Editor's Note: This is a developing story. If you are a dismissed or active federal worker with information to share, please reach out at [email protected]
Updated: April 4 at 9:54 a.m. ET
Secretary Robert F. Kennedy Jr. told reporters April 3 the Department of Health and Human Services (HHS) estimated 2,000, or 20%, of the recent job cuts at the department were done in error, adding reinstatements were "always part of the plan."
As part of an effort by the Department of Government Efficiency (DOGE) and Kennedy, the health divisions cut their workforce by 10,000 people this week. The cuts only further the agency's downsizing efforts, as seen by previous early retirement, buyout and probationary firings at HHS and across the federal government.
"Personnel that should not have been cut, were cut," Kennedy told CBS News during a stop in Virginia. "We're reinstating them. And that was always the plan. Part of the DOGE, we talked about this from the beginning, is we're going to do 80% cuts, but 20% of those are going to have to be reinstated, because we'll make mistakes."
Kennedy said during the stop the Centers for Disease Control and Prevention's Lead Poisoning and Prevention and Surveillance Branch was slashed in error. HHS did not respond to a request for comment.
The layoff plans had been unveiled on March 27, though HHS workers didn't begin receiving termination notices until early Tuesday morning.
The wide-reaching job cuts affected employees at the Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration, the CDC and more. While the full extent of the cuts are still developing, early indications suggest entire offices are now shuttered.
A notice of intent written by the HHS and sent to employees—later passed on to union leaders and obtained by Fierce Healthcare—stresses the "valuable contributions" made by the impacted workers, but reiterated the importance of the department's broader strategy.
Another document obtained by union officials show impacted employees were encouraged to contact Anita Pinder, former director at the Office of Equal Opportunity and Civil Rights at the CMS, who died in November.
At the FDA, the Office of Management is one of the causalities, according to one individual with knowledge of the situation who agreed to share anonymously with Fierce Healthcare under fear of retribution. This office provides services and resources to the Center for Drug Evaluation and Research, a government page explains. Many FDA employees were locked out of the headquarters April 1.
There were also huge cuts at the National Center on Birth Defects and Developmental Disabilities and the National Institute of Occupational Safety and Health (NIOSH). Within NIOSH is the National Personal Protective Technology Laboratory, which approves N95 respirators and other protective equipment. Closing this office in Pittsburgh, Pennsylvania, as reported, will directly strengthen rival countries to the U.S., said Eric Axel, the executive director of the American Medical Manufacturers Association.
"This decision effectively rewards foreign manufacturers who have not made the same investments in quality and safety while punishing American companies that have built their reputations on producing reliable, high-quality protective equipment that meets a global standard," said Axel.
Elsewhere, the entire Freedom of Information Act office, which helps the public understand the innerworkings of a government agency, was eliminated at the CDC and slashed dramatically at the FDA, reported media outlets. Another team focused on infertility was laid off, reported The Huffington Post, and communications offices throughout HHS faced heavy reductions. The Substance Abuse and Mental Health Services Administration was similarly affected. Other top officials at the National Institute of Allergy and Infectious Diseases, the CDC and FDA were offered a transfer to the Indian Health Services. And the Administration for Community Living, which handles aging and disability policy and handles Meals on Wheels, faced cuts of at least 40%.
The cuts don't stop there. Also eliminated is the HHS Office of Infectious Disease and HIV Policy under a reorganization of HHS.
"The expertise of the staff, along with their decades of leadership, has now been destroyed and cannot be replaced," said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. "We will feel the impacts of these decisions for years to come and it will certainly, sadly, translate into an increase in new HIV infections and higher medical costs."
And in the CDC, the deletion of a tobacco control program spells great trouble in tracking tobacco use and running prevention programs, which are not duplicative roles to tobacco product regulation at the FDA, said former CDC Director Tom Frieden in a LinkedIn post.
"Eliminating CDC’s tobacco prevention program would mean less data to inform physicians and parents, weaker state programs, fewer evidence-based strategies, and more people—especially kids—addicted to tobacco," he explained.
Within the Health Resources and Services Administration (HRSA), a fired worker told Fierce Healthcare that the Provider Relief Bureau—which oversees the integrity of the multi-billion-dollar Provider Relief Fund set up during the pandemic and works to recoup fraudulent payments—has been cut.
A source with ties to HHS said that CMS was largely spared from the April 1 cuts beyond the 300 individuals the department had announced would be cut in the original restructuring announcement on Thursday. The Administration for Children and Families faced deeper cuts, the source said. In a Monday report, insiders told Politico reporters that CMS had dodged much of the cuts through the intervention of a DOGE lead whose personal interests are tied to the CMS Innovation Center.
Still, former Deputy Director for the Center for Medicaid and CHIP at CMS Karen Shields posted on LinkedIn that she's heard the entire CMS Office of Equal Opportunity and Civil Rights was eliminated.
Another former agency head, Robert Califf, M.D., who twice served as director of the FDA, said Tuesday morning he was "overwhelmed" by messages he'd received on the firings at his old agency.
"The FDA as we've known it is finished, with most of the leaders with institutional knowledge and a deep understanding of product development and safety no longer employed," he wrote on LinkedIn. "I believe that history will see this a huge mistake. I will be glad if I'm proven wrong, but even then there is no good reason to treat people this way."
News reports have also outlined a slew of high-ranking officials who were let go, placed on administrative leave, pressured to leave the government or decided to do so upon being offered a diminished role at a separate office.
Among these names were Peter Stein, director of the FDA's Office of New Drugs; Brian King, director of the FDA's Center for Tobacco Products; Jeanne Marrazzo, M.D., director of the National Institute of Allergy and Infectious Diseases; Kayla Laserson, director of the CDC's Global Health Center; Julie Tierney, deputy director at the FDA's Center for Biologics Evaluation and Research; and Diana Bianchi, M.D., director of the NIH's National Institute of Child Health and Human Development.
They add to other high-profile departures from the federal health agencies in recent days, chief among which was FDA Center for Biologics Evaluation and Research Director Peter Marks, M.D.
On Tuesday afternoon, Senator Bill Cassidy, R-Louisiana, scheduled a hearing on April 10 for RFK Jr. to explain the cuts. Kennedy promised Cassidy he would appear quarterly before the Senate HELP Committee in exchange for Cassidy's crucial vote to confirm hearing.
"The news coverage on the HHS reorg is being set by anonymous sources and opponents are setting the perceptions," he said in a statement. "In the confirmation process, RFK committed to coming before the committee on a quarterly basis. This will be a good opportunity for him to set the record straight and speak to the goals, structure and benefits of the proposed reorganization."
The cuts are flatly opposed by numerous groups, including the National Health Council and the Robert Wood Johnson Foundation. RWJF CEO Richard Besser, M.D., called the cuts are "reckless" and will represent an abdication of the department’s essential responsibility to promote and protect health." This will impact many communities, including those with low-income, individuals in rural areas, older adults and people with disabilities, he said in a statement.
Executive order ends collective bargaining at CDC, FDA, others
While these cuts occur, the government is attempting to give itself more leverage to conduct mass layoffs.
President Donald Trump signed an executive order March 27 giving himself authority to end collective bargaining across federal unions, just hours after HHS Secretary Robert F. Kennedy Jr. announced the department could expect 10,000 job cuts in upcoming days.
The executive order said unions with "national security missions" would be impacted. The order applies to workers at the CDC, FDA, the Department of Veterans Affairs, the National Science Foundation, the HHS Office of General Counsel, the National Institute of Allergy and Infectious Disease, the Administration for Strategic Preparedness and Response (ASPR) and more. Trump's executive order claims current collective bargaining agreements (CBA) allows "hostile" unions to block a department's agenda.
A memo (PDF) from the Office of Personnel Management was published before the executive order. It said these departments are "no longer required to collectively bargain with federal unions. Government agencies were told to limit the required duration of performance improvement plans, makes it easier to fire VA workers "with a lower burden of proof," ignore CBA requirements surrounding reductions in force and disregard union protections against return-to-office policy.
On March 31, the 150,000-member National Treasury Employees Union filed a lawsuit against the order, which it said applied to more than 100,000 of its members and would damage the union's ability to collect dues.
One of the largest government labor unions, the American Federation of Government Employees (AFGE), also describe the announcement is a "clear threat" to its members and all Americans and affirmed plans to block the order in court.
"AFGE is preparing immediate legal action and will fight relentlessly to protect our rights, our members and all working Americans from these unprecedented attacks," said AFGE President Everett Kelley in a statement.
A host of government agencies sued (PDF) the AFGE, arguing the current CBAs "significantly constrain the executive branch."
The National Treasury Employers Union sued the HHS and other agencies March 3, saying (PDF) the executive order is unlawful and the CBAs should be respected.
Kennedy details full scope of HHS reorganization
The HHS is set to slash 10,000 full-time jobs and further remake the agency in the Trump administration’s vision.
These cuts—in line with the Department of Government Efficiency's (DOGE's) "workforce optimization" efforts—will save the agency $1.8 billion per year, HHS said in a March 27 morning news release. After factoring in early retirement and the “fork in the road” offering from earlier this year, the agency’s total headcount will decrease by 20,000 members.
In an announcement posted online, Secretary Robert F. Kennedy Jr. said good-natured, intelligent employees are bogged down by bureaucracy, with a budget that grew by 38% during the Biden administration.
Approximately 300 cuts will hit the Centers for Medicare and Medicaid Services (CMS). These layoffs will prioritize “reducing minor duplication,” but promising the reorganization will not impact Medicare and Medicaid services.
At the FDA, 3,500 workers will be let go. HHS said the cuts will not affect drug, medical device or food reviewers. Inspectors will also not be impacted.
The CDC will fire 2,400 employees, while the National Institutes of Health will slash its workforce by 1,200 workers and “centralize procurement, human resources and communications” across 27 institutes and centers, a fact sheet explains.
During the firing of probationary employees earlier this year, in tandem with the Department of Government Efficiency spearheaded by Tesla CEO Elon Musk, employees in these roles were fired and promptly asked to return. These terminations are working through the court system and are currently halted, with many on administrative leave as they wait for more clarification from supervisors and judges. A recent court filing said HHS sent out 3,248 termination notices to probationary employees.
HHS said they do not anticipate cuts beyond these, but the department will seek additional opportunities to “streamlines its operations and agencies.”
"This will be a painful period for HHS as we downsize from 82,000 employees to 62,000, but we are keenly focused on paring away excess administrators while increasing the number of scientists and frontline health providers so we can do a better job for the American people," Kennedy said.
Senator Ron Wyden, D-Oregon, and former HHS Secretary Xavier Becerra condemned the cuts in statements released the same morning.
"American families are going to be hurt by layoffs and closures of this magnitude, full stop,” Wyden warned. “These offices work closely with communities to make sure child care, hospitals and nursing homes are safe, strengthen rural health care, and much more. The chaos that is coming will guarantee that kids and seniors fall through the cracks with deadly consequences.”
"It's hard to make sense of the HHS cuts announced this morning," said Becerra. "This has the makings of a manmade disaster."
Offices to be consolidated
The department said there are 28 redundant offices that will be consolidated into 15 new divisions, and 10 regional offices will become five. Kennedy claimed there are more than 100 communications offices, more than 40 IT offices, a dozen procurement offices and nine human resource departments—all operating in silos without communicating together.
“Some of these little fiefdoms, for example, are so insulated and territorial that they actually hoard our patient medical data and sell it for profit to each other,” Kennedy said, adding some public health divisions are “neglecting” public health and are only interested in helping the industries they are supposed to regulate.
Kennedy accused some health divisions of not working in the best interest of Americans, a characterization that is sure to be criticized by Democratic lawmakers and current government employees.
Tammy Baldwin, a Democratic Senator from Wisconsin, decried the administration's plans. "The Trump Administration is endangering your family's health to make more room in the budget for their billionaire tax breaks and rig the system for themselves," she wrote in a statement.
As part of the change, HHS will now house an Administration for a Healthy America, or AHA, which will be focused on human resources, information technology, procurement, external affairs and policy.
AHA will combine the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry and NIOSH.
“This centralization will improve coordination of health resources for low-income Americans and will focus on areas including, primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development,” said HHS.
Local AFGE unions argued April 1 moving NIOSH out of the CDC will sever crucial ties between occupational and public health.
“Communicable diseases like tuberculosis, hepatitis, and influenza are occupational illnesses that disproportionately affect healthcare workers and other frontline employees,” said Brendan Demich, chief steward of AFGE Local 1916 from Pennsylvania and Washington, in a statement to Fierce Healthcare. “NIOSH’s work has been critical in ensuring that workers have the proper protection through research on things such as respirators and ventilation controls.
The CDC will assume control of the ASPR, an agency formerly tasked with natural disasters and other public health threats.
A new Assistant Secretary for Enforcement will oversee the Departmental Appeals Board, Office of Medicare Hearings and Appeals and the Office for Civil Rights. This person will be tasked with rooting out waste, fraud and abuse.
Long-rumored to be on the chopping block, the Agency for Healthcare Research and Quality will merge with the Assistant Secretary for Planning and Evaluation (ASPE). This new combination will become the Office of Strategy, to “enhance research that informs the Secretary’s policies and improves the effectiveness of federal health programs.”
The Administration for Community Living (ACL) will be dispersed between the Administration for Children and Families, the ASPE and the CMS. Some stakeholders worry the ACL's functions may be in danger under this reorganization.
"Just as you cannot slash billions from Medicaid or close Social Security field offices without harming older adults and people with disabilities, you cannot curtail CMS capacity, dismantle the ACL—the only federal agency charged with maximizing the independence, well-being, and health of older adults, people with disabilities, their families, and their caregivers—or otherwise weaken critical HHS programs, services and functions without causing irreparable damage," said Fred Riccardi, president of the nonprofit Medicare Rights Center, in a statement.
"Any realignment of the agency or its functions must preserve the essential work the government has long done to improve the lives of older adults and ensure alignment with Medicare and Medicaid to improve and expand delivery of the services on which Americans rely," said Sarita Mohanty, M.D., president and CEO of The SCAN Foundation.
Secretary of Education Linda McMahon, who is helping oversee the elimination her department, said last week HHS will assume control of special education programs traditionally under her domain, but no further timeline or information has yet been provided by HHS.
A core tenet of the Make America Healthy Again movement, spearheaded by Kennedy, is the focus on reversing chronic disease. The department will prioritize “safe, wholesome food, clean water and the elimination of environmental toxins.”