Eliminating Equity: A Culture-Centered Reading of the Attack on Health Equity in Project 2025's Mandate for Leadership.

Abstract

Project 2025's Mandate for Leadership proposes a sweeping reorganization of the United States Department of Health and Human Services (HHS). This article reads the Mandate's HHS chapter through the culture-centered approach (CCA), joining its account of structure, culture, agency, voice, and communicative inequality to a critical discourse analysis of the chapter's mission statement, its five governing goals, and its data provisions. The chapter does more than oppose equity policies. It reorganizes the conceptual and infrastructural conditions under which health inequity can be named, measured, and redressed. To describe that work the article develops communicative eliminationism: the administrative withdrawal of the categories that make the structural determinants of health visible to evidence, funding, and care. Five operations carry the withdrawal, recoding, un-naming, conditioning, displacing, and enumerating, and they reach three registers of increasing depth, from the recoding of a category through its administrative un-naming to the withdrawal of the infrastructure that sustains it. The chapter recodes equity as ideology, un-names disfavored forms of care, redistributes the power of refusal, installs a sacralized family form as a metric of health, and turns health surveillance from recognition toward monitoring. Read alongside the normative rationales its own authors offer, the chapter suspends each rationale exactly where it would protect the populations it names, and that asymmetry is the strongest evidence for the eliminationist reading. On culture-centered premises, defending health equity means protecting the infrastructures of recognition and organizing for structural transformation, not culturally sensitive communication inside categories that are being erased.