On March 27, 2025, the U.S. Department of Health and Human Services (HHS) unveiled a significant restructuring plan following President Trump's Executive Order titled “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” This ambitious restructuring aims to achieve several objectives while ensuring that critical health services remain unaffected.
One of the primary goals of this restructuring is to save taxpayers an impressive $1.8 billion annually. This will be accomplished through a reduction of approximately 10,000 full-time employees as part of this transformative initiative. When combined with HHS' ongoing efforts, such as early retirement programs and the "Fork in the Road" initiative, the total downsizing will reduce the workforce from 82,000 to 62,000 full-time employees.
The restructuring plan also seeks to streamline the numerous functions of the HHS. Currently, the department comprises 28 divisions, many of which contain overlapping units. The reorganization will consolidate these divisions into just 15 newly formed entities, including a significant new body known as the Administration for a Healthy America (AHA). This change will centralize key functions such as Human Resources, Information Technology, Procurement, External Affairs, and Policy. Additionally, regional offices will be reduced from 10 to 5, enhancing operational efficiency.
Another vital component of the restructuring is the HHS's renewed focus on addressing America's epidemic of chronic illness. The department will prioritize initiatives centered on safe and wholesome food, clean water, and the elimination of environmental toxins. These priorities will be integrated into the reorganization of HHS, ensuring a holistic approach to public health.
The overhaul aims to improve the overall experience of Americans interacting with HHS. By making the agency more responsive and efficient, the restructuring will ensure that essential health services such as Medicare and Medicaid remain intact and continue to serve the public effectively. “We aren't just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” stated HHS Secretary Robert F. Kennedy, Jr. “This Department will do more – a lot more – at a lower cost to the taxpayer.”
The following are key components of the announced restructuring plan:
Creation of the Administration for a Healthy America (AHA): This new entity will combine several agencies, including the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry (ATSDR), and the National Institute for Occupational Safety and Health (NIOSH). This centralization aims to enhance coordination of health resources, particularly for low-income Americans, focusing on areas like Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce Development. Strengthening the Centers for Disease Control and Prevention (CDC): The Administration for Strategic Preparedness and Response (ASPR) will be transferred to the CDC, reinforcing its mission to protect Americans from health threats. New Assistant Secretary for Enforcement: HHS will create this position to oversee various boards and offices, including the Departmental Appeals Board (DAB), Office of Medicare Hearings and Appeals (OMHA), and Office for Civil Rights (OCR), in an effort to combat waste, fraud, and abuse in federal health programs. Research and Evaluation for Health Policy: HHS plans to merge the Assistant Secretary for Planning and Evaluation (ASPE) with the Agency for Healthcare Research and Quality (AHRQ) to form the Office of Strategy. This new office will enhance research that informs health policies and improves federal health program effectiveness. Reorganization of the Administration for Community Living (ACL): Essential programs supporting older adults and individuals with disabilities will be integrated into other HHS agencies, ensuring continued support without impacting Medicare and Medicaid services.As Secretary Kennedy noted, "Over time, bureaucracies like HHS become wasteful and inefficient even when most of their staff are dedicated and competent civil servants." This comprehensive restructuring is designed to be mutually beneficial for both taxpayers and the individuals HHS serves. The ultimate goal is to Make America Healthy Again, reinforcing the department's commitment to public health and wellness for all Americans.
