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Updated: March 28 at 10:23 a.m. ET
President Donald Trump signed an executive order March 27 giving himself authority to end collective bargaining across federal unions, just hours after Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced the department could expect 10,000 job cuts in upcoming days.
The executive order said unions with “national security missions” would be impacted. The order applies to workers at the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Department of Veterans Affairs, the National Science Foundation, the HHS Office of General Counsel, the National Institute of Allergy and Infectious Disease, the Administration for Strategic Preparedness and Response (ASPR) and more. Trump’s executive order claims current collective bargaining agreements (CBA) allows “hostile” unions to block a department’s agenda.
A memo (PDF) from the Office of Personnel Management was published before the executive order. It said these departments are “no longer required to collectively bargain with federal unions. Government agencies were told to limit the required duration of performance improvement plans, makes it easier to fire VA workers “with a lower burden of proof,” ignore CBA requirements surrounding reductions in force and disregard union protections against return-to-office policy.
One of the largest government labor unions, often suing Trump in court during his second term, said the announcement is a “clear threat” to its members and all Americans.
“AFGE is preparing immediate legal action and will fight relentlessly to protect our rights, our members and all working Americans from these unprecedented attacks,” said American Federation of Government Employees President Everett Kelley in a statement.
Simultaneously, the HHS is set to slash 10,000 full-time jobs and further remake the agency in the Trump administration’s vision.
These cuts—in line with the Department of Government Efficiency’s (DOGE’s) “workforce optimization” efforts—will save the agency $1.8 billion per year, HHS said in a Thursday morning news release. After factoring in early retirement and the “fork in the road” offering from earlier this year, the agency’s total headcount will decrease by 20,000 members.
In an announcement posted online, Secretary Robert F. Kennedy Jr. said good-natured, intelligent employees are bogged down by bureaucracy, with a budget that grew by 38% during the Biden administration.
Approximately 300 cuts will hit the Centers for Medicare and Medicaid Services (CMS). These layoffs will prioritize “reducing minor duplication,” but promising the reorganization will not impact Medicare and Medicaid services.
At the FDA, 3,500 workers will be let go. HHS said the cuts will not affect drug, medical device or food reviewers. Inspectors will also not be impacted.
The CDC will fire 2,400 employees, while the National Institutes of Health will slash its workforce by 1,200 workers and “centralize procurement, human resources and communications” across 27 institutes and centers, a fact sheet explains.
During the firing of probationary employees earlier this year, in tandem with the Department of Government Efficiency spearheaded by Tesla CEO Elon Musk, employees in these roles were fired and promptly asked to return. These terminations are working through the court system and are currently halted, with many on administrative leave as they wait for more clarification from supervisors and judges. A recent court filing said HHS sent out 3,248 termination notices to probationary employees.
HHS said they do not anticipate cuts beyond these, but the department will seek additional opportunities to “streamlines its operations and agencies.”
“This will be a painful period for HHS as we downsize from 82,000 employees to 62,000, but we are keenly focused on paring away excess administrators while increasing the number of scientists and frontline health providers so we can do a better job for the American people,” Kennedy said.
Senator Ron Wyden, D-Oregon, and former HHS Secretary Xavier Becerra condemned the cuts in statements Thursday morning.
“American families are going to be hurt by layoffs and closures of this magnitude, full stop,” Wyden warned. “These offices work closely with communities to make sure child care, hospitals and nursing homes are safe, strengthen rural health care, and much more. The chaos that is coming will guarantee that kids and seniors fall through the cracks with deadly consequences.”
“It’s hard to make sense of the HHS cuts announced this morning,” said Becerra. “This has the makings of a manmade disaster.”
Reorganization and consolidation
The department said there are 28 redundant offices that will be consolidated into 15 new divisions, and 10 regional offices will become five. RFK. Jr. claimed there are more than 100 communications offices, more than 40 IT offices, a dozen procurement offices and nine human resource departments—all operating in silos without communicating together.
“Some of these little fiefdoms, for example, are so insulated and territorial that they actually hoard our patient medical data and sell it for profit to each other,” RFK Jr. said, adding some public health divisions are “neglecting” public health and are only interested in helping the industries they are supposed to regulate.
RFK Jr. accused some health divisions of not working in the best interest of Americans, a characterization that is sure to be criticized by Democratic lawmakers and current government employees.
Tammy Baldwin, a Democratic Senator from Wisconsin, decried the administration’s plans. “The Trump Administration is endangering your family’s health to make more room in the budget for their billionaire tax breaks and rig the system for themselves,” she wrote in a statement.
As part of the change, HHS will now house an Administration for a Healthy America, or AHA, which will be focused on human resources, information technology, procurement, external affairs and policy.
AHA will combine the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry and the National Institute for Occupational Safety and Health.
“This centralization will improve coordination of health resources for low-income Americans and will focus on areas including, primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development,” said HHS.
The CDC will assume control of the ASPR, an agency formerly tasked with natural disasters and other public health threats.
A new Assistant Secretary for Enforcement will oversee the Departmental Appeals Board, Office of Medicare Hearings and Appeals and the Office for Civil Rights. This person will be tasked with rooting out waste, fraud and abuse.
Long-rumored to be on the chopping block, the Agency for Healthcare Research and Quality will merge with the Assistant Secretary for Planning and Evaluation (ASPE). This new combination will become the Office of Strategy, to “enhance research that informs the Secretary’s policies and improves the effectiveness of federal health programs.”
The Administration for Community Living (ACL) will be dispersed between the Administration for Children and Families, the ASPE and the CMS. Some stakeholders worry the ACL’s functions may be in danger under this reorganization.
“Just as you cannot slash billions from Medicaid or close Social Security field offices without harming older adults and people with disabilities, you cannot curtail CMS capacity, dismantle the ACL—the only federal agency charged with maximizing the independence, well-being, and health of older adults, people with disabilities, their families, and their caregivers—or otherwise weaken critical HHS programs, services and functions without causing irreparable damage,” said Fred Riccardi, president of the nonprofift Medicare Rights Center, in a statement.
“Any realignment of the agency or its functions must preserve the essential work the government has long done to improve the lives of older adults and ensure alignment with Medicare and Medicaid to improve and expand delivery of the services on which Americans rely,” said Sarita Mohanty, M.D., president and CEO of The SCAN Foundation.
Secretary of Education Linda McMahon, who is helping oversee the elimination her department, said last week HHS will assume control of special education programs traditionally under her domain, but no further timeline or information has yet been provided by HHS.
A core tenet of the Make America Healthy Again movement, spearheaded by Kennedy, is the focus on reversing chronic disease. The department will prioritize “safe, wholesome food, clean water and the elimination of environmental toxins.”