In a sweeping reorganization, the U.S. Department of Health and Human Services (HHS) is set to lay off 10,000 employees and discontinue entire agencies, including those that manage billions of dollars in funding for addiction services and community health centers nationwide.
This drastic move is part of a broader restructuring plan announced by Health Secretary Robert F. Kennedy Jr., who has criticized the department as an inefficient "sprawling bureaucracy."
According to The Associated Press, Kennedy, in a video posted on social media, blamed the department's 82,000 workers for a decline in Americans' health. He stated, I want to promise you now that were going to do more with less. This announcement comes after weeks of upheaval at the nation's top health department, which has been riddled with rumors of mass firings, the withdrawal of $11 billion in public health funding for cities and counties, a lukewarm response to a measles outbreak, and controversial remarks about vaccines from its new leader.
Despite the turmoil, Kennedy warned of a "painful period" ahead for the HHS, which is tasked with monitoring infectious diseases, inspecting foods and hospitals, and overseeing health insurance programs for nearly half the country. The department will downsize to 62,000 positions, losing nearly a quarter of its staff 10,000 jobs through layoffs and another 10,000 workers who opted for early retirement and voluntary separation offers encouraged by President Donald Trumps administration.
The Wall Street Journal was the first to report these staffing cuts. The plans were met with swift criticism from public health experts, doctors, current and former HHS workers, and congressional Democrats, who warned of potential dire consequences for millions of people. Brian Ronholm, director of food policy at Consumer Reports, said in a statement, These staff cuts endanger public health and food safety. They raise serious concerns that the administrations pledge to make Americans healthy again could become nothing more than an empty promise.
However, Kennedy, while announcing the restructuring, lambasted HHS for failing to improve Americans lifespans and not doing enough to drive down chronic disease and cancer rates. He said, All of that money, referring to the departments $1.7 trillion yearly budget, has failed to improve the health of Americans.
Despite these claims, the American Cancer Society reports that cancer death rates have dropped 34% over the past two decades, translating to 4.5 million deaths avoided. This is largely due to smoking cessation, the development of better treatments many funded by the National Institutes of Health, including groundbreaking immunotherapy and earlier detection.
The restructuring plan also highlights Kennedys push to centralize control of the public health agencies the NIH, the Food and Drug Administration, and the Centers for Disease Control and Prevention which have traditionally operated with a level of autonomy from the health secretary. Under the plan, external communications, procurement, information technology, and human resources will be centralized under HHS.
Federal health workers across the country, including at the NIH and FDA, both in Maryland, expressed shock, fear, and anxiety following the announcement. Workers were not given advance notice of the cuts, and many remained uncertain about their job security. One FDA staffer, speaking anonymously out of fear of retaliation, said, Its incredibly difficult and frustrating and upsetting to not really know where we stand while were trying to keep doing the work. Were being villainized and handicapped and have this guillotine just hanging over our necks.
The HHS provided a breakdown of some of the cuts, which include 3,500 jobs at the FDA, 2,400 jobs at the CDC, 1,200 jobs at the NIH, and 300 jobs at the Centers for Medicare and Medicaid Services. The department anticipates that these changes will save $1.8 billion per year but did not provide a detailed breakdown.
The depth of the cuts and consolidation has left many employees devastated. An NIH employee said, Were all pretty devastated. We dont know what this means for public health. Union leaders for CDC workers in Atlanta received notice from HHS that reductions will focus on administrative positions, including human resources, finance, procurement, and information technology.
At CMS, where cuts focus on workers who troubleshoot problems for Medicare beneficiaries and Affordable Care Act enrollees, the result will be the lowest customer service standards for thousands of cases, according to Jeffrey Grant, a former deputy director at the agency who resigned last month.
Beyond the loss of workers, Kennedy plans to shut down entire agencies, some of which were established by Congress decades ago. Several will be folded into a new Administration for a Healthy America. These include the Health Resources and Services Administration, which oversees and provides funding for hundreds of community health centers around the country, and the Substance Abuse and Mental Health Services Administration, which funds clinics and oversees the national 988 hotline. Both agencies pump billions of dollars into local community work.
Keith Humphreys, a Stanford University addiction researcher, raised concerns about Kennedys commitment to treating addiction and mental health, saying, Burying the agency in an administrative blob with no clear purpose is not the way to highlight the problem or coordinate a response.
The Administration for Healthy America will focus on maternal and child health, environmental health, and HIV/AIDS work, according to HHS. The Administration for Strategic Preparedness and Response, responsible for maintaining the national stockpile that was quickly drained during the COVID-19 pandemic, will also be eliminated and moved into the CDC.
Republican Sen. Mike Rounds of South Dakota said the ramifications of Kennedys plans for HHS are unclear, stating, Well just wait and see what it is, and then well go back and try to fix if there is something broken.
However, Democratic Sen. Patty Murray of Washington warned that the fallout is clear, stating, It does not take a genius to understand that pushing out 20,000 workers at our preeminent health agencies wont make Americans healthier. Itll just mean fewer health services for our communities, more opportunities for disease to spread, and longer waits for lifesaving treatments and cures.
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