Officials across various agencies in the Department of Health and Human Services are preparing for significant layoffs as Secretary Robert F. Kennedy Jr. and his team approach their final decisions regarding a comprehensive reorganization of the department.
Multiple senior health officials have been informed that decisions regarding the reshaping of the department’s structure and composition are anticipated within the next week or two. An official mentioned that aides have started to draft an announcement regarding the reorganization.
The department did not provide a comment when requested.
In addition to the official head of the White House’s Department of Government Efficiency (DOGE), Amy Gleason, several other DOGE members are employees of HHS. Some have been closely involved in the planning process, including former insurance executive Brad Smith, who held a prominent role in Medicare and Medicaid during the initial Trump administration.
The anticipated layoffs as part of the reorganization and “reduction-in-force” measures mandated by the White House follow a series of firings and departures throughout the nation’s health agencies, driven by other initiatives like prior attempts to eliminate thousands of probationary workers, dismantle fellowship programs, and terminate contractor agreements.
Here’s the latest update on the reorganization across several HHS agencies, gathered from discussions with over a dozen health officials who were not authorized to speak publicly.
Agency for Healthcare Research and Quality
The workforce reductions outlined by HHS and DOGE officials for some senior leaders have been unprecedented. Specifically, within the Agency for Healthcare Research and Quality, DOGE officials indicated on March 11 that up to 90% of their staff could be cut.
This agency employs approximately 300 individuals, many of whom are responsible for collecting and analyzing key federal metrics on health care, including long-standing datasets tracking hospitalizations and emergency room visits that economists and health policy researchers rely upon.
AHRQ is also engaged in multiple programs funded by Congress aimed at enhancing patient safety and reducing health care errors, such as initiatives designed to combat antibiotic-resistant bacteria.
“The current team includes about 45 highly skilled economists and statisticians. DOGE has requested that this be reduced to just six staff members. It’s unlikely that the six individuals willing to remain under those circumstances would be the top choices,” one health official commented to CBS News about cuts impacting one of the agency’s teams overseeing a large federal database concerning medical expenditures.
Centers for Disease Control and Prevention
At the Centers for Disease Control and Prevention, some management personnel have been warned that cuts from the department could lead to a reduction of up to 30% of the agency’s workforce based in Atlanta.
Federal records indicate that approximately 12,820 individuals were employed by the CDC at the conclusion of the last fiscal year, an increase from 10,487 during the final year of the first Trump administration.
“A 30% reduction would be catastrophic. We are already short-staffed in numerous critical areas, and employees who are barely managing are experiencing burnout after five years,” stated one CDC official.
Some reductions may be accomplished through voluntary departures. Managers at the agency have reported that around 400 employees sought early retirement, while approximately 600 opted for buyouts, as per offers made across HHS this month. The number of individuals applying for both options remains unclear.
Additional reductions might arise through restructuring the agency’s operations. One proposal under consideration includes relocating the CDC’s HIV prevention efforts to other sections within the department.
Food and Drug Administration
In contrast to other health agencies, certain groups within the Food and Drug Administration were informed that they are not eligible to partake in the HHS buyout offer.
This group includes reviewers of new drug applications, whose salaries derive mainly from fees charged by drug manufacturers during the approval process, rather than taxpayer funds.
Other employees at the FDA have been warned to brace for layoffs. Internal communications from FDA management indicate they are somewhat uninformed about the extent and targets of the impending cuts.
DOGE officials have made several visits to the agency’s headquarters in Maryland, according to one official. Another mentioned that DOGE representatives had been inquiring about the FDA’s laboratories this week.
Numerous FDA employees have cited the ongoing “brain drain” at the agency as a contributor to expected job losses. The agency has faced a daunting return-to-office transition that is unlikely to improve anytime soon. Hundreds of retirement applications are being processed, one employee noted.
The FDA employs far more staff than its headquarters facilities can accommodate, leading to shortages in parking, office space, and even basic necessities in restrooms.
National Institutes of Health
Officials anticipate workforce reductions at the National Institutes of Health, reverting to levels comparable to those at the end of the Trump administration.
At the close of the fiscal year 2024, over 21,000 people were employed by the medical science research agency, a rise from 17,705 at the end of the 2019 fiscal year.
As with other agencies, some expected cuts may be offset by voluntary departures of scientists and other staff. One individual reported hearing in meetings that around 1,400 employees had applied for either the buyout, early retirement, or both.
Estimates suggest that up to 3,800 employees could be removed from the agency’s payroll, depending on the number of staff counted among those departures.
Centers for Medicare and Medicaid Services
Reductions at the Centers for Medicare and Medicaid Services might be less severe, as the agency was already experiencing hiring constraints under the Biden administration.
The agency’s chief operating officer noted late last year that hiring could resume following a recovery in its financial situation, as reported by InsideHealthPolicy in November.
As of 2024, the agency had 6,557 employees, a slight increase from 6,074 in 2019.
One CMS official mentioned that internal discussions indicated that early retirements and buyouts in certain sectors of the agency might have been sufficient to protect a majority of the remaining workforce.
Substance Abuse and Mental Health Services Administration
Numerous staff members within the Substance Abuse and Mental Health Services Administration have reported a lack of communication from agency leadership regarding potential layoffs.
There is some hope that a letter from House Democrats to Kennedy, expressing concern over reports of possible reductions affecting half the agency’s staff, might mitigate extensive layoffs.
The agency’s workforce, which stood at 916 employees at the end of the previous fiscal year, had fallen to a low of 521 during the first Trump administration.
The earlier firings of probationary workers this year by DOGE have already led to a reduction of more than 10% of the agency’s staff, including those involved in initiatives related to the 988 hotline for individuals facing mental health crises.
