HHS restructuring plan sparks debate over public health impact
Pranjal Chandra | Mar 27, 2025, 22:00 IST
HHS has announced plans to drastically reduce its workforce by eliminating 10,000 full-time employees, including significant cuts to the CDC, FDA, and NIH. This consolidation aims to increase efficiency but raises concerns about its impact on public health services, particularly in disease prevention and drug approvals.
The Department of Health and Human Services (HHS) has announced plans to significantly downsize its workforce, eliminating 10,000 full-time jobs across multiple agencies, including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH). This move is part of a broader government restructuring initiative by the Trump administration aimed at consolidating departments and reducing redundancies. However, the sweeping changes have raised concerns about the potential impact on public health services, particularly in areas such as disease prevention, emergency preparedness, and drug approvals.
As part of the restructuring, HHS will merge 28 divisions into 15 under a newly established organization, the Administration for Healthy America (AHA). HHS Secretary Robert F. Kennedy Jr. described this consolidation as a necessary step toward eliminating inefficiencies while maintaining core functions. Among the agencies affected are the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA), which provides support for HIV treatment programs.
In addition to these changes, the CDC will see a workforce reduction of 2,400 employees, including cuts to divisions responsible for global health, domestic HIV prevention, and injury prevention initiatives. The FDA will lose approximately 3,500 staff members, while the NIH and the Centers for Medicare and Medicaid Services (CMS) will see reductions of 1,200 and 300 employees, respectively.
Impact on
Public health experts have expressed concern that these cuts could weaken the government’s ability to respond to health crises. For example, the downsizing of the CDC’s global health division could hinder efforts to monitor and prevent the spread of infectious diseases worldwide. Similarly, reducing the workforce in the HIV prevention division has raised alarms among advocacy groups who worry that progress in reducing infection rates could be stalled or reversed.
One of the most controversial aspects of the restructuring is the potential relocation of HIV prevention responsibilities from the CDC to HRSA, which primarily focuses on treatment rather than prevention. Experts warn that shifting resources in this way could undermine preventive efforts, potentially leading to increased infection rates.
The FDA, which plays a critical role in approving new drugs, medical devices, and food safety regulations, is also facing substantial workforce cuts. While HHS officials have assured the public that drug review timelines will not be affected, some FDA employees have expressed concerns that fewer staff members could lead to slower approvals and reduced oversight.
"The cuts to FDA will still adversely affect our mission, it doesn't matter if they're not directly cutting reviewers," said an FDA employee who requested anonymity. "We're only able to review because of a lot of back-end support."
Meanwhile, the CMS, which oversees Medicare and Medicaid, will see a relatively smaller reduction in its workforce. HHS officials insist that these changes will not impact beneficiaries, but critics argue that fewer employees could lead to delays in customer service and processing claims.
The restructuring has sparked political debate, with supporters arguing that the plan will make HHS more efficient by eliminating bureaucratic redundancies, while critics contend that it is an attempt to shrink government at the expense of public health.
"This is not just a reorganization of HHS," said Larry Levitt, executive vice president of health policy at KFF. "It's also a slashing of the federal workforce, which will ultimately affect government services. People and healthcare providers may find themselves waiting longer to get help and get their questions answered, and that will cause frustration and delays in services."
The administration’s decision to proceed with these cuts despite previous judicial interventions has also raised legal questions. Federal judges had earlier ruled against large-scale firings of probationary employees at federal health agencies, temporarily reinstating some of those affected workers. Nonetheless, the new restructuring plan appears to move forward with broader layoffs and departmental shifts.
Employees within the affected agencies are expected to receive layoff notifications as early as Friday, according to a memo obtained by NBC News. The full impact of the restructuring will likely become clearer in the coming months as the agencies adjust to their new operational frameworks.
While the administration has stated that no additional cuts are currently planned, public health advocates and lawmakers are watching closely to assess how these changes will affect critical health programs. With some agency leaders resigning in anticipation of the cuts and concerns about maintaining the integrity of public health services, the debate over HHS's restructuring is far from over.
Consolidation under the administration for healthy america
In addition to these changes, the CDC will see a workforce reduction of 2,400 employees, including cuts to divisions responsible for global health, domestic HIV prevention, and injury prevention initiatives. The FDA will lose approximately 3,500 staff members, while the NIH and the Centers for Medicare and Medicaid Services (CMS) will see reductions of 1,200 and 300 employees, respectively.
Impact on public health programs
One of the most controversial aspects of the restructuring is the potential relocation of HIV prevention responsibilities from the CDC to HRSA, which primarily focuses on treatment rather than prevention. Experts warn that shifting resources in this way could undermine preventive efforts, potentially leading to increased infection rates.
Drug approvals and healthcare services at risk
"The cuts to FDA will still adversely affect our mission, it doesn't matter if they're not directly cutting reviewers," said an FDA employee who requested anonymity. "We're only able to review because of a lot of back-end support."
Meanwhile, the CMS, which oversees Medicare and Medicaid, will see a relatively smaller reduction in its workforce. HHS officials insist that these changes will not impact beneficiaries, but critics argue that fewer employees could lead to delays in customer service and processing claims.
Political and public reactions
"This is not just a reorganization of HHS," said Larry Levitt, executive vice president of health policy at KFF. "It's also a slashing of the federal workforce, which will ultimately affect government services. People and healthcare providers may find themselves waiting longer to get help and get their questions answered, and that will cause frustration and delays in services."
The administration’s decision to proceed with these cuts despite previous judicial interventions has also raised legal questions. Federal judges had earlier ruled against large-scale firings of probationary employees at federal health agencies, temporarily reinstating some of those affected workers. Nonetheless, the new restructuring plan appears to move forward with broader layoffs and departmental shifts.
Looking ahead
While the administration has stated that no additional cuts are currently planned, public health advocates and lawmakers are watching closely to assess how these changes will affect critical health programs. With some agency leaders resigning in anticipation of the cuts and concerns about maintaining the integrity of public health services, the debate over HHS's restructuring is far from over.