RFK Jr. cuts jobs at minority health offices at HHS

Robert F. Kennedy Jr.’s overhaul of the Department of Health and Human Services involves deep cuts to several divisions that help protect and improve the health of minority and underserved populations and eliminate health disparities within the U.S., CNBC has learned.

Kennedy, the Health and Human Services secretary, has gutted a minimum of seven minority health offices across the department, in accordance with people conversant in the matter, who requested anonymity to talk freely. HHS has laid off a big share of employees at those offices, or in some cases all of them, together with their directors, the people said.

The affected units include the HHS Office of Minority Health and the National Institute on Minority Health and Health Disparities, or NIMHD. The cuts also hit offices with similar functions on the Food and Drug Administration, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration, in accordance with the people. 

Health policy experts told CNBC that deep cuts to those divisions could widen existing health disparities within the U.S., undoing years of progress toward addressing them. Over time, that would worsen health outcomes for already underserved groups, threaten overall public health, strain the U.S. health-care system and drive up health-care costs. 

“It is going to have negative health impacts, obviously, for groups that they are focused on, so racial and ethnic minorities, but I believe what gets missed within the story is it ultimately impacts all of us, irrespective of what your background is,” Dr. Stephanie Ettinger De Cuba, research professor of health law, policy and management at Boston University, told CNBC. 

“It isn’t a zero-sum game. So I believe that is what is deeply disturbing to me, as we’re going to see people get hurt,” she said. “Decimating or cutting staff from these offices ultimately makes it worse for everybody.”

The Trump administration cannot shutter the affected offices entirely, which might be against the law since they were authorized by the Reasonably priced Care Act greater than a decade ago, the people said. The precise fate of every office and the NIH institute is unclear, they added. 

The administration likely hopes to a minimum of “narrow the scope” of what NIMHD and the agency offices do, curtailing their authority and limiting resources, said Brandyn Churchill, professor of public administration and policy at American University. 

The cuts come as health disparities remain a serious challenge within the U.S., affecting not only people of color but additionally rural residents, low-income communities and individuals with disabilities, amongst several other groups. These communities often face worse health outcomes – comparable to lower life expectancy and better rates of infant mortality and chronic disease – and more limited access to care and other resources than the U.S. population as a complete. 

The Covid-19 pandemic deepened lots of these gaps, highlighting how the long U.S. history of exclusionary policies and systemic issues comparable to poverty and racism contribute to unequal health outcomes across the country. 

Health policy experts stress that addressing those disparities results in stronger overall public health, as healthier communities improve outcomes for everybody. It could also relieve an enormous economic burden on the U.S: a 2023 study funded by NIMHD found that racial and ethnic health disparities cost the U.S. economy $451 billion in 2018.  

Kennedy is consolidating divisions and slashing 10,000 jobs at HHS, a $1.7 trillion agency that oversees vaccines and other medicines, scientific research, public health infrastructure, pandemic preparedness, and food and tobacco products. HHS also manages government-funded health take care of thousands and thousands of Americans – including seniors, disabled people and lower-income patients who depend on Medicare, Medicaid and the Reasonably priced Care Act’s markets.

Kennedy plans to create a brand new HHS agency called the Administration for a Healthy America, which can mix several existing offices. That features HRSA, SAMHSA, the Office of the Assistant Secretary for Health, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health.

A leaked 64-page preliminary budget document also indicates that the HHS Office of Minority Health would fall under that latest agency, in accordance with several reports. But that proposal, which might slash the HHS budget by a 3rd, or roughly $40 billion, requires congressional approval. 

HHS didn’t immediately reply to a request for comment.

While the breadth of the cutbacks varied at agencies inside HHS, the minority health agencies across the departments will now be only a fraction of their former size.

All 40 staff members on the CMS Office of Minority Health were laid off, in accordance with the people. CMS plans to appoint a brand new director for that unit, but the present director has not resigned from the role, CNBC previously reported.

Nearly all staff on the CDC’s Office of Minority Health were cut, in accordance with the people. To stick to the letter of the law, the Trump administration is considering reconstituting that unit and the Office of Women’s Health in order that each office could be made up of a minimum of one director or a really small group of employees, the people said. 

The agency’s Office of Minority Health works across CDC to advertise research of health disparities and create programs to enhance the health of racial and ethnic minority groups.

On the FDA’s Office of Minority Health and Health Equity, all staff were cut, the people said. The long run of that office is unclear. 

The unit focuses on efforts comparable to increasing clinical trial diversity, improving transparency around how medical products affect different populations, and creating health resources tailored to a variety of languages and cultures.

No staff are left at HRSA’s Office of Health Equity after the layoffs, in addition to some retirements and reassignments, in accordance with the people. That office leads efforts to cut back disparities in health-care access, quality and outcomes through HRSA, which focuses on people who find themselves uninsured, geographically isolated, or economically and medically vulnerable.

The long run of that office can also be unclear, other than the Trump administration’s plans to fold HRSA into Kennedy’s latest agency.

The identical goes for SAMHSA’s Office of Behavioral Health Equity, which saw all remaining staff cut aside from a brand new, recently hired director, in accordance with the people. The office also had a retirement and one employee on probation who was placed on administrative leave. 

The office works to make sure that SAMHSA’s resources for mental health and substance abuse treatment, including grant programs and other initiatives, are equitably distributed across all communities and populations.

Roughly a 3rd of staff are gone at NIMHD, a few of whom were laid off and others who left resulting from early retirements and buyouts, the people said. Some employees on probation were placed on leave several weeks before Kennedy began cuts, they said. 

The institute’s deputy director accepted a proposal to be acting director within the short term, the people added. NIMHD, which is an element of the National Institutes of Health, works to cut back health disparities through conducting and funding research and developing latest programs.

The HHS Office of Minority Health also faced cuts, though it’s unclear what number of staff were impacted, the people said. That office leads the federal effort to enhance health outcomes for racial and ethnic minority groups, developing policies and programs and providing funding.

The fate of most of the grants that NIMHD and a few of the offices provide is unclear. That features $11.6 million in recent grant awards from HHS’ Office of Minority Health to twenty organizations for a four-year initiative to discover strategies that increase the usage of preventive health services in communities. 

But when offices in the reduction of that funding or stop it altogether, it could also weaken the nation’s ability to cut back health disparities, Boston University’s Ettinger De Cuba said. 

Community-based organizations depend on federal money to deliver culturally tailored care to different groups, and could possibly be forced to reduce or shut down programs. The lack of grants could also stall research, innovation and public health interventions by outside entities, comparable to universities, health-care systems and social service organizations. 

“Philanthropy is just not capable of step up at this level long run. The one actor that is capable of do this is the federal government,” Ettinger De Cuba said. 

Nathan Boucher, research professor at Duke’s Sanford School of Public Policy, added that the cuts will “degrade any effort of those larger governmental organizations to have any accountability with regards to protecting the people they assist and serve day-after-day.” 

While Kennedy has said his cuts are focused on making HHS more “responsive and efficient,” Boucher said targeting minority health offices could do the other. 

“I actually think it’s an efficiency argument to give you the chance to have these minority health offices, since it permits you to discover and goal some real problem areas and use taxpayer dollars in essentially the most efficient way possible,” said Boucher.