What to KnowIn a major overhaul, the U.S. Department of Health and Human Services will lay off 10,000 workers and shut down entire agencies, including ones that oversee billions of dollars in funds for addiction services and community health centers across the country.Health Secretary Robert F. Ke nnedy Jr. criticized the department he oversees as an inefficient “sprawling bureaucracy” in a video announcing the restructuring Thursday. He faulted the department’s 82,000 workers for a decline in Americans’ health.Kennedy acknowledged that it will be a “painful period” for the nation’s top health agencies, which are responsible for monitoring infectious diseases, inspecting foods and hospitals and overseeing health insurance programs for nearly half the country. In a major overhaul, the U.S. Department of Health and Human Services will lay off 10,000 workers and shut down entire agencies, including ones that oversee billions of dollars in funds for addiction services and community health centers across the country. Health Secretary Robert F. Kennedy Jr. criticized the department he oversees as an inefficient “sprawling bureaucracy” in a video announcing the restructuring Thursday. He faulted the department’s 82,000 workers for a decline in Americans’ health. “I want to promise you now that we’re going to do more with less,” Kennedy said in the video, posted to social media. Kennedy acknowledged that it will be a “painful period” for the nation’s top health agencies, which are responsible for monitoring infectious diseases, inspecting foods and hospitals and overseeing health insurance programs for nearly half the country. Overall, the department will downsize to 62,000 positions — losing 10,000 jobs through layoffs and another 10,000 workers who took early retirement and voluntary separation offers encouraged by President Donald Trump’s administration. HHS provided on Thursday a breakdown of cuts at the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health and the Centers for Medicare and Medicaid Services: — 3,500 jobs at the FDA, which inspects and sets safety standards for medications, medical devices and foods. — 2,400 jobs at the CDC, which monitors for infectious disease outbreaks and works with public health agencies nationwide. — 1,200 jobs at the NIH, the world’s leading public health research arm. — 300 jobs at CMS, which oversees the Affordable Care Act marketplace, Medicare and Medicaid. HOW WILL THE RESTRUCTURING IMPACT PUBLIC HEALTH PROGRAMS? The major restructuring comes amid one of the worst measles outbreaks in the country in more than two decades, and as the bird flu continues to spread worldwide — with recent human cases. In its statement, HHS said it anticipates the changes will save $1.8 billion per year, but it did not provide a breakdown or any other details about the savings. The department has a $1.7 trillion annual budget, most of which is dedicated to funding Medicare and Medicaid programs used by older, disabled and poor Americans. SUICIDE PREVENTION HOTLINE Beyond losing workers, Kennedy said he will shut down entire agencies, some of which were established by Congress decades ago. Several agencies will be folded into a new Administration for a Healthy America, Kennedy said. HHS will also drop five of its 10 regional offices, but it said essential health services won’t be affected. Those include the Health Resources and Services Administration, which oversees and provides funding for hundreds of community health centers around the country, as well as the Substance Abuse and Mental Health Services Administration, which funds clinics and oversees the national suicide prevention 988 hotline. Both agencies pump billions of dollars into on-the-ground work in local communities. It is currently unclear if this restructuring will impact the services of these clinics or the closure of them. It is also unclear how the overhaul will affect the suicide prevention hotline. The hotline is active across the United States. It received the shorter number of 988 for people to remember and access confidential emotional support and mental health crisis services for free to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States and its territories. The 988 Lifeline is comprised of a network of over 200 local crisis centers, combining local care and resources. The 988 Lifeline, previously known as the National Suicide Prevention Hotline, launched New Year’s Day 2005 with funding from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Since the new number was unveiled in 2022, the hotline served more than 14.5 million people through calls, texts and chats, according to its official website. MEDICAL STOCKPILE FOR EMERGENCY PREPAREDNESS The Administration for Strategic Preparedness and Response, created by a law signed by then-President George W. Bush and responsible for maintaining the nation’s medical and public health preparedness for, response to, and recovery from disasters and public health emergencies, will be folded into the CDC. This stockpile was what was used during the pandemic. “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,” Kennedy said. “This Department will do more – a lot more – at a lower cost to the taxpayer.” MEDICARE AND MEDICAID Additionally, the HHS oversees the federally run health insurance programs of Medicare and Medicaid. At this moment, it is unclear how the layoffs and restructuring will impact individuals who use either of these programs to obtain medical care. However, when announcing the mass layoffs and restructuring of the HHS Thursday, the agency said in a statement that “Medicare, Medicaid, and other essential health services remain intact.” Medicaid is for certain individuals and families with low incomes and resources, with the eligibility and benefits varying by state. It currently covers more than 72 million people which included low-income Americans, their children and people with disabilities. Meanwhile, Medicare insurance is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease.  Trump and Republicans have for years called for lowering government spending on health care, but they have struggled to formulate a serious plan that gains traction. Trump, for example, has spent nearly a decade arguing for an overhaul of the Affordable Care Act, commonly known as Obamacare. His efforts to repeal the Obama-era national health care law failed during his first term, and in his most recent presidential campaign he offered only “concepts of a plan” to adapt the program. Additionally, it is also unclear how the HHS overhaul could impact the Affordable Care Act marketplace and by extension those insured through it. Michael Cannon, a director of health studies at libertarian Cato Institute, believes Medicaid needs an overhaul because it is a significant part of the federal budget and a contributor to the nation’s growing debt. But Republicans, he said, are not looking at serious ways to drive down the cost of health care. “The only reason for the cuts right now is to pay for the tax cuts,” Cannon said. “None of them are talking about the need to do better health reform.” SAFETY STANDARDS FOR DRUGS, FOOD AND MEDICAL DEVICES The layoffs will also impact workers in the FDA, which work in all 50 states and internationally to inspect and set safety standards for medications, medical devices, food, cosmetics, emit radiation and tobacco products. The FDA faced a first round of layoffs, like other agencies, last month when terminations went to employees in their probationary period, typically the first two years of federal employment. But that approach resulted in the terminations across key areas where the agency has been working to beef up staffing, including rapidly evolving fields like artificial intelligence and digital health. The cuts also included agency leaders who were recently hired for senior roles. “The disarray caused by the wholesale termination of a wide swath of device center staff was counterproductive and appears to have caused a variety of unintended and negative results,” said Steve Silverman, a former FDA device official who now runs a consulting firm. “It’s encouraging to see a shift in the opposite direction that recognizes the critical expertise of these staffers.” Many reviewers have advanced degrees in specialized medical and technological fields. They can typically earn more in the private sector than in government. Mere days after the initial round of layoffs, the Trump administration changed course and tried to rehire some probationary staffers back. It is unclear how many were rehired and if this latest round of cuts impacted the same staffers once again. FDA staffers said entire teams of five or more medical device reviewers had been reinstated. There did not appear to be a similar effort to rehire staffers in other parts of the agency, including its food and tobacco centers. More than half the device program’s $791 million budget last year came from industry fees, according to federal figures. In return, the FDA is obligated to meet certain benchmarks for quickly and predictably reviewing applications for new and updated devices. Meanwhile, nearly half the FDA’s budget, or about $3.3 billion, comes from fees paid by drugmakers, device and tobacco companies. The result is that broad cuts to those programs won’t add much toward Musk’s stated goal of shrinking the federal budget. MONITORING INFECTIOUS DISEASE OUTBREAKS The CDC, with a core budget of more than $9 billion, is charged with protecting Americans from disease outbreaks and other public health threats. At the beginning of this year, it had more than 13,000 employees, and nearly 13,000 other contract workers. At least 550 probationary employees were laid off in February, although those layoffs were challenged in lawsuits and two federal judges ordered that the employees be reinstated. Thursday’s news of additional layoffs come at a time when the United States is grappling with a huge spike in measles and tuberculosis outbreaks. Additionally, it comes at a time when there is a global outbreak of bird flu which has put a stress on the poultry business, resulting in a hike in egg prices. It is unclear how these layoff will impact the monitoring, research and in turn the response to outbreaks. ...read more read less