
US judge says layoffs at Department of Health and Human Services were likely unlawful and must be halted
US District Judge Melissa DuBose granted the preliminary injunction sought by a coalition of attorneys general from 19 states and the District of Columbia in a lawsuit filed in early May.
DuBose said the states had shown 'irreparable harm,' from the cuts and were likely to prevail in their claims that 'HHS's action was both arbitrary and capricious as well as contrary to law.'
'The executive branch does not have the authority to order, organize, or implement wholesale changes to the structure and function of the agencies created by Congress,' DuBose wrote in a 58-page order handed down in US District Court in Providence, Rhode Island, on Tuesday.
Her order blocks the Trump administration from finalizing layoffs announced in March or issuing any further firings. HHS is directed to file a status report by July 11.
The ruling applies to terminated employees in four divisions of HHS: the US Centers for Disease Control and Prevention; the Center for Tobacco Products within the Food and Drug Administration; the Office of Head Start within the Administration for Children and Families and employees of regional offices who work on Head Start matters; and the Office of the Assistant Secretary for Planning and Evaluation.
Health Secretary Robert F. Kennedy Jr. eliminated more than 10,000 employees in late March and consolidated 28 agencies to 15. Since then, agencies including the CDC have repeatedly rescinded layoffs affecting hundreds of employees, including in branches that monitor HIV, hepatitis and other diseases.
The attorneys general argued that the massive restructuring was arbitrary and outside of the scope of the agency's authority. The lawsuit also says that the action decimated essential programs and pushed burdensome costs onto states.
'The intended effect … was the wholesale elimination of many HHS programs that are critical to public health and safety,' the lawsuit argued.
The cuts are part of a federal 'Make America Healthy Again' directive to streamline costly agencies and reduce redundancies. Kennedy told senators at a May 14 hearing that there is 'so much chaos and disorganization' at HHS.
But the restructuring had eliminated key teams that regulate food safety and drugs, as well as support a wide range of programs for tobacco, HIV prevention and maternal and infant health. Kennedy has since said that because of mistakes, 20% of people fired might be reinstated.
The states who joined the lawsuit have Democratic governors, and many of the same states — plus a few others — also sued the Trump administration over $11 billion in cuts to public health funding. A preliminary injunction was granted in that case in mid-May.
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This transcript has been edited for clarity. Welcome to Impact Factor , your weekly dose of commentary on a new medical study. I'm Dr F. Perry Wilson from the Yale School of Medicine. Burnout is a huge problem across multiple professions in the United States. Grades K-12 teachers have about a 50% burnout rate. So do people in quality assurance. But I was unable to find a profession with a higher rate of burnout, or a higher potential for harm from burnout, than — you guessed it — physicians. A 2022 survey found that 63% of physicians had burnout, rates that have been among the highest of all US workers since 2011. And this is a huge problem. When docs are burned out, they are more likely to commit medical errors, be named in malpractice suits, and even exhibit racial biases. Administrators of health systems have taken notice. But their solutions have often been criticized as tone-deaf. 'Mandatory burnout workshops' are not helping anyone's burnout, I promise you. 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One group got a smartwatch, specifically the Venu 2 Plus from Garmin, to wear for 6 months. The other group got nothing. Well, to be fair, they got a smartwatch as well — just after a 6-month wait so the team would have 6 months of high-quality comparison data. At the beginning of the study and several times over those 6 months, the participants took surveys about their mental health: a resilience survey, a quality-of-life survey, a depression survey, a stress survey, a sleep survey and, importantly, a burnout survey. At baseline, 50% of people in the intervention arm were burned out and 43% were burned out in the control arm. After 6 months, burnout dropped to 41% in the intervention arm and rose to 51% in the control arm. 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The private-practice model is rapidly dying and the physician workforce is learning what it means to be labor instead of management. They are feeling what it is like to be exploited, for lack of a better word — pushed to see more patients in less time, pushed to generate more RVUs, pushed to work weekends and nights to increase margins. It's not what they signed up for. The problem of burnout is from the system. If you want to cut rates in half, you don't send docs a smartwatch. You give them more time to see fewer patients. You change the insurance system that leaves us on the phone arguing for prior authorization for hours at a time. And if that affects the bottom line of the health system, you look for cuts in the — and this is true — 10 administrators for each physician in the US. Look, I love my smartwatch. It helps me delete emails while I'm waiting for the elevator. But the solution to physician burnout is not here. It's out there.
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