Robert F. Kennedy Jr., secretary of the Department of Health and Human Services, or HHS, announced a major restructuring and RIF of the agency he leads. Jason C. Andrew/Bloomberg/Getty Images hide caption

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Jason C. Andrew/Bloomberg/Getty Images

The Trump administration Thursday announced a major restructuring of the U.S. Department of Health and Human Services that will cut 20,000 full-time jobs.

The cuts include employees who have taken the Trump administration’s Fork in the Road offer and early retirement, plus an additional reduction in force of 10,000 jobs. It will take the HHS workforce from 82,000 to 62,000, according to a press release from the agency.

The restructuring also includes a reorganization of HHS’s many divisions to reduce them from 28 to 15.

“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 the press release. “This Department will do more — a lot more — at a lower cost to the taxpayer.”

HHS is the umbrella agency that includes the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, the National Institutes of Health and other smaller divisions.

The restructuring will include the creation of a new Administration for a Healthy America, or AHA, intended to “more efficiently coordinate chronic care and disease prevention programs.” It will consolidate several existing agencies, with a focus on primary care, maternal and child health, mental health and HIV/AIDS.

The cuts include 3,500 full-time employees at the FDA, 2,400 at the CDC, 1,200 at NIH, and 300 at CMS, according to an HHS fact sheet. It states that the new job cuts at the FDA will not affect drug, medical device, or food reviewers or inspectors. The reorganization will not impact Medicare or Medicaid.

HHS states that the job cuts will save $1.8 billion. The agency currently has a budget of nearly $2 trillion, the majority of which pays for benefits for Americans covered by Medicaid and Medicare.

These cuts align with President Trump’s vision of drastically reducing the size and scope of the federal government — an effort that has been led so far by Elon Musk and his Department of Government Efficiency or DOGE.

“There is a benefit to occasional reorganizations of HHS. But, this is also about big staff and program reductions,” Larry Levitt of the nonpartisan health research organization KFF wrote on social media.

“A lot of what HHS employees do is behind the scenes oversight, to prevent fraud and abuse and ensure health care programs provide the services promised. Reductions in the federal workforce could result in more wasteful spending down the road.”

In a social media video posted Thursday morning, Secretary Kennedy characterized HHS as a dysfunctional, sprawling bureaucracy.

In the video, he vacillated between praising his department’s staff and their work and accusing them of harming Americans’ health.

“When I arrived, I found that over half of our employees don’t even come to work,” he said. (HHS did not immediately respond to a question about whether the employees were in approved teleworking arrangements, placed on administrative leave or something else.)

“HHS has more than 100 communications offices and more than 40 IT departments and dozens of procurement offices and nine H.R. departments. In many cases, they don’t even talk to each other.”

He described “little fiefdoms” within HHS of being “so insulated and territorial that they actually hoard our patient medical data and sell it for profit to each other,” though he didn’t offer further details.

“While public health declines, a few isolated divisions are neglecting public health altogether and seem only accountable to the industries that they’re supposed to be regulating,” he said, without naming the divisions or industries he was referencing.

Senator Angela Alsobrooks, D-Md., wrote in a statement that the plan to cut 20,000 jobs from HHS was “dangerous and deadly.”

“These mass layoffs at Health and Human Services will cost human lives,” Alsobrooks said. “I will do all I can to fight this.”

Sen. Bill Cassidy, R-La. posted on X that he’d like to see HHS work better on things like rapidly approving drugs and improving Medicare services. “I look forward to hearing how this reorganization furthers these goals.”

And one of Kennedy’s allies in the Make America Healthy Again movement, writer and entrepreneur Calley Means wrote an X post praising the restructure: “The insane spending and staffing in healthcare is actually the cause of our bad health outcomes. “

The cuts are rattling staff at the health agencies, according to three current NIH employees who did not want to be identified because of fears of retribution.

“People are exhausted. More than worried for their own livelihoods, people are scared for the future of the NIH [and] its science,” one employee said. “I’m hearing people express some tepid hope they’ll be spared, some resignation that they’ll likely be fired, and lots of people not even sure that NIH will be a hospitable place to be even if they survive the RIF.”

Another NIH employee said the agency has lost about 4,400 employees so far out of a staff of about 18,000. These include 1,200 in the RIFs today, 1,200 probationary employees who were previous fired and about 2,000 who took early retirement, the buy-out or the Fork in the Road offer.

People will find out if they are losing their jobs Friday and the RIFs will take effect in May, the person said, NIH employees are bracing for more possible cuts that could occur if Dr. Jay Bhattacharya, the new incoming NIH director, orders his own reorganization of the NIH.

A third NIH employee says the RIFs are primarily affecting administrative staff, like HR, IT, procurement, and finance.

“It is impossible for me to imagine that cuts of this size will not substantially affect functions negatively,” said Jeremy Berg of the University of Pittsburgh, who served as the director of the National Institute of General Medical Sciences, part of the National Institutes of Health, from 2003 to 2011. “This represents yet another assault on the ability of NIH to achieve its important missions,” he added.

Dr. Georges Benjamin, head of the American Public Health Association, said in a statement that the HHS restructuring, paired with an $11 billion cut in funding to state and local health departments announced earlier this week, runs counter to the goal of improving health in the U.S.

“This is a nonsensical rearrangement of the agencies under their charge and an excuse to devastate the workforce for financial reasons,” said Benjamin. “It will increase the morbidity and mortality of our population, increase health costs and undermine our economy.”

The union representing many federal workers, the National Treasury Employees Union, issued a statement Thursday condemning the cuts and saying it will “fight back.”

“If this disastrous plan is carried out and the agency loses an additional 10,000 employees, as proposed, the impact to public health services across the country will be devastating,” said NTEU president Doreen Greenwald.

Have information you want to share about the ongoing changes across federal health agencies? Reach out to these authors via encrypted communications: Selena Simmons-Duffin @selena.02, Pien Huang @pienhuang.88 and Rob Stein @robstein.22.