In a far reaching reorganization, the U.S. Department of Health and Human Services (HHS) will lay off 10,000 workers and close a number of agencies that include those tasked with monitoring billions of dollars in funding for addiction treatment and community health programs across the country.

Health Secretary Robert F. Kennedy Jr. criticized the department’s inefficiency in a video announcement on Thursday, calling it a "sprawling bureaucracy" that has failed to improve Americans' health. "We’re going to do more with less," Kennedy stated.

The reorganization comes after weeks of rumors of wholesale layoffs, the removal of 11 billion in public health funding, and criticism of the administration's response to a measles outbreak. HHS, which oversees infectious disease surveillance, food and hospital inspections, and healthcare programs for almost half the country, will cut its workforce from 82,000 to 62,000 jobs. This will involve 10,000 layoffs and another 10,000 leaving through early retirement and voluntary departures.

Public Health Concerns About the Impact

The move has received criticism from lawmakers, public health experts, and HHS workers, who worry that the budget cuts will imperil crucial services. Brian Ronholm, who is a food policy director at Consumer Reports, cautioned that cuts in staff levels could risk undermining public health as well as food safety.
Kennedy, however, defended the restructuring, arguing that despite the department’s 1.7 trillion annual budget, health outcomes in the U.S. have not significantly improved. While cancer death rates have declined by 34% in the past two decades largely due to medical advancements and prevention efforts Kennedy insisted that HHS has failed to make a meaningful impact on public health.

Deep Cuts to FDA, CDC, and NIH

Federal health employees reacted in shock and dismay, since most were not pre-advised about the dismissal. The reduction will have a considerable effect on the major agencies:

• Food and Drug Administration (FDA): 3,500 jobs eliminated
• Centers for Disease Control and Prevention (CDC): 2,400 jobs reduced
• National Institutes of Health (NIH): 1,200 jobs taken away
• Centers for Medicare and Medicaid Services (CMS): 300 jobs lost

HHS estimates the changes will save 1.8 billion a year but has not given detailed breakdowns.

Agency Closures and Structural Changes

Kennedy also plans to close down whole agencies, such as the Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), both of which oversee billions in funding for local health programs. These will be merged into a new Administration for a Healthy America, which will manage maternal and child health, environmental health, and HIV/AIDS programs.

In addition, the Administration for Strategic Preparedness and Response, which houses the national emergency medical supply stockpile, will be folded into the CDC.

The decision has raised bipartisan alarm Democratic Sen. Patty Murray cautioned that cutting 20,000 jobs could result in reduced healthcare services , more outbreaks of disease, and slower delivery of lifesaving treatments. Republican Sen. Mike Rounds indicated that lawmakers will review the changes and address any resulting problems.

In spite of the criticism, Kennedy insists that the restructuring is needed to make the health department more effective and results oriented. Public health activists, however, contend that the extreme cuts may destroy vital healthcare services and research programs for several years to come.