Reorganizing the HHS

In 2025, the Department of Health and Human Services (HHS) went through one of the largest reorganizations in its history. The plan created a new Administration for a Healthy America by merging several agencies and laying off nearly 20,000 employees. Supporters of the move said it would reduce overlap and make the department run more efficiently, with fewer layers of bureaucracy slowing things down.

The reasoning behind the overhaul was that HHS had grown too large and complicated. By cutting management positions and combining agencies, officials hoped more resources could be directed to frontline services like Medicare and Medicaid. Some compared it to private companies streamlining operations to focus on their main goals.

But not everyone agreed this was a smart move. Critics worried that the layoffs included experts at the CDC, FDA, and NIH—agencies that play critical roles in drug approval, disease prevention, and research. Losing experienced staff, they argued, would make the country less prepared for emergencies like pandemics or natural disasters.

Public health leaders also raised concerns about “institutional memory.” When long-time employees leave, years of knowledge and expertise disappear with them. That could slow down future responses, even if the structure looks more efficient on paper.

The reorganization raises an important question about government: does making it smaller automatically make it better? The answer may not be clear until the next crisis puts the system to the test. If the new structure can respond quickly and effectively, it may be seen as a bold reform. If it fails, critics will argue it was a risky gamble.