Former employees are expressing serious concerns about significant layoffs and budget cuts at the Department of Health and Human Services (HHS), suggesting these changes pose “real dangers” to vital services, including child support and HIV treatment.
Recently, workers within HHS, alongside public health advocates like Robert F. Kennedy Jr., highlighted in interviews how the chaotic and flawed cuts could lead to far-reaching negative impacts both in the U.S. and internationally.
Under Donald Trump’s administration, the HHS workforce shrank from 82,000 to 62,000 due to layoffs and downsizing. In particular, Elon Musk’s initiative, branded as the “Doctor of Government Efficiency,” heavily influenced decisions at state health agencies, resulting in job losses.
For instance, the South Carolina Department of Public Health let go of over 70 employees in March as part of their funding cuts.
An epidemiologist from the department, who found their role eliminated, remarked, “Symptom surveillance is crucial for understanding health issues, like spikes in foodborne illnesses or viral outbreaks in communities. Losing this ability means we might not catch problems early enough to help.” They further stressed, “With fewer public health staff, we lose response time and precision, ultimately endangering community health.”
They pointed out how public health functions might seem invisible until something goes wrong. “We safeguard drinking water, food safety, schools, and community health,” they noted.
A representative for the South Carolina Department of Public Health did not provide specific comments but mentioned that the layoffs affected temporary staff funded by grants, who would lose their jobs if funding was cut.
In Washington, HHS is facing deeper cuts than other federal agencies. Numerous grants have been awarded to local governments and research institutions, but over $6.8 billion in unpaid obligations were eliminated.
HHS typically accounts for about a quarter of federal spending, mainly geared towards programs like Medicare and Medicaid. Trump’s budget proposal called for a 26.2% reduction in the department’s discretionary spending, totaling around $33.3 billion.
RFK Jr., who has previously promoted conspiracy theories, was appointed by Trump, with the Senate voting largely along party lines, save for one Republican dissenting voice.
After claiming 10,000 staff cuts, RFK Jr. suggested that about 20% were unwarranted and that those employees would be reinstated, though this has yet to manifest.
A spokesperson for HHS responded to the concerns over data collection but did not address other reported issues.
AIDS Relief Program “Dismantling”
At the CDC, employees involved with the President’s Emergency Plan for AIDS Relief (PEPFAR) were taken aback by the cuts impacting their efforts to support maternal and child health, specifically early in the administration.
Many federal HIV prevention experts focusing on global programs for children were dismissed during this reduction.
One epidemiologist involved in the cuts expressed disbelief at initially misinterpreting their job elimination as a mistake. “There was a 20% error rate, and we were expected to remain engaged,” they said, highlighting their ongoing responsibilities to work on new pediatric HIV medications that are now at risk.
Reports indicate that 22 epidemiologists from the CDC were laid off. Established by George W. Bush in 2003, PEPFAR is known for preventing HIV infections in mothers and children and has been credited with saving approximately 26 million lives.
Another impacted epidemiologist noted the dismay of being placed on administrative leave abruptly. “It’s baffling how our department is being dismantled, especially when the State Department emphasizes these services must continue,” they stated.
They also remarked that regions dependent on USAID for HIV treatment, such as Zambia, have already seen services halted. “This program has been one of the most effective global health initiatives, focusing on accountability and results. The disassembly of these frameworks jeopardizes success,” they concluded.
“Long-term Impact” on U.S. Families
Within HHS, the Administration for Children and Families oversees child support payments mandated by courts. For every federal dollar received, it’s said that $5 in child support can be raised.
Some anonymous HHS child support specialists expressed concern that reduced staff has made it hard to ensure compliance with federal requirements. “There aren’t enough local staff actively managing the program anymore,” they explained. “Now, two employees are responsible for a quarter of the workload without adequate support.”
Following the Trump administration’s arrival, it appears staff received an unofficial order to suspend their operations. Until recently, employees were restricted from providing necessary support to grantees.
Reportedly, about half of ACF personnel involved in child support have been let go, with cuts continuing into April.
Experts warn that failing to provide essential training and support could lead states to lose substantial funding, which would have long-term negative impacts on vulnerable families and children across the nation.
The specialists reiterated that the program’s essential objective is to prevent children from requiring government assistance.
“Living Hell”
Even among the HHS workforce, issues of legality around the layoffs have surfaced, particularly within the Centers for Medicare and Medicaid Services, wherein it was alleged that proper procedures weren’t followed. Complaints regarding the layoffs emphasize inaccuracies in notifications received by workers.
On April 1, staff came to understand their positions were being eliminated through a generic letter just before being cut off from government systems. “We started reaching out to our remaining supervisors for clarity, but no one could provide answers,” they said.
A few days later, they discovered that they had been placed on administrative leave, despite no prior notice, and only received formal layoff notifications weeks later after inquiring.
“My experience and service as a disabled veteran should have warranted at least a chance for reassignment,” a worker mentioned, pointing to the unfairness of the situation. “I’m not angry about losing my job; it happens. It’s just that the conditions created by this administration make it feel like a real struggle for civil servants.”
