HHS cuts 10,000 employees in major overhaul of health agencies

CNN

By Meg Tirrell, Tami Luhby, Brenda Goodman and Jamie Gumbrecht, CNN

(CNN) — The US Department of Health and Human Services announced Thursday that it is cutting 10,000 full-time employees across health agencies, the department told CNN.

This comes on top of 10,000 employees who’ve left voluntarily, shrinking the workforce from about 82,000 full-time employees to 62,000.

In addition, there are about 5,200 probationary workers, who have been in their positions less than a year or two and were terminated last month. Most are on temporary administrative leave as their fate winds its way through federal courts. They are not included in the latest announcement, HHS spokesman Andrew Nixon said.

The cuts were first reported by The Wall Street Journal.

In its announcement, HHS said it will consolidate from 28 to 15 divisions, including a new Administration for a Healthy America, and will reduce regional offices from 10 to five. The workforce reduction will save $1.8 billion per year, the agency said.

HHS’s new priority will be to end “America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins,” the agency said.

“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 a statement. “This Department will do more – a lot more – at a lower cost to the taxpayer.”

But the agency also said that it will ensure that Medicare, Medicaid and other essential health services will “remain intact” in the restructuring.

After the cuts were announced Thursday, public health experts said that maintaining services would be a challenge — or impossible — based on the existing public health workload, steep reductions in funding to state and local health departments and possible cuts to Medicaid.

“Reducing duplication and improving government efficiency is needed, the question is consequences,” said Brian Castrucci, president and CEO of the de Beaumont Foundation, a nonprofit that studies and supports the US public health workforce. “Cutting your home budget might be a good idea, but not if it means your kids starve. Makes one wonder who will be left at HHS to lead their efforts to Make America Healthy Again.”

In a video posted on X on Thursday, Kennedy acknowledged it will be a “painful period” as health agencies shrink but promised they would be more efficient, do more with less and focus on the new mission.

“No American is going to be left behind,” Kennedy said in the video.

“I want every HHS employee to wake up every morning asking themselves, what can I do to restore American health today?”

Thousands of jobs cut across agencies

HHS said Thursday that cuts will include:

• 3,500 full-time employees at the US Food and Drug Administration, not affecting drug, medical device or food reviewers or inspectors
• 2,400 employees at the US Centers for Disease Control and Prevention
• 1,200 employees at the National Institutes of Health due to centralizing procurement, human resources and communications
• 300 employees at the Centers for Medicare & Medicaid Services

Among the changes will be the new Administration for a Healthy America, which will combine the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry and the National Institute for Occupational Safety and Health. HHS said it will focus on areas such as primary care, maternal and child health, mental health, environmental health, HIV/AIDS and workforce development.

HHS will also create a new assistant secretary for enforcement, who will oversee the Office for Civil Rights, the Office of Medicare Hearings and Appeals and the Departmental Appeals Board.

A new Office of Strategy will combine the Assistant Secretary for Planning and Evaluation with the Agency for Healthcare Research and Quality “to enhance research that informs the Secretary’s policies and improves the effectiveness of federal health programs.”

The Administration for Strategic Preparedness and Response, which handles disaster and public health emergency responses, will move under the CDC. About 1,000 employees will move to the CDC as part of the change.

The Administration for Community Living, which support older adults and people with disabilities, will be integrated into other HHS agencies.

At the Centers for Medicare & Medicaid Services, the cuts will weigh heavily on caseworkers and account management teams, according to a former HHS employee. Caseworkers assist Affordable Care Act health plan consumers and Medicare Advantage beneficiaries with enrollment if they can’t be helped by call center personnel. And account management teams deal with health insurance plans to make sure they are complying with regulations and to answer their questions.

“Service standards for Medicare Advantage beneficiaries and Affordable Care Act consumers will suffer with a reduction in the people that handle their cases and with diminished oversight of the Medicare Advantage plans,” the person said.

Employee notices to go out as soon as Friday

HHS sent a formal reduction in force, or RIF, notice to American Federation of Government Employees union leaders early Thursday morning.

About 8,000 to 10,000 employees will be affected by the layoffs, with the probable effective date being May 27, said the email, which was sent by Thomas J. Nagy Jr., deputy assistant secretary for human resources at HHS, and viewed by CNN.

Specific notices to employees may be sent as soon as Friday, the email said.

The reductions are mainly aimed at administrative jobs, including human resources, information technology, procurement and finance, according to the email. It will also target roles in high-cost regions and employees in areas that have been deemed redundant or duplicative within HHS or across the federal government.

HHS is still finalizing the list of so-called “competitive areas,” which defines the organizational or geographical scope in which employees compete for positions during a RIF, the email said.

The union was asked to advise if or when it would like to start negotiating on impact and implementation.

The National Treasury Employees Union, which also represents workers at the agency, called the plan “disastrous” and vowed to fight for its members and HHS’ overall mission.

“The American people do not support indiscriminate cuts curtailing or eliminating local health programs, endangering the health and safety of children and families, and inflicting real economic harm in small towns and big cities across the country,” union National President Doreen Greenwald said in a statement.

Heavy workloads and impacts to care

Chiquita Brooks-LaSure, former administrator of the Centers for Medicare & Medicaid Services, likened the cuts to a “wrecking ball.”

“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,” Brooks-LaSure, now a fellow at the Century Foundation, said in a statement. “We certainly have progress to make to ensure every American can access safe, affordable, timely health care, but laying off thousands of people working toward that progress doesn’t move us forward.”

Dr. Georges Benjamin, executive director of the American Public Health Association, said morale at public health agencies was already the “lowest it’s ever been” as people struggle with heavy workloads.

“I’ve done big reorganizations before. You have to do them very, very carefully, very deliberately. Every time you move the boxes around, every time you downsize or upsize organizations, you make them dysfunctional for some period of time,” he said.

With the confirmation of staffing cuts and defunding of state health agencies, Benjamin said American life expectancy would almost certainly get worse, not better, as a result of these changes.

“Not only are they breaking the federal infrastructure, but they just broke the state and local infrastructure on top of this, so the states and locals can’t even pick up the slack,” Benjamin said.

The personnel reductions “will ultimately affect government services and be felt by the public and health care providers,” said Larry Levitt, executive vice president for health policy at KFF, a nonpartisan health research group.

“Reductions in the federal workforce may seem more efficient, but it could result in more wasteful spending down the road,” Levitt said. “New efforts to improve healthy behaviors may work at cross purposes to dramatic reductions in federal programs and big cuts to Medicaid being considered by Congress.”

Dr. Stella Dantas, president of the American College of Obstetricians and Gynecologists, said in a statement that the the “work and expertise of HHS staff are critical to the well-being of our entire population—and to physicians’ ability to provide care to patients.”

The cuts were “alarming,” she said, and risk “reverberating damage” to the US health system now and in the future: “This attack on public health—and HHS’ ability to advance it—will hurt people across the United States every single day.”

America’s Essential Hospitals, the trade association for hospitals that care for low-income and uninsured people, also voiced concerns that the restructuring could “compromise the infrastructure needed to serve patients effectively.”

“Assistance from federal partners is key for our hospitals to ensure that low-income and older Americans have access to health care,” Beth Feldpush, the group’s senior vice president of policy and advocacy, said in a statement.

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