Trump Administration Proposes Major Cuts to Health Department

In March 2025, the Trump administration announced a comprehensive reorganization of the U.S. Department of Health and Human Services (HHS), proposing significant budget cuts and structural changes aimed at streamlining operations and reducing federal expenditures. This plan has sparked widespread debate over its potential impact on public health services nationwide.

The fiscal year 2026 budget proposal outlines a 26.2% reduction in HHS funding, amounting to a $93.8 billion decrease. Key agencies affected include the National Institutes of Health (NIH), facing a $17.96 billion cut, and the Centers for Disease Control and Prevention (CDC), with a $3.58 billion reduction. These cuts are part of a broader effort to consolidate 28 operating divisions into 15, with the creation of the Administration for a Healthy America (AHA) being a central component. The AHA is intended to merge several existing agencies, including the Health Resources and Services Administration and the Substance Abuse and Mental Health Services Administration, to improve efficiency and reduce redundancy within HHS.

The restructuring plan also includes a reduction of approximately 20,000 full-time employees within HHS, decreasing the federal health workforce from 82,000 to 62,000 employees. Initial layoffs affected around 10,000 federal health workers, with further reductions anticipated. The FDA and CDC are each expected to decrease their workforce by about 20%, equating to 3,500 and 2,400 positions, respectively.

These budget cuts have had a profound effect on state and local health departments. In March 2025, the CDC announced the withdrawal of $11.4 billion in COVID-19 relief funds that had been repurposed for essential services such as vaccination programs and disease monitoring. This abrupt funding loss led to layoffs, program closures, and diminished capacity to respond to public health threats.

The reorganization and associated budget cuts have drawn significant criticism from various stakeholders. Public health experts and former officials argue that the layoffs and budget reductions would severely impair the nation's ability to address current and future 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 have also expressed strong opposition. Doreen Greenwald, president of the National Treasury Employees Union, which represents around 18,500 HHS staff, stated that the administration's claims that deep cuts to agencies like the FDA would not be harmful were "preposterous," and vowed to "pursue every opportunity to fight back."

Democratic lawmakers have raised concerns about centralizing oversight under HHS Secretary Robert F. Kennedy Jr., who has a history of promoting discredited claims regarding vaccine safety. They argue that such consolidation could undermine public trust in health agencies and compromise the effectiveness of public health initiatives.

The proposed changes have significant implications for the nation's public health infrastructure. The reduction in funding and workforce may hinder the ability to respond effectively to health emergencies, conduct essential research, and provide critical services to vulnerable populations. Additionally, the consolidation of agencies into the AHA raises questions about the potential loss of specialized expertise and the effectiveness of a more centralized approach to public health.

As the debate continues, the future of the proposed reorganization and budget cuts remains uncertain. The administration's plan requires congressional approval, and it is expected that lawmakers will scrutinize the potential impacts on public health before making a final decision. The outcome of this legislative process will have lasting effects on the structure and function of the nation's health system.