Project 2025 abortion surveillance idea comes back to bite Trump

As Donald Trump continues to flounder around his response to a sustained assault from Democrats over policy prescriptions in the Heritage Foundation’s Project 2025, his rivals are sticking the knife in further.

The DNC is out with a new memo on Thursday detailing how conservatives hope to use a second Trump presidency to expand state-led efforts to monitor women who get abortions — even if they do so in states where the practice is legal.

Those efforts directly conflict with Trump’s stated desire to leave the issue up to state governments. A shift in federal policy could end up being a clear thumb on the scale in favor of conservative states who wish to police the practice of abortion outside their borders.

The ex-president has trodden a winding path on the issue of abortion rights. He routinely insists that he does not support a national ban on abortion and wants the issue left up to the states, even as he simultaneously and repeatedly has claimed credit for the end of federal protections on abortion.

He has also endorsed any conservative state government push to monitor womens’ pregnancies in past interviews. In two separate instances this year, Trump implied that he would not oppose any Republican push to level such surveillance against pregnant women.

Democrats have seen an angle of opportunity here, and are now tying the former president to language in the Project 2025’s section on the Department of Health and Human Services (HHS.) The project details how it would direct a conservative HHS chief to get rid of guidance around the agency’s rules regarding patient information disclosures, including a portion which explicitly states that a health care provider would be prohibited from reporting a patient’s intent to seek abortion care in a state where the practice is legal to government officials in the patient’s home state.

“A pregnant individual in a state that bans abortion informs their health care provider that they intend to seek an abortion in another state where abortion is legal. The provider wants to report the statement to law enforcement to attempt to prevent the abortion from taking place. However, the Privacy Rule would not permit this disclosure of PHI to law enforcement under this permission for several reasons,” reads the HHS rule guidance Project 2025 wants to delete. The conservative-led effort describes the rule guidance as “unnecessary” and “ideologically motivated fearmongering about abortion”.

Trump has made efforts within the past few weeks to burn his bridges with Project 2025. The project is a collaboration of dozens of groups that support his campaign and is spearheaded by officials with direct experience in Trump’s first administration. Its policy lead announced that he would step down this week, an announcement which was quickly celebrated as a successful targeted hit by the Trump campaign.

Notably, the deletion of any rule guidance on confidentiality in health care would not change the rules themselves. The agency would have to go through the formal rule review process to amend or throw out a HIPAA rule finalized by the agency earlier this year which HHS officials said was meant to “better protect patient confidentiality and prevent medical records from being used against people for providing or obtaining lawful reproductive health care”.

But Project 2025 and Donald Trump’s running mate, JD Vance, both have stated clear opposition to this rule.

“Abortion is not health care — it is a brutal act that destroys the life of an unborn child and hurts women. Congress did not authorize HHS to extend special provisions for abortion such as these under the guise of ‘health care.’ The Proposed Rule unlawfully thwarts the enforcement of compassionate laws protecting unborn children and their mothers, and directs health care providers to defy lawful court orders and search warrants,” read a letter to the agency Vance signed on to in 2023 when the rule was first proposed.

Vance has sought to aid Trump’s efforts to find a more politically palatable abortion position ahead of the general election. Explaining how his own statements in support of a national ban gelled with his running mate’s, Vance said this month: “I’m the vice presidential nominee and not the presidential nominee, and if I want my views on abortion to dominate the Republican party then I run for president. And I didn’t and I haven’t. Donald Trump ran for president.“

“Obviously as a member of the campaign I’m going to support... states making the decision, having a respect for the will of the voters to decide what local abortion policy will be,” he added.

But Democrats are seeking to remind voters that much of Trump’s policymaking in a second term would likely mirror his first — i.e. carried out by political appointees across government and not necessarily through the stroke of a pen at the White House.

"Because of Trump, prosecutors looking to enforce draconian anti-abortion laws in the states are now free to go after reproductive health data in mobile apps,” said DNC national press secretary Emilia Rowland in a statement to The Independent. “ But Trump and Vance’s Project 2025 agenda would go even further — calling for every abortion, miscarriage, stillbirth, and incidental pregnancy loss from medical treatments like chemo to be reported to the federal government under a Trump administration, tearing away health data privacy protections under HIPAA, and allowing states to surveil patients and doctors, monitor pregnancies, restrict women’s freedom to travel for abortion care, and ultimately use health data against patients and providers in court. This isn’t about policy, it’s about control.”