The end of March in the United States brought more staff cuts by the Department of Government Efficiency (DOGE), this time at the Department of Health and Human Services.
The HHS, now led by Secretary Robert Kennedy, Jr., announced 10,000 full-time positions across health agencies will be eliminated, as reported by CNN, in accordance with efforts by DOGE and President Donald Trump to end government waste. The staff cuts come after 10,000 employees already voluntarily resigned, so what was a workforce of 82,000 will become 62,000.
An abrupt end to federal grant funding for local and state health departments caught officials off guard. The funding began during the COVID-19 pandemic.
In February, approximately 5,200 HHS probationary workers were terminated in Trump’s first round of federal layoffs. Although not affecting drug, medical device or food reviewers/inspectors, the U.S. Food and Drug Administration will lose 3,500 full-time employees, the U.S. Centers for Disease Control & Prevention will lose 2,400, the National Institutes of Health will lose 1,200 and the Centers for Medicare and Medicaid Services will lose 300 employees.
With reduced staffing, the HHS will consolidate 28 divisions into 15 and reduce regional offices from 10 to five. A new division will be called the Administration for a Healthy America. The federal government will save $1.8 billion per year with the staff reductions. HHS will prioritize ending “America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins.” The HHS will ensure Medicare, Medicaid and other health services “remain intact” in the restructuring.
“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic. This department will do more – a lot more – at a lower cost to the taxpayer,” said Kennedy in a statement.
The Administration for a Healthy America will be a combination of the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry and the National Institute for Occupational Safety and Health. The new division will focus on primary care, workforce development, HIV/AIDS, maternal and child health, environmental health and mental health.
Public health experts expressed concern about the existing public health workload on a reduced staff.
“Reducing duplication and improving government efficiency is needed, the question is consequences. Cutting your home budget might be a good idea, but not if it means your kids starve. Makes one wonder who will be left at HHS to lead their efforts to Make America Healthy Again,” Brian Castrucci, president and CEO of the de Beaumont Foundation, said.
Larry Levitt, executive vice president for health policy at KFF, a nonpartisan health research group, said the staff cuts “will ultimately affect government services and be felt by the public and health care providers.”
“Reductions in the federal workforce may seem more efficient, but it could result in more wasteful spending down the road. New efforts to improve healthy behaviors may work at cross purposes to dramatic reductions in federal programs and big cuts to Medicaid being considered by Congress,” Levitt said.
The cuts are “alarming” and could cause “reverberating damage,” according to American College of Obstetrics and Gynecologists President Dr. Stella Dantas. She said in a statement that the “work and expertise of HHS staff are critical to the well-being of our entire population — and to physicians’ ability to provide care to patients.”
“This attack on public health — and HHS’ ability to advance it — will hurt people across the United States every single day,” Dantas said.
America’s Essential Hospitals is the trade association for hospitals that care for low-income and uninsured people. The association said the restructure of the HHS will “compromise the infrastructure needed to serve patients effectively.”
“Assistance from federal partners is key for our hospitals to ensure that low-income and older Americans have access to health care,” Beth Feldpush, the group’s senior vice president of policy and advocacy, said in a statement.
Kennedy said in a video posted on X in late March that a “painful period” is ahead but necessary for efficiency.
“No American is going to be left behind,” Kennedy said in the video.
A new assistant secretary for enforcement will oversee the Office for Civil Rights, the Department of Appeals Board and the Office of Medicare Hearings and Appeals.
The Assistant Secretary for Planning and Evaluation and the Agency for Healthcare Research and Quality will be combined into the new Office of Strategy “to enhance research that informs the Secretary’s policies and improves the effectiveness of federal health programs.”
The CDC will oversee the Administration for Strategic Preparedness and Response, which includes 1,000 employees moving to the CDC.
Cuts at the Centers for Medicare & Medicaid Services will most affect account management teams and caseworkers, who assist Affordable Care Act health plan consumers and Medicare Advantage beneficiaries with enrollment. Account management teams handle health insurance plans and ensure compliance with regulations.
The HHS said the probable effective date for all employees affected by the layoffs, which mostly includes administrative jobs in information technology, human resources and procurement and finance, would be May 27. The goal is to target positions in areas of redundancy or duplicative efforts at the HHS or the entire federal government.
The HHS layoffs are considered “disastrous” according to the National Treasury Employees Union and promised to fight for union members.
“The American people do not support indiscriminate cuts curtailing or eliminating local health programs, endangering the health and safety of children and families, and inflicting real economic harm in small towns and big cities across the country,” NTEU National President Doreen Greenwald said in a statement.
Thirteen lawmakers, including U.S. Sen. Mark R. Warner of Virginia sent a letter to Kennedy on April 3 regarding staff members cut who administered the Low Income Home Energy Program (LIHEAP). The letter states that the layoffs “threaten to devastate a critical program dedicated to helping Americans afford their home energy bills.”
For more than 40 years, the program has been the main federal program to assist low-income households and seniors with energy bills. In 2024, more than 6 million American households relied on the program.
“It is an indispensable lifeline, helping to ensure that recipients do not have to choose between paying their energy bills and affording other necessities like food and medicine,” the lawmakers wrote.
Concerned for the HHS’s ability to deliver critical funding to low-income seniors and families, the lawmakers also expressed concern for local community action agencies that help enroll qualified beneficiaries. The states are expecting the HHS to release nearly $400 million in FY25 funding in late April.
“Any delay in providing this funding will set back efforts to provide summer cooling grants, weatherize low-income homes, and plan for the next winter heating season,” they wrote.
Affordable home energy is a matter of health and safety for America‘s low-income households, children and seniors. The lawmakers encouraged the HHS to reverse staffing cuts.
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Rebecca Barnabi
