The Trump Administration Just Gutted U.S. Health Institutions
The layoffs came in many formats: in emails at 5 a.m., in person when employees tried to swipe their badges at the workplace and found they were deactivated, in messages while they waited in line to try to get into their offices, according to current and former employees.
HHS first announced a 'dramatic restructuring' on March 27 that would shrink HHS to 62,000 employees from 82,000, including about 10,000 layoffs and about 10,000 people who retired or resigned. In a press release, the department said that it would consolidate 28 divisions into 15 new divisions, calling the reorganization a 'Transformation to Make America Healthy Again.'
Included in the April 1 layoffs, according to current and former staff interviewed by TIME, were dozens of members of a division of the U.S. Food and Drug Administration (FDA) that oversees the safety of food, including administrative staff, project managers, HR, and communications staff. An entire division of the U.S. Centers for Disease Control and Prevention (CDC) that oversees the cleanliness of cruise ships was apparently let go, as were staff managing the CDC's Freedom of Information Act requests. Staff for the Low Income Home Energy Assistance Program, which helps keep on utilities for struggling families, were eliminated. All regional administrators for the Administration for Community Living, which oversees programs supporting older adults and people with disabilities, were relieved of their duties. Staff of five of the 10 regional offices for the Administration for Children and Families—which oversees programs like Temporary Assistance for Needy Families (commonly known as food stamps)—were laid off.
HHS did not return an email and call seeking comment or confirming these cuts. But in the March 27 news release, HHS Secretary Robert F. Kennedy Jr. said that the department was 'reducing bureaucratic sprawl' and that the much smaller department would do more, at a lower cost to the taxpayer.
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High-profile leaders appear to have been targeted. Jeanne Marrazzo, the head of the National Institute of Allergy and Infectious Diseases and the successor to Dr. Anthony Fauci, was put on administrative leave, as was Jonathan Mermin, the director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention.
'They are eliminating entire teams, offices, divisions—the impact of which is going to leave our nation less prepared to deal with a variety of health challenges,' says Adrian Shanker, who was the deputy assistant secretary for health policy in the Biden Administration. 'The cruelty seems to be the point.'
The cuts come as HHS also cancels $11.4 billion COVID-era grants that were providing essential services on a state and local level. Communities are already feeling the effects. Uplift Wisconsin, a call line operated through Mental Health of Wisconsin, will be shut down by April 4 because its COVID-19 grant was canceled, according to reporting by the Milwaukee Journal Sentinel. 'The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,' the department said in late March.
In the April 1 layoffs, infectious diseases programs and especially HIV research appear to have been targeted. Prior to staff being laid off, HHS had announced the termination of dozens of grants related to HIV research.
'It's just a massive assault and decimation of HIV prevention—they are really focused on gutting prevention and research,' says Carl Schmid, the executive director of the HIV+Hepatitis Policy Institute, who is tracking the layoffs. The cuts affected staff for the Presidential Advisory Council on HIV/AIDS, HIV/AIDS communications staff, and more, he says.
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Communications staff are especially important as new treatments for HIV/AIDS are released, he says. For example, there is a new version of the HIV drug PrEP (pre-exposure prophylaxis) coming out, he says, and the communication staff are responsible for making sure that patients and providers know about the new medication. White men may be accessing PrEP, but certain groups of people are not, including transgender people, Black men, and Latino men, he says. 'I anticipate that HIV cases will go up, and this is going to be more costly to our system,' Schmid says.
HHS's March 27 memo said that it would reorganize the Administration for Community Living, which oversees programs supporting older adults and people with disabilities. But all regional administrators of the Administration for Community Living, along with the entire staff overseeing grants, were laid off, according to Alison Barkoff, who was the acting administrator of ACL from Jan. 2021 to Oct. 2024.
Congress has appropriated money to local and state groups that help seniors and people with disabilities, but there is no staff left to administer it, she says. The Administration for Community Living often helped seniors and people with disabilities live at home and avoid facilities.
'I don't know when they will get this funding, and many of them cannot go for a long time without access to funding and continue to provide these services,' she says.
One laid-off worker at the Administration for Community Living is Fay Gordon, a single mother of two who is undergoing breast cancer treatment and who was the Region 9 Administrator. She helped coordinate disaster response for seniors and people with disabilities.
'We are the ones providing care and service so that people can live at home and in their community,' she says. 'The fact that any leadership would not value this lean, cost-effective service is heartbreaking.'
It's too early to tell the layoff's impact on food safety, but the FDA was already struggling to create and enforce regulations even before it was gutted, says Sarah Sorscher, director of regulatory affairs at the Center for Science in the Public Interest. After the 2022 formula recall, in which infants were hospitalized after drinking tainted powdered formula made from an Abbott Laboratories' plant, the FDA underwent a dramatic reorganization. There is now a unified Human Foods Program that oversees inspections and safety of food.
But, Sorscher says, 'this program is so small, there's not a lot of room to make cuts before you lose functioning.'
Contact us at letters@time.com.
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