Trump officials defended the layoffs imposed by billionaire Elon Musk's unofficial Department of Government Efficiency, describing them as methodical decisions designed to preserve the core functions of the Department of Health and Human Services (HHS). However, insiders within the agencies contested this account, portraying the cuts as deep and at times indiscriminate. Even some Trump political appointees were unaware of which employees were being fired or the reasons behind these decisions.
The cuts affected officials working on Medicare and Medicaid initiatives at the Center for Medicare and Medicaid Innovation (CMMI) and the CMS office overseeing Obamacare. Staff at the FDA offices that regulate prescription drugs and medical devices were also impacted. The layoffs at the FDA included personnel who review medical device products, raising concerns about potential delays in the agency's ability to evaluate and approve new devices.
The HHS' Administration for Strategic Preparedness and Response (ASPR) was also affected, drawing sharp criticism from public health experts who warned that the cuts could impair the government's frontline response to threats such as bird flu. The administration plans to terminate most of the CDC's public health fellows, including those involved in public health research at the Laboratory Leadership Service.
Reshma Ramachandran, a Yale health professor and chair of the FDA task force for the nonprofit Doctors for America, expressed concern, stating, “On day one, the new HHS secretary is gutting the agencies necessary to make America healthy again.”
Democratic lawmakers criticized the firings as a threat to the government's public health defense, with Sen. Jon Ossoff (D-Ga.) commenting that the deep cuts at the CDC "leave Americans exposed to disease and devastate careers and livelihoods for the world's most talented doctors and scientists."
The firings at CMS, FDA, and ASPR followed announcements by Trump officials to various media outlets, claiming exemptions for employees in core areas such as Medicare, Medicaid, and emergency preparedness. Yet, the weekend layoffs seemed to contradict those assurances. An administration official argued that the ASPR cuts affected only those not actively engaged in emergency preparedness, like those in legislative affairs or human resources.
Despite official claims of a methodical process, insiders described mass confusion and disorder within the department leading up to the layoffs. Managers scrambled to review lists of probationary employees eligible for firing, often laden with errors, and submit justifications for retaining essential personnel. Many Trump political appointees remained uninformed about the number of cuts or the criteria used by the administration.
Layoffs were conducted haphazardly, with some employees receiving termination letters while others were locked out of their email without notice. Termination letters obtained by POLITICO cited inadequate performance despite recent evaluations indicating excellence.
As the situation unfolded, employees at CMMI were assured by supervisors that they were safe, only to later receive termination emails. Some were notified on Friday evening, while others learned of their fate on Saturday, forcing them to notify supervisors of their unavailability for work in the coming week. With no guidance on remaining layoffs or the official end of the purge, employees spent Sunday anxiously checking emails for updates on their employment status.
