On March 27, the Department of Health and Human Services (HHS) announced a “dramatic restructuring” of the agency as required by President Trump’s executive order (EO), “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” Secretary Robert F. Kennedy Jr. has justified the disruption by claiming that the Department will be more “responsive and efficient” and “do more – a lot more – at a lower cost to the taxpayer.”
HHS will consolidate its 28 divisions into 15, adding a new Administration for a Healthy America, and reduce the 10 regional offices to five. Furthermore, the Department implemented a reduction in force (RIF) of 10,000 full-time employees on April 1. This came after another 10,000 employees had already voluntarily left HHS due to early retirement and the Fork in the Road offer. As a result of these combined efforts, the Department has downsized its workforce from 82,000 full-time employees to 62,000 since President Donald Trump took office in late January. However, in the aftermath of the chaotic April 1 terminations, on April 3 Kennedy announced that certain programs and employees had been mistakenly cut, resulting in the rehiring of some HHS staff, at least temporarily. He suggested that the Department will ultimately reinstate about 20 percent of fired staff.
The restructuring has hit the National Institutes of Health (NIH) especially hard, and the loss of expertise and capacity will devastate public health as well as biomedical and behavioral research. NIH has laid off approximately 1,200 employees, many from communications, policy, records, and IT offices. HHS offered reassignment to the Indian Health Service to several institute and centers (IC) directors, including Dr. Jeanne Marrazzo (National Institute of Allergy and Infectious Diseases, NIAID) and Dr. Diana Bianchi (National Institute of Child Health and Human Development, NICHD), and placed others on administrative leave. However, in line with chaotic RIFs elsewhere, NIH ordered some employees to return to work, but without cancelling their RIF notices. The administration has not indicated what role Dr. Jay Bhattacharya, confirmed as NIH Director shortly after the March 27 announcement, has played, if any, in the cuts at NIH.
The widespread layoffs, and resulting chaos at HHS, seem to have caught lawmakers by surprise, with committees in both the House and the Senate announcing their intentions to hold hearings on HHS restructuring. In the Senate, leaders of the Health, Education, Labor, and Pensions (HELP) committee – Chair Bill Cassidy (R-LA) and Ranking Member Bernie Sanders (I-VT) – sent a letter to Kennedy asking him to give an update on the proposed HHS reorganization on April 10. However, Kennedy will not attend, despite the hearing being an opportunity to provide the transparency he promised Cassidy during his confirmation hearing, and the committee will likely postpone the event. FABBS initially welcomed this bipartisan move toward Congressional oversight of HHS and hope to see the hearing rescheduled
Over in the House, the Energy and Commerce (E&C) Committee is not as united in its approach. On April 2, E&C Democrats – including Ranking Member Frank Pallone Jr. (D-NJ) and Health Subcommittee Ranking Member Diana DeGette (D-CO) – sent a letter to Chair Brett Guthrie (R-KY) urging him to bring Kennedy in for a hearing on the restructuring. This followed a Health Subcommittee hearing in which Guthrie agreed Congress must provide “proper oversight.” Guthrie committed to a briefing by HHS staff, scheduled for April 11, but Democrats continue to push for an open hearing with Kennedy
FABBS will continue to monitor the HHS reorganization and advocate on the Hill for Congress to fulfill its oversight duties.
