On March 27, 2025, the US Department of Health and Human Services (HHS) announced a significant restructuring plan that includes cutting 10,000 full-time employees across various health agencies. This move follows the voluntary departure of another 10,000 employees, reducing the workforce from approximately 82,000 to 62,000. Additionally, around 5,200 probationary workers, who were terminated last month, are not included in this latest announcement. The cuts are part of a broader reorganization that aims to consolidate the department’s divisions from 28 to 15 and reduce regional offices from 10 to five. HHS Secretary Robert F. Kennedy Jr. claims these changes will save $1.8 billion annually.

The Rationale Behind the Cuts

HHS argues that the restructuring is necessary to streamline operations and realign the organization with its core mission of improving public health. The new priority, according to Kennedy, is to end “America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins”. He asserts that the department will “do more—a lot more—at a lower cost to the taxpayer”. This vision includes the creation of a new Administration for a Healthy America, which will combine several existing agencies to focus on primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development.

The Impact on Public Health Services

Despite assurances that essential services like Medicare and Medicaid will remain intact, public health experts are skeptical. Brian Castrucci, president and CEO of the de Beaumont Foundation, warns that while reducing duplication and improving efficiency are necessary, the consequences of such drastic cuts are uncertain. He likens the situation to cutting a household budget at the expense of one’s children’s well-being, questioning who will be left at HHS to lead efforts to improve public health.

The National Treasury Employees Union, which represents many HHS workers, has called the plan “disastrous” and vowed to fight for its members and the department’s mission. Union President Doreen Greenwald argues that the cuts will endanger the health and safety of American families and inflict economic harm across the country.

The Broader Implications

The restructuring will affect several key agencies within HHS. The US Food and Drug Administration (FDA) will lose 3,500 full-time employees, though drug, medical device, and food reviewers and inspectors will remain unaffected. The Centers for Disease Control and Prevention (CDC) will cut 2,400 employees, while the National Institutes of Health (NIH) will reduce its workforce by 1,200 due to centralization of procurement, human resources, and communications. The Centers for Medicare & Medicaid Services will also see a reduction of 300 employees.

These changes could have far-reaching consequences. Former HHS employee Chiquita Brooks-LaSure likens the cuts to a “wrecking ball,” emphasizing the need for careful consideration when making cuts to health agencies. Dr. Georges Benjamin, executive director of the American Public Health Association, warns that morale at public health agencies is already at an all-time low due to heavy workloads. He argues that the cuts will likely worsen American life expectancy and break both federal and state health infrastructures.

A Balancing Act

The HHS restructuring represents a bold attempt to streamline operations and realign priorities. However, the potential negative impact on public health services and morale cannot be ignored. As the department moves forward with these changes, it will be crucial to monitor the effects closely and ensure that essential services remain accessible to all Americans. The success of this transformation will depend on striking a delicate balance between efficiency and effectiveness, while maintaining a commitment to the health and well-being of the nation.