- Robert F. Kennedy Jr., the newly appointed HHS Secretary, has proposed a major restructuring of health agencies based on President Trump's Executive Order.
- It includes two major actions: eliminating 10,000 employee positions and consolidating HHS's 28 divisions into 15, with new divisions added.
- The restructuring of HHS may have significant consequences for cardiothoracic surgeons and their patients.
- If HHS restructuring changes Medicare and Medicaid policies, cardiothoracic surgeons may face new requirements and uncertainty around coverage for complex procedures.
- STS is committed to supporting our members through the new structure and advocating for our specialty and patients.
Robert F. Kennedy Jr, the newly appointed Department of Health and Human (HHS) Secretary, has introduced plans to significantly restructure health agencies under his purview. This restructuring is based on President Trump's Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”
It will include two major actions:
1. Eliminate 10,000 employee positions across departments.
The employees impacted by the restructuring cut across the major departmental domains of HHS including research, public health, oversight of new drugs and devices, and administering Medicare and Medicaid.
The 10,000 jobs eliminated this week are in addition to the roughly 10,000 HHS employees who opted to leave HHS since January. In total, there will be a reduction of approximately 25 percent of the HHS workforce.
Early reports of the workforce reductions by agency are as follows:
- Food and Drug Administration (FDA): 3,500 full-time employees, which represents approximately 19% of the agency's workforce
- Centers for Disease Control and Prevention (CDC): 2,400 employees, or about 18% of its workforce
- National Institutes of Health (NIH): 1,200 employees, or around 6% of its workforce
- Centers for Medicare and Medicaid Services (CMS): 300 employees, representing about 4% of its workforce
2. Consolidate the current 28 divisions of HHS into 15 and include new divisions.
The restructuring plan will consolidate several existing agencies and introduce new ones, including the Administration for a Healthy America (AHA). The AHA will merge multiple agencies, such as 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.
Additionally, the CDC will absorb the Administration for Strategic Preparedness and Response, which is responsible for disaster and public health emergency response. A new Assistant Secretary for Enforcement will be established to oversee the Departmental Appeals Board, the Office of Medicare Hearings and Appeals, and the Office for Civil Rights. Furthermore, the Assistant Secretary for Planning and Evaluation (ASPE) will merge with the Agency for Healthcare Research and Quality to form the Office of Strategy. Lastly, the Administration for Community Living will be reorganized into several other HHS agencies, including the Administration for Children and Families, ASPE, and CMS.
Impact on Cardiothoracic Surgery
The restructuring of HHS may have significant consequences for cardiothoracic surgeons and their patients. Reducing the workforce within key regulatory bodies like CMS, FDA, and NIH could slow the approval and rollout of new cardiovascular treatments, medical devices, and surgical innovations. Cardiothoracic surgeons rely on timely access to the latest technologies to improve patient outcomes, and any bureaucratic delays caused by staffing shortages may hinder the adoption of these advancements. Additionally, the consolidation of agencies could disrupt already declining funding and research pipelines that support innovation.
Moreover, reducing regulatory oversight and consolidating healthcare agencies could impact the delivery of patient care. If the restructuring of HHS leads to shifts in Medicare and Medicaid policies or reimbursement models, cardiothoracic surgeons may face new requirements and uncertainty regarding coverage for complex procedures. Fewer personnel within federal health agencies could also result in less support for quality improvement initiatives.
How this restructuring will be implemented is unclear and it is possible the courts will be involved. Given this uncertainty, STS remains committed to helping our members navigate the new structure and will continue advocating for our specialty and our patients.