RFK Jr. is gutting minority health offices across HHS that are key to reducing health disparities

CNBC

30-04-2025

Robert F. Kennedy Jr.'s overhaul of the Department of Health and Human Services involves deep cuts to several divisions that help protect and improve the health of minority and underserved populations and eliminate health disparities in the U.S., CNBC has learned.
Kennedy, the Health and Human Services secretary, has gutted at least seven minority health offices across the department, according to people familiar with the matter, who requested anonymity to speak freely. HHS has laid off a significant share of workers at those offices, or in some cases all of them, along with their directors, the people said.
The affected units include the HHS Office of Minority Health and the National Institute on Minority Health and Health Disparities, or NIMHD. The cuts also hit offices with similar functions at the Food and Drug Administration, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration, according to the people.
Health policy experts told CNBC that deep cuts to those programs could widen existing health disparities in the U.S., undoing years of progress toward addressing them. Over time, that could worsen health outcomes for already underserved groups, threaten overall public health, strain the U.S. health-care system and drive up health-care costs.
"It will have negative health impacts, obviously, for groups that they're focused on, so racial and ethnic minorities, but I think what gets missed in the story is it ultimately impacts all of us, no matter what your background is," Dr. Stephanie Ettinger De Cuba, research professor of health law, policy and management at Boston University, told CNBC.
"It's not a zero-sum game. So I think that's what is deeply disturbing to me, as we are going to see people get hurt," she said. "Decimating or cutting staff from these offices ultimately makes it worse for everyone."
The Trump administration can't shutter the affected offices entirely, which would be against the law since they were authorized by the Affordable Care Act more than a decade ago, the people said. The exact fate of each office and the NIH institute is unclear, they added.
The administration likely hopes to at least "narrow the scope" of what NIMHD and the agency offices do, curtailing their authority and limiting resources, said Brandyn Churchill, professor of public administration and policy at American University.
The cuts come as health disparities remain a major challenge in the U.S., affecting not only people of color but also rural residents, low-income communities and individuals with disabilities, among several other groups. These communities often face worse health outcomes – such as lower life expectancy and higher rates of infant mortality and chronic disease – and more limited access to care and other resources than the U.S. population as a whole.
The Covid-19 pandemic deepened many of these gaps, highlighting how the long U.S. history of exclusionary policies and systemic issues such as poverty and racism contribute to unequal health outcomes across the country.
Health policy experts stress that addressing those disparities leads to stronger overall public health, as healthier communities improve outcomes for everyone. It could also relieve a huge economic burden on the U.S: a 2023 study funded by NIMHD found that racial and ethnic health disparities cost the U.S. economy $451 billion in 2018.
Kennedy is consolidating divisions and slashing 10,000 jobs at HHS, a $1.7 trillion agency that oversees vaccines and other medicines, scientific research, public health infrastructure, pandemic preparedness, and food and tobacco products. HHS also manages government-funded health care for millions of Americans – including seniors, disabled people and lower-income patients who rely on Medicare, Medicaid and the Affordable Care Act's markets.
Kennedy plans to create a new HHS agency called the Administration for a Healthy America, which will combine several existing offices. That includes HRSA, SAMHSA, the Office of the Assistant Secretary for Health, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health.
A leaked 64-page preliminary budget document also indicates that the HHS Office of Minority Health would fall under that new agency, according to several reports. But that proposal, which would slash the HHS budget by a third, or roughly $40 billion, requires congressional approval.
HHS did not immediately respond to a request for comment.
While the breadth of the cutbacks varied at agencies within HHS, the minority health agencies across the departments will now be only a fraction of their former size.
All 40 staff members at the CMS Office of Minority Health were laid off, according to the people. CMS plans to appoint a new director for that unit, CNBC previously reported. But current Director Martin Mendoza has not resigned from his role, the people said.
The office works with local and federal partners to eliminate disparities in health coverage, aiming to ensure that minority and underserved populations can access Medicare, Medicaid and Affordable Care Act marketplace plans. It also conducts research and analysis to help lower costs and reduce the incidence and severity of chronic diseases in the U.S.
Nearly all staff at the CDC's Office of Minority Health were cut, according to the people. To adhere to the letter of the law, the Trump administration is considering reconstituting that unit and the Office of Women's Health so that each office would be made up of at least one director or a very small group of employees, the people said.
The agency's Office of Minority Health works across CDC to promote research of health disparities and create programs to improve the health of racial and ethnic minority groups.
At the FDA's Office of Minority Health and Health Equity, all staff were cut, the people said. The future of that office is unclear.
The unit focuses on efforts such as increasing clinical trial diversity, improving transparency around how medical products affect different populations, and creating health resources tailored to a range of languages and cultures.
No staff are left at HRSA's Office of Health Equity after the layoffs, as well as some retirements and reassignments, according to the people. That office leads efforts to reduce disparities in health-care access, quality and outcomes through HRSA, which focuses on people who are uninsured, geographically isolated, or economically and medically vulnerable.
The future of that office is also unclear, apart from the Trump administration's plans to fold HRSA into Kennedy's new agency.
The same goes for SAMHSA's Office of Behavioral Health Equity, which saw all remaining staff cut except for a new, recently hired director, according to the people. The office also had a retirement and one worker on probation who was put on administrative leave.
The office works to ensure that SAMHSA's resources for mental health and substance abuse treatment, including grant programs and other initiatives, are equitably distributed across all communities and populations.
Roughly a third of staff are gone at NIMHD, some of whom were laid off and others who left due to early retirements and buyouts, the people said. Some workers on probation were put on leave several weeks before Kennedy started cuts, they said.
The institute's deputy director accepted an offer to be acting director in the short term, the people added. NIMHD, which is part of the National Institutes of Health, works to reduce health disparities through conducting and funding research and developing new programs.
The HHS Office of Minority Health also faced cuts, though it's unclear how many staff were impacted, the people said. That office leads the federal effort to improve health outcomes for racial and ethnic minority groups, developing policies and programs and providing funding.
It will likely take several months to a year before the U.S. sees direct consequences from the cuts to NIMHD and the offices, said Terry McGovern, professor at the CUNY Graduate School of Public Health and Health Policy.
But the staff reductions could cause the U.S. to lose out on crucial data, which is the cornerstone for addressing health disparities, according to Samantha Artiga, director for the racial equity and health policy program at KFF, a health policy research organization.
Artiga said data and research are essential for pinpointing where disparities exist, understanding their root causes, crafting effective solutions, and tracking progress over time. For example, data can reveal whether certain groups experience worse surgical outcomes or wait longer at the emergency room, or if a vaccination program is being equitably distributed across regions.
"Without focused data and research, those disparities may remain unseen and unaddressed, creating blind spots," Artiga said, adding that the U.S. would eventually have to rebuild that knowledge in the future.
The fate of many of the grants that NIMHD and some of the offices provide is unclear. That includes $11.6 million in recent grant awards from HHS' Office of Minority Health to 20 organizations for a four-year initiative to identify strategies that increase the use of preventive health services in communities.
But if offices cut back that funding or stop it altogether, it could also weaken the nation's ability to reduce health disparities, Boston University's Ettinger De Cuba said.
Community-based organizations rely on federal money to deliver culturally tailored care to different groups, and could be forced to scale back or shut down programs. The loss of grants could also stall research, innovation and public health interventions by outside entities, such as universities, health-care systems and social service organizations.
"Philanthropy is not able to step up at this level long term. The only actor that's able to do that is the government," Ettinger De Cuba said.
Nathan Boucher, research professor at Duke's Sanford School of Public Policy, added that the cuts will "degrade any effort of these larger governmental organizations to have any accountability when it comes to protecting the people they help and serve every day."
While Kennedy has said his cuts are focused on making HHS more "responsive and efficient," Boucher said targeting minority health offices could do the opposite.
"I actually think it's an efficiency argument to be able to have these minority health offices, because it allows you to identify and target some real problem areas and use taxpayer dollars in the most efficient way possible," said Boucher.