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

Robert F. Kennedy Jr. announced the reorganization on March 27, 2025, as an implementation of President Donald Trump's Executive Order 14210.|left The current overall organizational structure of HHS is the result of the Public Health Service reorganizations of 1966–1973, 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. Since then there have been a few new operating agencies and minor reorganizations. 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. 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. 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. == Provisions ==

Organizational changes holds the headquarters of HRSA, SAMHSA, and AHRQ, all of which are planned to be merged into other agencies. , 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 three agencies, and components of three more: • It is planned to absorb the following top-level agencies: the Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, and Office of the Assistant Secretary for Health (OASH). • The Office of the Assistant Secretary for External Affairs is planned to consolidate global, legislative, intergovernmental, and public affairs functions. The Division of HIV Prevention would also be eliminated or reduced. • The National Institutes of Health is proposed to have four of its institutes eliminated, and the remainder consolidated into eight institutes: Most of these reductions are planned to be targeted towards administrative functions. The layoffs were projected to take effect on May 27, 2025. However, the Center for Devices and Radiological Health faced significant layoffs. The Centers for Disease Control and Prevention (CDC) is proposed to decrease its workforce by ~2,400, 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, as well as the National Firefighter Registry for Cancer. 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. == Implementation ==

The reorganization was announced through a press release and video posted on social media on March 27, 2025. 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. More details about the reorganization were contained in the Trump Administration's presidential budget request for fiscal year 2026, which was released on May 30, 2025. == Litigation ==

The case AFGE v. Trump was brought by the American Federation of Government Employees and other plaintiffs seeking to stop implementation of Executive Order 14210 in several government agencies including HHS. On May 9, 2025, the District Court for the Northern District of California issued a temporary restraining order preventing any new reduction in force (RIF) firings in the affected agencies. This was later extended into a preliminary injunction that also ordered that RIFs be reversed, but stayed this until appeals were exhausted. On May 30, the Court of Appeals for the Ninth Circuit declined to overturn the ruling, but the Supreme Court overturned it on July 8. The case New York v. Kennedy was brought by 19 states and the District of Columbia challenging the personnel actions and reorganization for HHS specifically. On July 1, the District Court for the District of Rhode Island issued a preliminary injunction ruling that the reorganization likely violated the Administrative Procedure Act, and preventing HHS from issuing or enforcing new or existing RIF firings or placement on administrative leave, or implementing the announced restructurings. On July 18 the court rejected that the AFGE Supreme Court decision was controlling. == Reaction ==

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. == References ==