets communities where the premature mortality gap is the largest.

“We feel optimistic that we may be able to start shifting some of this premature mortality that we have noticed in those most impacted communities,” said Olusimbo Ige, Commissioner of the Chicago Department of Public Health, in a Jan. 2025 statement. 

Threats to Community Health Centers

The impact would be particularly severe for Chicago’s network of community health centers, which serve as crucial healthcare access points in underserved neighborhoods. Project 2025’s proposed changes to the 340B program and Medicaid funding could force many of these centers to scale back services or close entirely.

“Free colonoscopies and mammograms, mobile clinics and free transportation to appointments are not a luxury for people without other options. They only happen at our clinics and at hospitals across the state through the 340B Program,” explained Ollie Idowu, President and CEO of Illinois Primary Health Care Association. “Limiting their ability to provide care would create healthcare deserts in communities that already face significant barriers to access.”

Looking Ahead

As Chicago works to implement its ambitious health equity agenda, Project 2025 threatens to roll back progress in the expansion of medical care and exacerbate existing health disparities in a city already struggling with significant inequities.

“The consequences of these proposed changes would reverberate through Chicago’s healthcare system for years to come,” warned Micheal Smith, Board Certified Chaplain for Bishop Anderson House Chicago. “We’re not just talking about policy changes, we’re talking about the potential reversal of hard-won progress in addressing systemic health inequities.”
For Chicago’s priority communities–from East Garfield Park to Englewood–the stakes couldn’t be higher. As the city continues its work to close the life expectancy gap, the potential implementation of Project 2025 presents a critical challenge to achieving health equity in one of America’s most segregated cities.

More Reads by TCR