On March 27, 2025, the U.S. Department of Health and Human Services (HHS) unveiled a sweeping reorganization plan under the banner of President Donald Trump’s “Make America Healthy Again” initiative. The structural overhaul, guided by the executive order establishing the Department of Government Efficiency’s Workforce Optimization Initiative, aims to streamline operations and reduce federal spending by eliminating approximately 10,000 full-time positions across the agency.
The restructuring is projected to save taxpayers $1.8 billion annually, according to HHS officials. However, the dramatic scope of the changes—including a 20% workforce reduction at both the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA)—has sparked alarm among public health professionals and advocates concerned about the nation’s preparedness for health crises and the delivery of critical services.
Key Elements of the Reorganization
The reorganization consolidates five existing HHS agencies into a newly formed entity called the Administration for a Healthy America (AHA). Although the precise makeup of the merged agencies has not been fully detailed, officials stated the AHA will focus on streamlining public health education, community outreach, and preventive care initiatives.
Other significant structural changes include:
- A Narrower Mandate for the CDC: The CDC will be reoriented to focus primarily on infectious disease programs, with responsibilities related to chronic disease, environmental health, and health equity initiatives reassigned or eliminated.
- Restructuring of the FDA: In addition to the staff reductions, the FDA will undergo internal realignment to prioritize drug and vaccine approvals and reduce regulatory timelines. Oversight of food safety programs will be decentralized to state-level agencies.
- Disbanding of the Administration for Community Living (ACL): Functions of the ACL, which supports services for older adults and individuals with disabilities, will be absorbed by other HHS branches or phased out, depending on program evaluations.
Secretary of Health and Human Services Robert F. Kennedy Jr. described the changes as “bold but necessary,” stating that the reforms reflect a commitment to reducing bureaucratic inefficiencies while “empowering communities and returning decision-making authority to local stakeholders.”
Public Health Community Reacts with Concern
Despite assurances from HHS that critical services will not be disrupted, public health experts have expressed deep concern over the plan’s implications for emergency preparedness, regulatory oversight, and equity in health access.
“This is not a rational optimization—it’s a political maneuver that threatens to gut our public health infrastructure,” said Dr. Lena Diaz, a former CDC epidemiologist. “Reducing the CDC’s capacity just as global threats like antimicrobial resistance and long COVID continue to emerge is incredibly short-sighted.”
Advocates for seniors and individuals with disabilities also fear that dismantling the ACL will lead to service gaps at the state and local level, particularly in rural and underserved areas. “There is no equivalent infrastructure ready to pick up the slack,” said Susan Wahl, director of the National Disability Network. “This reorganization risks leaving millions without essential care.”
Political and Legal Scrutiny
The changes are already drawing scrutiny from Congressional Democrats and some moderate Republicans, who are demanding greater transparency about how programs were selected for cuts and whether sufficient impact assessments were conducted.
House Energy and Commerce Committee Chair Frank Pallone (D-NJ) said the plan “reflects a disturbing disregard for the people who rely on these services,” and pledged to hold hearings on the restructuring’s impact on public health and safety.
Legal experts note that while the executive branch has some discretion to reorganize agencies, the elimination or fundamental transformation of congressionally mandated programs may face legal challenges.
An Ideological Shift in Health Governance
The reorganization is emblematic of a broader philosophical shift under the Trump administration’s second term—a move toward reducing federal intervention in favor of localized solutions and private sector alternatives. The Department of Government Efficiency (DOGE), led by Elon Musk, has played a central role in auditing agency operations and recommending cost-saving measures.
Supporters of the restructuring argue that the changes will foster innovation, eliminate redundancy, and refocus federal agencies on their core missions. “This is a needed course correction,” said economist and conservative policy advisor Dr. Mark Whitmore. “For too long, HHS has tried to do too much with too little accountability.”
Next Steps
The implementation of the HHS restructuring is expected to unfold over the coming months, with workforce reductions beginning in late spring and agency realignments continuing through the end of the fiscal year. The administration has committed to issuing monthly updates on the progress of the reforms and providing transition assistance to affected employees.
As the nation continues to confront complex health challenges, from pandemic recovery to mental health crises and chronic disease management, the long-term impact of the “Make America Healthy Again” initiative remains to be seen.
