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2025 U.S. Department of Health and Human Services reorganization

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In March 2025, a reorganization of the U.S. Department of Health and Human Services (HHS) was announced. The planned reorganization includes several organizational changes, including merging five existing agencies into a new Administration for a Healthy America, reorienting the Centers for Disease Control and Prevention towards infectious disease programs, and breaking up the Administration for Community Living. In addition, the plan proposes a reduction in workforce totalling about 20,000 full-time employees throughout HHS through multiple avenues, with the greatest relative reductions to the Food and Drug Administration and Centers for Disease Control and Prevention, which are each expected to reduce their workforce by 20%.

Background

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HHS Secretary Robert F. Kennedy Jr. announced the reorganization on March 27, 2025, as an implementation of President Donald Trump's Executive Order 14210.

The current organizational structure of HHS is the result of the Public Health Service reorganizations of 1966–1973,[1] as well as the 1980 spinoff of the Department of Education which caused HHS to be renamed from its former name, Department of Health, Education, and Welfare.[2] Since then there have been a few new operating agencies and minor reorganizations.[3]

The individual agencies within HHS draw their statutory authority from a patchwork of authorization bills passed by Congress, and administrative regulations instituted by the department or its agencies through the federal rulemaking process. On one extreme, the National Institutes of Health is authorized by the 1930 Ransdell Act and its subsequent amendments, which also specify all of its constituent institutes and centers, meaning these can only be changed by an act of Congress.[4] On the other extreme, the Centers for Disease Control and Prevention is not directly established by any statute, but by departmental regulation that delegates to it some authorities of the umbrella 1944 Public Health Service Act as amended, although specific statutes exist for three of its component centers.[5]

After the 2024 presidential election and the beginning of the second Trump administration, Robert F. Kennedy Jr. was confirmed as Secretary of Health and Human Services.[6] On February 11, 2025, President Trump signed Executive Order 14210, "Implementing the President's 'Department of Government Efficiency' Cost Efficiency Initiative". The order required large-scale reductions in force in consultation with the Department of Government Efficiency program, and submission of a reorganization plan by each agency to the Office of Management and Budget within 30 days.[7][8]

Provisions

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Organizational changes

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The Mary E. Switzer Memorial Building in Washington, DC contains the headquarters of ACL, which is planned to be broken up
5600 Fishers Lane in Rockville, Maryland holds the headquarters of HRSA, SAMHSA, and AHRQ, all of which are planned to be merged into other agencies
NIOSH, whose Taft Laboratory in Cincinnati, Ohio is pictured, is planned to be transferred from CDC to the new AHA

The reorganization is planned to reduce the number of top-level HHS divisions from 28 to 15.[7] The following top-level agencies are planned to be created from merging existing agencies:

The changes to existing top-level agencies are:

Offices at each agency dealing with human resources, information technology, procurement, external affairs, and policy are planned to be replaced with centralized HHS-wide offices.[7] Currently, HHS is said to have over 100 communications offices, over 40 information technology departments, dozens of procurement offices, and nine human resources departments.[13] Additionally, the ten existing HHS regional offices are planned to be consolidated into five.[7]

Reduction in force

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FDA, whose White Oak Campus headquarters is pictured, and CDC are each projected to lose 20% of their workforce

The plan proposes a reduction in workforce of about 10,000 full-time employees, in addition to 10,000 additional employees who voluntarily left through other programs including a Voluntary Early Retirement Authority and the Deferred Resignation Program. Taken together, these programs are expected to reduce HHS's workforce from 82,000 to 62,000 full-time employees, a figure that excludes about 5,200 probationary workers who were targets of the disputed 2025 mass layoffs.[7][14][15] Most of these reductions are planned to be targeted towards administrative functions.[7][14][13] The layoffs were projected to take effect on May 27, 2025.[13]

The Food and Drug Administration (FDA) is proposed to decrease its workforce by ~3,500 full-time employees,[7][14] a reduction of about 20%.[13] The FDA cuts would not be applied to drug, medical device, and food reviewers and inspectors.[16] However, the Center for Devices and Radiological Health faced significant layoffs.[17]

The Centers for Disease Control and Prevention (CDC) is proposed to decrease its workforce by ~2,400,[7][14] also a reduction of about 20%.[13] The announcement stated that only 1,000 of the Administration for Strategic Preparedness and Response's 5,000 employees would join CDC, implying that the rest would be laid off or reassigned.[16][12] Over two-thirds of the staff of the National Institute for Occupational Safety and Health was laid off, which most strongly impacted its mining safety research and respirator approval programs,[10] with its laboratory in Spokane, Washington expected to close completely,[18] as well as the National Firefighter Registry for Cancer.[17][19]

The National Institutes of Health is proposed to decrease it workforce by ~1,200, and the Centers for Medicare & Medicaid Services by ~300.[7][14] The Health Resources and Services Administration's workforce was decreased by a third, especially impacting its Bureau of Primary Health Care. The Indian Health Service was exempt from firings.[17]

Implementation

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The video announcement of the reorganization

The reorganization was announced through a press release and video posted on social media on March 27, 2025.[7][20][14] It was reported that there was no input from agency-level human resources staff or leadership before the reorganization was announced, and details beyond the press release were not immediately provided to employees.[16][12] The sending of notices was delayed due to tensions between HHS leadership and the DOGE lead for HHS, with the former being given extra time to scrutinize the firing plans.[21]

Notices went out to employees early in the morning of April 1, although some employees learned they had been laid off only when their entry badges failed to work when they arrived in the morning.[22][23][17] Long lines formed at the entrances to some federal buildings due to increased security. Because the layoffs targeted entire units, the normal process of ranking individual personnel to lay off was avoided.[17] Many senior leaders were told they were being reassigned to Indian Health Service locations in Alaska, Montana, New Mexico, Minnesota, or other locations far from Washington, DC, to entice them to leave voluntarily.[22][23]

Reaction

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The creation of the Administration for a Healthy America and the broader HHS restructuring have drawn criticism from public health experts, former officials, labor unions, and Democratic lawmakers. Critics argue that the layoffs—part of a plan to reduce HHS staff by 20,000 employees—will severely impact the department's capacity to respond to public health crises. Senator Patty Murray described the plan as “an absurd suggestion” that “defies common sense,” citing ongoing outbreaks of bird flu, measles, and the fentanyl epidemic.[13]

Labor unions also raised concerns. Doreen Greenwald, president of the National Treasury Employees Union, which represents around 18,500 HHS staff, stated the administration's claims that deep cuts to agencies like the Food and Drug Administration would not be harmful were "preposterous," and vowed to “pursue every opportunity to fight back.”[13] Critics further expressed unease about centralizing oversight under HHS Secretary Robert F. Kennedy Jr., who has a long history of promoting discredited claims regarding vaccine safety. Some employees cited fears about political interference in health data, particularly after Kennedy suggested in a public video that “defiant bureaucrats impeded the secretary’s office from accessing closely guarded databases.”[24]

References

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  1. ^ "Records of the Public Health Service [PHS], 1912-1968". National Archives. August 15, 2016. Sections 90.7, 90.8. Retrieved August 28, 2020.
  2. ^ "HHS Historical Highlights". U.S. Department of Health and Human Services. March 14, 2023. Retrieved March 27, 2025.
  3. ^ Redhead, C. Stephen; Dabrowska, Agata (October 13, 2015). "Public Health Service Agencies: Overview and Funding (FY2010–FY2016)" (PDF). U.S. Congressional Research Service. Retrieved October 16, 2018.
  4. ^ Sekar, Kavya (January 13, 2025). "The National Institutes of Health (NIH): Background and Congressional Issues". Congressional Research Service. Retrieved March 27, 2025.
  5. ^ Keyes, Drew; Zinberg, Joel M. (July 24, 2023). "Unauthorized and Unprepared: Refocusing the CDC after COVID-19". Paragon Health Institute. Retrieved March 27, 2025.
  6. ^ Weixel, Nathaniel (February 13, 2025). "Senate confirms RFK Jr. as Health secretary; McConnell lone GOP dissenter". The Hill. Retrieved March 30, 2025.
  7. ^ a b c d e f g h i j k l m n o "HHS Announces Transformation to Make America Healthy Again". U.S. Department of Health and Human Services. March 27, 2025. Archived from the original on March 27, 2025. Retrieved March 27, 2025.
  8. ^ "Implementing the President's "Department of Government Efficiency" Cost Efficiency Initiative". The White House. February 26, 2025. Retrieved March 27, 2025.
  9. ^ Owermohle, Sarah (March 28, 2025). "HHS emergency response unit given two days to figure out its fate". STAT. Retrieved March 31, 2025.
  10. ^ a b c Tin, Alexander (March 31, 2025). "RFK Jr.'s layoffs expected to gut worker safety agency NIOSH, officials say - CBS Colorado". CBS News. Retrieved April 1, 2025.
  11. ^ Lovelace Jr., Berkeley (March 27, 2025). "HHS plans to shutter or downsize several health agencies, including at CDC". NBC News. Retrieved March 27, 2025.
  12. ^ a b c Katz, Eric (March 31, 2025). "Uncertainty grips HHS as employees await their fate and leadership is left in the dark: 'It's madness'". Government Executive. Retrieved March 31, 2025.
  13. ^ a b c d e f g Stolberg, Sheryl Gay; Jewett, Christina (March 27, 2025). "10,000 Federal Health Workers to Be Laid Off". The New York Times. Retrieved March 27, 2025.
  14. ^ a b c d e f "The Trump administration restructures federal health agencies, cuts 20,000 jobs". NPR. Retrieved April 3, 2025.
  15. ^ Tirrell, Meg; Luhby, Tami; Goodman, Brenda; Gumbrecht, Jamie (March 27, 2025). "HHS cuts 10,000 employees in major overhaul of health agencies". CNN. Retrieved March 27, 2025.
  16. ^ a b c "HHS to lay off 10,000 employees and cut overall workforce by 20,000". Government Executive. March 27, 2025. Retrieved March 31, 2025.
  17. ^ a b c d e Katz, Eric (April 1, 2025). "Cancer researchers, opioid abuse analysts, infectious disease experts: Layoffs at HHS begin to take shape". Government Executive. Retrieved April 2, 2025.
  18. ^ Saglimbeni, Vinny; Gallo, Regan (April 1, 2025). "Concerns over safety rise as Spokane National Institute of Occupational Safety and Health workers face layoffs". KREM. Retrieved April 2, 2025.
  19. ^ Carey, Bill (April 2, 2025). "National Firefighter Registry for Cancer goes offline following NIOSH layoffs". FireRescue1. Retrieved April 3, 2025.
  20. ^ Kennedy Jr., Robert F. (March 27, 2025). "We are streamlining HHS to make our agency more efficient and more effective". X (formerly Twitter). Archived from the original on March 28, 2025. Retrieved March 31, 2025.
  21. ^ Cai, Sophia; Cancryn, Adam; Gardner, Lauren (March 31, 2025). "Internal fallout at HHS delays 10,000 firings". Politico. Retrieved April 2, 2025.
  22. ^ a b Johnson, Carolyn Y.; Roubein, Rachel; Achenbach, Joel; Sun, Lena H.; Weber, Lauren (April 1, 2025). "Widespread layoffs, purge of leadership underway at U.S. health agencies". The Washington Post. ISSN 0190-8286. Retrieved April 2, 2025.
  23. ^ a b Valencia, Nick; Goodman, Brenda; Tirrell, Meg; Luhby, Tami; Lyngaas, Sean (April 1, 2025). "'It's a bloodbath': Massive wave of job cuts underway at US health agencies". CNN. Retrieved April 2, 2025.
  24. ^ Cirruzzo, Chelsea; Cancryn, Adam (March 27, 2025). "'Painful period': RFK Jr. eliminates 10,000 jobs at HHS". Politico. Retrieved March 27, 2025.
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