2025 U.S. Department of Health and Human Services reorganization

File:Robert F. Kennedy Jr., official portrait (2025) (cropped 3-4).jpg Robert F. Kennedy Jr. announced the reorganization on March 27, 2025, as an implementation of President Donald Trump's Executive Order 14210.]]

The current overall organizational structure of HHS is the result of the Public Health Service reorganizations of 1966–1973,{{Cite book |url=https://books.google.com/books?id=M-n4arYE5ScC |title=History, mission, and organization of the Public Health Service |date=1976 |publisher=U.S. Public Health Service |pages=3–4, 20, 22 |language=en}} as well as the 1980 spinoff of the Department of Education which caused HHS to be renamed from its former name, Department of Health, Education, and Welfare.{{Cite web |date=2023-03-14 |title=HHS Historical Highlights |url=https://www.hhs.gov/about/historical-highlights/index.html |access-date=2025-03-27 |website=U.S. Department of Health and Human Services}} Since then there have been a few new operating agencies and minor reorganizations.{{Cite web |date=2016-08-15 |title=Records of the Health Resources and Services Administration [HRSA] |url=https://www.archives.gov/research/guide-fed-records/groups/512.html |access-date=2020-08-29 |website=National Archives |at=Section 512.2 |language=en}}{{Cite web |date=2016-08-15 |title=Records of the Indian Health Service |url=https://www.archives.gov/research/guide-fed-records/groups/513.html |access-date=2020-08-29 |website=National Archives |language=en}}{{Cite web |date=2016-08-15 |title=Records of the Agency for Health Care Policy and Research |url=https://www.archives.gov/research/guide-fed-records/groups/510.html |access-date=2020-08-29 |website=National Archives |language=en}}{{Cite web |date=2016-08-15 |title=Records of the Alcohol, Drug Abuse, and Mental Health Administration [ADAMHA] |url=https://www.archives.gov/research/guide-fed-records/groups/511.html |access-date=2020-08-29 |website=National Archives |at=Section 511.1 |language=en}}

The individual agencies within HHS draw their statutory authority from a patchwork of authorization bills passed by Congress, and administrative regulations instituted by the department or its agencies through the federal rulemaking process. On one extreme, the National Institutes of Health is authorized by the 1930 Ransdell Act and its subsequent amendments, which also specify all of its constituent institutes and centers, meaning these can only be changed by an act of Congress. On the other extreme, the Centers for Disease Control and Prevention is not directly established by any statute, but by departmental regulation that delegates to it some authorities of the umbrella 1944 Public Health Service Act as amended, although specific statutes exist for three of its component centers.{{Cite web |last1=Keyes |first1=Drew |last2=Zinberg |first2=Joel M. |date=2023-07-24 |title=Unauthorized and Unprepared: Refocusing the CDC after COVID-19 |url=https://paragoninstitute.org/public-health/unauthorized-unprepared-refocusing-cdc-after-covid19/ |access-date=2025-03-27 |website=Paragon Health Institute |language=en-US}}{{Cite web |last=Sekar |first=Kavya |date=2025-01-13 |title=The National Institutes of Health (NIH): Background and Congressional Issues |url=https://www.congress.gov/crs-product/R41705 |access-date=2025-03-27 |website=Congressional Research Service}}

After the 2024 presidential election and the beginning of the second Trump administration, Robert F. Kennedy Jr. was confirmed as Secretary of Health and Human Services.{{Cite web |last=Weixel |first=Nathaniel |date=February 13, 2025 |title=Senate confirms RFK Jr. as Health secretary; McConnell lone GOP dissenter |url=https://thehill.com/policy/healthcare/5141880-robert-f-kennedy-jr-confirmed/ |access-date=2025-03-30 |work=The Hill |language=en-US}} On February 11, 2025, President Trump signed Executive Order 14210, "Implementing the President's 'Department of Government Efficiency' Cost Efficiency Initiative". The order required large-scale reductions in force in consultation with the Department of Government Efficiency program, and submission of a reorganization plan by each agency to the Office of Management and Budget within 30 days.{{Cite web |last= |first= |date=2025-03-27 |title=HHS Announces Transformation to Make America Healthy Again |url=https://www.hhs.gov/about/news/hhs-restructuring-doge.html |url-status=live |archive-url=http://web.archive.org/web/20250327135807/https://www.hhs.gov/about/news/hhs-restructuring-doge.html |archive-date=2025-03-27 |access-date=2025-03-27 |website=U.S. Department of Health and Human Services |language=en}}{{Cite web |date=2025-02-26 |title=Implementing the President's "Department of Government Efficiency" Cost Efficiency Initiative |url=https://www.whitehouse.gov/presidential-actions/2025/02/implementing-the-presidents-department-of-government-efficiency-cost-efficiency-initiative/ |access-date=2025-03-27 |website=The White House |language=en-US}}

File:Mary E. Switzer Memorial Building (53840483320).jpg in Washington, DC contains the headquarters of ACL, which is planned to be broken up]]

File:5600 Fishers Lane 2020b.jpg holds the headquarters of HRSA, SAMHSA, and AHRQ, all of which are planned to be merged into other agencies]]

File:NIOSH Taft Laboratory Cincinnati 2017.jpg, whose Taft Laboratory in Cincinnati, Ohio is pictured, is planned to be transferred from CDC to the new AHA]]

The reorganization is planned to reduce the number of top-level HHS divisions from 28 to 15. The following top-level agencies are planned to be created from merging existing agencies:

• The Administration for a Healthy America is planned to be created from merging the Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Office of the Assistant Secretary for Health, and Agency for Toxic Substances and Disease Registry; and absorbing the National Institute for Occupational Safety and Health from the Centers for Disease Control and Prevention.
• The new Office of the Assistant Secretary for Enforcement is planned to absorb the existing Departmental Appeals Board, Office of Medicare Hearings and Appeals, and Office for Civil Rights, all of which are currently directly under the Office of the Secretary.
• The Office of Strategy is planned to be created from merging the Agency for Healthcare Research and Quality and the Office of the Assistant Secretary for Planning and Evaluation.
• An Office of Healthy Futures is planned to combine the Biomedical Advanced Research and Development Authority with the Advanced Research Projects Agency for Health.{{Cite web |last=Owermohle |first=Sarah |date=2025-03-28 |title=HHS emergency response unit given two days to figure out its fate |url=https://www.statnews.com/2025/03/28/hhs-emergency-response-unit-given-48-hours-to-plan-move-to-cdc-control/ |access-date=2025-03-31 |website=STAT |language=en-US}}{{Cite web |last=Tin |first=Alexander |date=2025-03-31 |title=RFK Jr.'s layoffs expected to gut worker safety agency NIOSH, officials say - CBS Colorado |url=https://www.cbsnews.com/colorado/news/rfk-jr-layoffs-hhs-niosh-worker-safety-agency/ |access-date=2025-04-01 |website=CBS News |language=en-US}}

The changes to existing top-level agencies are:

• The Centers for Disease Control and Prevention would be reoriented towards infectious disease programs. It is planned to absorb the Administration for Strategic Preparedness and Response and departmental global affairs staff, while the National Institute for Occupational Safety and Health is planned to move into the new Administration for a Healthy America. Additionally, the Global Health Center, National Center for Injury Prevention and Control, and Division of HIV Prevention would be eliminated or reduced,{{Cite web |last=Lovelace Jr. |first=Berkeley |date=2025-03-27 |title=HHS plans to shutter or downsize several health agencies, including at CDC |url=https://www.nbcnews.com/health/health-news/hhs-plans-shutter-downsize-several-health-agencies-cdc-rcna198254 |access-date=2025-03-27 |website=NBC News |language=en}} and its Freedom of Information Act office would be closed.{{Cite web |last=Katz |first=Eric |date=2025-03-31 |title=Uncertainty grips HHS as employees await their fate and leadership is left in the dark: 'It's madness' |url=https://www.govexec.com/workforce/2025/03/uncertainty-grips-hhs-employees-await-their-fate-and-leadership-left-dark-its-madness/404179/ |access-date=2025-03-31 |website=Government Executive |language=en}}
• The Administration for Community Living is planned to be broken up, with components moving into the existing Administration for Children and Families, and Centers for Medicare and Medicaid Services, and the new Office of Strategy.

Offices at each agency dealing with human resources, information technology, procurement, external affairs, and policy are planned to be replaced with centralized HHS-wide offices. According to Kennedy, HHS is said to have over 100 communications offices, over 40 information technology departments, dozens of procurement offices, and nine human resources departments. Additionally, the ten existing HHS regional offices are planned to be consolidated into five.

File:FDA Entrance (16792957331).jpg, whose White Oak Campus headquarters is pictured, and CDC are each projected to lose 20% of their workforce]]

The plan proposes a reduction in workforce of about 10,000 full-time employees, in addition to 10,000 additional employees who voluntarily left through other programs including a Voluntary Early Retirement Authority and the Deferred Resignation Program. Taken together, these programs are expected to reduce HHS's workforce from 82,000 to 62,000 full-time employees, a figure that excludes about 5,200 probationary workers who were targets of the disputed 2025 mass layoffs.{{Cite news |title=The Trump administration restructures federal health agencies, cuts 20,000 jobs |url=https://www.npr.org/sections/shots-health-news/2025/03/27/nx-s1-5342414/hhs-doge-rif-rfk-job-cuts |access-date=2025-04-03 |work=NPR |language=en}}{{Cite web |last1=Tirrell |first1=Meg |last2=Luhby |first2=Tami |last3=Goodman |first3=Brenda |last4=Gumbrecht |first4=Jamie |date=2025-03-27 |title=HHS cuts 10,000 employees in major overhaul of health agencies |url=https://www.cnn.com/2025/03/27/health/hhs-rfk-job-cuts/index.html |access-date=2025-03-27 |website=CNN |language=en}} Most of these reductions are planned to be targeted towards administrative functions.{{Cite web |last1=Stolberg |first1=Sheryl Gay |last2=Jewett |first2=Christina |date=March 27, 2025 |title=10,000 Federal Health Workers to Be Laid Off |url=https://www.nytimes.com/2025/03/27/us/politics/health-department-job-layoffs-rfk-jr.html |access-date=March 27, 2025 |website=The New York Times}} The layoffs were projected to take effect on May 27, 2025.

The Food and Drug Administration (FDA) is proposed to decrease its workforce by ~3,500 full-time employees, a reduction of about 20%. The FDA cuts would not be applied to drug, medical device, and food reviewers and inspectors.{{Cite web |date=2025-03-27 |title=HHS to lay off 10,000 employees and cut overall workforce by 20,000 |url=https://www.govexec.com/workforce/2025/03/hhs-lay-10000-employees-and-cut-overall-workforce-20000/404092/ |access-date=2025-03-31 |website=Government Executive |language=en}} However, the Center for Devices and Radiological Health faced significant layoffs.{{Cite web |last=Katz |first=Eric |date=2025-04-01 |title=Cancer researchers, opioid abuse analysts, infectious disease experts: Layoffs at HHS begin to take shape |url=https://www.govexec.com/workforce/2025/04/cancer-researchers-opioid-abuse-analysts-infectious-disease-experts-layoffs-hhs-begin-take-shape/404212/ |access-date=2025-04-02 |website=Government Executive |language=en}}

The Centers for Disease Control and Prevention (CDC) is proposed to decrease its workforce by ~2,400, also a reduction of about 20%. The announcement stated that only 1,000 of the Administration for Strategic Preparedness and Response's 5,000 employees would join CDC, implying that the rest would be laid off or reassigned. Over two-thirds of the staff of the National Institute for Occupational Safety and Health was laid off, which most strongly impacted its mining safety research and respirator approval programs, with its laboratory in Spokane, Washington expected to close completely,{{Cite web |last1=Saglimbeni |first1=Vinny |last2=Gallo |first2=Regan |date=2025-04-01 |title=Concerns over safety rise as Spokane National Institute of Occupational Safety and Health workers face layoffs |url=https://www.krem.com/article/news/local/spokane-national-institute-of-occupational-safety-and-health-employee-layoffs/293-7119fa11-339e-4171-bb03-675f49be3699 |access-date=2025-04-02 |website=KREM |language=en-US}} as well as the National Firefighter Registry for Cancer.{{Cite web |last=Carey |first=Bill |date=2025-04-02 |title=National Firefighter Registry for Cancer goes offline following NIOSH layoffs |url=https://www.firerescue1.com/cancer/national-firefighter-registry-for-cancer-goes-offline-following-niosh-layoffs |access-date=2025-04-03 |website=FireRescue1 |language=en-US}}

The National Institutes of Health is proposed to decrease it workforce by ~1,200, and the Centers for Medicare & Medicaid Services by ~300. The Health Resources and Services Administration's workforce was decreased by a third, especially impacting its Bureau of Primary Health Care. The Indian Health Service was exempt from firings.

File:Secretary Robert F. Kennedy Jr. HHS reorganization announcement 2025.webm

The reorganization was announced through a press release and video posted on social media on March 27, 2025.{{Cite news |last=Kennedy Jr. |first=Robert F. |date=2025-03-27 |title=We are streamlining HHS to make our agency more efficient and more effective |url=https://x.com/SecKennedy/status/1905243470366670926 |archive-url=http://web.archive.org/web/20250328002402/https://x.com/SecKennedy/status/1905243470366670926 |archive-date=2025-03-28 |access-date=2025-03-31 |work=X (formerly Twitter) |language=en}} It was reported that there was no input from agency-level human resources staff or leadership before the reorganization was announced, and details beyond the press release were not immediately provided to employees. It was also reported that the sending of notices was delayed due to tensions between HHS leadership and the DOGE lead for HHS, with the former being given extra time to scrutinize the firing plans.{{Cite web |last1=Cai |first1=Sophia |last2=Cancryn |first2=Adam |last3=Gardner |first3=Lauren |date=2025-03-31 |title=Internal fallout at HHS delays 10,000 firings |url=https://www.politico.com/news/2025/03/31/doge-hhs-firings-delayed-00262115 |access-date=2025-04-02 |website=Politico |language=en}}

Notices went out to employees early in the morning of April 1, although some employees learned they had been laid off only when their entry badges failed to work when they arrived in the morning.{{Cite web |last1=Valencia |first1=Nick |last2=Goodman |first2=Brenda |last3=Tirrell |first3=Meg |last4=Luhby |first4=Tami |last5=Lyngaas |first5=Sean |date=2025-04-01 |title='It's a bloodbath': Massive wave of job cuts underway at US health agencies |url=https://www.cnn.com/2025/04/01/health/staff-cuts-at-federal-health-agencies-have-begun/index.html |access-date=2025-04-02 |website=CNN |language=en}} Long lines formed at the entrances to some federal buildings due to increased security. Because the layoffs targeted entire units, the normal process of ranking individual personnel to lay off was avoided. Many senior leaders were told they were being reassigned to Indian Health Service locations in Alaska, Montana, New Mexico, Minnesota, or other locations far from Washington, DC, to entice them to leave voluntarily.{{Cite news |last1=Johnson |first1=Carolyn Y. |last2=Roubein |first2=Rachel |last3=Achenbach |first3=Joel |last4=Sun |first4=Lena H. |last5=Weber |first5=Lauren |date=2025-04-01 |title=Widespread layoffs, purge of leadership underway at U.S. health agencies |url=https://www.washingtonpost.com/health/2025/04/01/hhs-senior-leaders-put-on-leave-nih/ |access-date=2025-04-02 |newspaper=The Washington Post |language=en-US |issn=0190-8286}}

The creation of the Administration for a Healthy America and the broader HHS restructuring have drawn criticism from public health experts, former officials, labor unions, and Democratic lawmakers. Critics argue that the layoffs—part of a plan to reduce HHS staff by 20,000 employees—will severely impact the department's capacity to respond to public health crises. Senator Patty Murray described the plan as “an absurd suggestion” that “defies common sense,” citing ongoing outbreaks of bird flu, measles, and the fentanyl epidemic.

Labor unions also raised concerns. Doreen Greenwald, president of the National Treasury Employees Union, which represents around 18,500 HHS staff, stated the administration's claims that deep cuts to agencies like the Food and Drug Administration would not be harmful were "preposterous," and vowed to “pursue every opportunity to fight back.” Critics further expressed unease about centralizing oversight under HHS Secretary Robert F. Kennedy Jr., who has a long history of promoting discredited claims regarding vaccine safety.{{Cite web |last1=Cirruzzo |first1=Chelsea |last2=Cancryn |first2=Adam |date=March 27, 2025 |title='Painful period': RFK Jr. eliminates 10,000 jobs at HHS |url=https://www.politico.com/news/2025/03/27/hhs-to-cut-thousands-of-workers-in-sweeping-reorganization-00253359 |access-date=March 27, 2025 |website=Politico}}

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