Updated March 27, 2025 at 14:33 PM ET
The Trump administration Thursday announced a major restructuring of the U.S. Department of Health and Human Services that will cut 20,000 full-time jobs.
The cuts include employees who have taken the Trump administration's Fork in the Road offer and early retirement, plus an additional reduction in force of 10,000 jobs. It will take the HHS workforce from 82,000 to 62,000, according to a news release from the agency.
The restructuring also includes a reorganization of the department's many divisions to reduce them from 28 to 15.
"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," HHS Secretary Robert F. Kennedy Jr. said in the news release. "This Department will do more — a lot more — at a lower cost to the taxpayer."
HHS is the umbrella agency that includes the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the National Institutes of Health (NIH) and other smaller divisions.
The restructuring will include the creation of a new Administration for a Healthy America (AHA), which is intended to "more efficiently coordinate chronic care and disease prevention programs," according to an HHS fact sheet. It will consolidate several existing agencies, with a focus on primary care, maternal and child health, mental health and HIV/AIDS.
The cuts include 3,500 full-time employees at the FDA, 2,400 at the CDC, 1,200 at NIH and 300 at the Centers for Medicare & Medicaid Services, according to the fact sheet. It states that the new job cuts at the FDA will not affect drug, medical device or food reviewers or inspectors. The reorganization will not impact Medicare or Medicaid.
HHS states that the job cuts will save $1.8 billion. The agency currently has a budget of nearly $2 trillion, the majority of which pays for benefits for Americans covered by Medicaid and Medicare.
These cuts align with President Trump's vision of drastically reducing the size and scope of the federal government — an effort that has been led so far by Elon Musk and his Department of Government Efficiency (DOGE).
"There is a benefit to occasional reorganizations of HHS. But, this is also about big staff and program reductions," Larry Levitt of the nonpartisan health research organization KFF wrote on social media.
"A lot of what HHS employees do is behind the scenes oversight, to prevent fraud and abuse and ensure health care programs provide the services promised. Reductions in the federal workforce could result in more wasteful spending down the road."
In a social media video posted Thursday morning, Kennedy characterized HHS as a dysfunctional, sprawling bureaucracy.
In the video, he vacillated between praising his department's staff and their work and accusing them of harming Americans' health.
"When I arrived, I found that over half of our employees don't even come to work," he said. (HHS did not immediately respond to a question about whether the employees were in approved teleworking arrangements, placed on administrative leave or something else.)
"HHS has more than 100 communications offices and more than 40 IT departments and dozens of procurement offices and nine HR departments. In many cases, they don't even talk to each other."
He described "little fiefdoms" within HHS of being "so insulated and territorial that they actually hoard our patient medical data and sell it for profit to each other," though he didn't offer further details.
"While public health declines, a few isolated divisions are neglecting public health altogether and seem only accountable to the industries that they're supposed to be regulating," he said, without naming the divisions or industries he was referencing.
Sen. Angela Alsobrooks, D-Md., wrote in a statement that the plan to cut 20,000 jobs from HHS was "dangerous and deadly."
"These mass layoffs at Health and Human Services will cost human lives," Alsobrooks said. "I will do all I can to fight this."
Sen. Bill Cassidy, R-La., posted on X that he'd like to see HHS work better on things like rapidly approving drugs and improving Medicare services. "I look forward to hearing how this reorganization furthers these goals."
And one of Kennedy's allies in the Make America Healthy Again movement, writer and entrepreneur Calley Means, wrote an X post praising the restructure: "The insane spending and staffing in healthcare is actually the cause of our bad health outcomes."
The cuts are rattling staff at the health agencies, according to three current NIH employees who did not want to be identified because of fears of retribution.
"People are exhausted. More than worried for their own livelihoods, people are scared for the future of the NIH [and] its science," one employee said. "I'm hearing people express some tepid hope they'll be spared, some resignation that they'll likely be fired, and lots of people not even sure that NIH will be a hospitable place to be even if they survive the RIF [reduction in force]."
Another NIH employee said the agency has lost about 4,400 employees so far out of a staff of about 18,000. These include 1,200 in the RIFs announced on Thursday, 1,200 probationary employees who were previously fired and about 2,000 who took early retirement, the buyout or the Fork in the Road offer.
People will find out whether they are losing their jobs Friday and the RIFs will take effect in May, the person said. NIH employees are bracing for more possible cuts that could occur if Dr. Jay Bhattacharya, the new incoming NIH director, orders his own reorganization of NIH.
A third NIH employee said the RIFs are primarily affecting administrative staff, like HR, IT, procurement and finance.
"It is impossible for me to imagine that cuts of this size will not substantially affect functions negatively," said Jeremy Berg of the University of Pittsburgh, who served as the director of the National Institute of General Medical Sciences, part of the National Institutes of Health, from 2003 to 2011. "This represents yet another assault on the ability of NIH to achieve its important missions," he added.
The restructure also moves the Administration for Strategic Preparedness and Response (ASPR) — which handles medical responses to natural disasters and public health emergencies — from reporting directly to the health secretary to being housed under the CDC. Dawn O'Connell, former head of ASPR in the Biden administration, told NPR that the move could limit its scope. "It's curious to me that they would put us into CDC at a time when they want CDC to focus on infectious disease work."
Under the Biden administration, ASPR was elevated into an operating division so it could respond more nimbly to emergencies, in response to lessons learned during the COVID-19 pandemic, O'Connell said.
"I don't begrudge a new administration coming in to figure out whether we got it right. But this idea of wholesale losing the progress that we made and fought for is going to put them back," she said.
Dr. Georges Benjamin, head of the American Public Health Association, said in a statement that the HHS restructuring, paired with an $11 billion cut in funding to state and local health departments announced this week, runs counter to the goal of improving health in the United States.
"This is a nonsensical rearrangement of the agencies under their charge and an excuse to devastate the workforce for financial reasons," said Benjamin. "It will increase the morbidity and mortality of our population, increase health costs and undermine our economy."
The union representing many federal workers, the National Treasury Employees Union, issued a statement Thursday condemning the cuts and saying it will "fight back."
"If this disastrous plan is carried out and the agency loses an additional 10,000 employees, as proposed, the impact to public health services across the country will be devastating," said NTEU President Doreen Greenwald.
Have information you want to share about the ongoing changes across federal health agencies? Reach out to these authors via encrypted communications: Selena Simmons-Duffin @selena.02, Pien Huang @pienhuang.88 and Rob Stein @robstein.22.
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