Robert F Kennedy Jr said the nation’s health agencies will cut 10,000 jobs from their 82,000-person workforce – an enormous reduction the US health secretary characterized as streamlining federal bureaucracy amid internal resistance to the administration’s agenda.
The cuts announced on Thursday, along with previous restructuring and voluntary buyouts, mean the Department of Health and Human Services (HHS) will lose roughly 20,000 workers.
Kennedy said the department will also close half of its regional offices and create a new agency called the “administration for a healthy America”, or AHA.
“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,” Kennedy said on Thursday morning.
HHS is among the largest branches of the federal government, overseeing a $1.7tn budget and agencies that are household names. Among the agencies under HHS’s oversight are the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Centers for Medicare and Medicaid Services (CMS), and the Food and Drug Administration (FDA).
The critical work performed by these agencies includes protecting Americans from outbreaks and infectious disease at the CDC, helming the world’s largest publicly funded biomedical and behavioral research agency at the NIH, providing health insurance to 137 million Americans through the public programs Medicare and Medicaid at the CMS, and approving and regulating the nation’s medical devices, drugs and foods at the FDA.
Donald Trump and his billionaire ally Elon Musk, who oversees the massive federal job-cutting initiative via the unofficial “department of government efficiency”, have been gutting agencies as part of an effort to shrink the federal bureaucracy, with cuts that have roiled health agencies in particular.
“Any cut you make to a health agency should be done with incredible care and consideration for the hundreds of millions of Americans who rely on their work to stay healthy and get treatment when they’re sick,” said Chiquita Brooks-LaSure, previously the Biden administration’s CMS administrator and now a senior fellow at the Century Foundation. Taking a “wrecking ball” to health agencies and “laying off thousands of people … doesn’t move us forward”, Brooks-LaSure said.
In his announcement, Kennedy also alluded to internal resistance to the upheaval at HHS, saying: “In one case, defiant bureaucrats impeded the secretary’s office from accessing the closely guarded databases that might reveal the dangers of certain drugs and medical interventions.” Kennedy did not specify the databases or medical interventions in question.
In a description of the cuts, HHS said it plans to eliminate 3,500 full-time employees at the FDA. The administration claimed the cuts would not affect inspectors or drug, medical device and food reviewers. The CDC will lose 2,400 staff members, with the Administration for Strategic Preparedness and Response folded into the CDC. The NIH will lose a further 1,200 employees across its 27 institutes and centers. The CMS will lose 300 people. HHS did not provide a detailed breakdown of the programs, services or roles to be cut.
“We are getting panicked calls from our health agencies about what funding is going to get cut off,” said Democratic US senator Patty Murray of Washington state, noting the country is in the midst of a severe flu season and expanding measles outbreak in west Texas. Murray added the administration’s move appears to be an illegal “impounding” of funds allocated by Congress.
The restructuring will also consolidate 28 branches of the department into 15 new divisions, including the new AHA. AHA will combine offices in HHS that address addiction, mental health, toxic substances and occupational safety, among others, into one central office, the agency said. The new units will also centralize functions such as external affairs, human resources and IT, HHS said.
“Today’s announcement is not just a restructuring of the Department of Health and Human Services, it is a catastrophe for the health of every American,” said Democratic senator Edward Markey of Massachusetts. “Kennedy, Musk and Trump only serve themselves and the wealthiest people in our country.”
While Democrats argued the downsizings are in service of extending tax cuts to the wealthy, consumer advocates also sounded alarms, arguing mass layoffs will inevitably close programs.
The consumer group Public Citizen said cuts to the FDA increase “the chances that more unsafe drugs and medical devices will be marketed and that all of us will suffer preventable diseases”.
The massive restructuring comes as research funding is under threat. The NIH canceled nearly 400 active grants since the administration took the reins, with diversity, equity and inclusion programs; transgender issues; and research into South Africa and now Covid-19 as targets for defunding. The Office of Long Covid Research and Practice announced this week it would be shuttered as part of the reorganization.
A report in Nature on Wednesday revealed that federal workers who manage the government’s research investments with scientists had been directed to cancel Covid-19 research grants, a category potentially encompassing $850m and more than 600 projects. Funding freezes at the same agency have thrown into upheaval critical research on diseases as diverse as pediatric cancer and Alzheimer’s disease.
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Reuters contributed reporting
