HHS DOGE Changes Alarm U.S. Health Sector

The “DOGE”-led restructuring of the Department of Health and Human Services (HHS) continues this week with multiple agencies reporting instructions to cut billions in contracts. But confusion reigns as court cases over firing procedure loom and critical public health laboratories are shuttered.

Both the Centers for Medicare and Medicaid Services (CMS) and the National Institutes of Health (NIH) were notified by Elon Musk’s “DOGE” unit that they must cut $2.7 billion and $2.6 billion in contracts, respectively. According to Inside Health Policy, CMS employees received an email on the last day of March demanding the agency “reduce contract costs across the entire CMS portfolio” by April 3.

Similarly, leaders at the NIH met last week to find contracts to meet the Trump administration’s demanded cuts. STAT reports that the DOGE task force directed the reduction in spending across each of the 27 institutes and centers overseen by NIH by 35%, with a compliance date of April 8. Last week, NIH fired 1,200 employees including the directors of key institutes and the heads of several labs.

On Tuesday, the Centers for Disease Control and Prevention (CDC) laid off hundreds of employees working on prevention for concerns like drowning, gun violence and smoking, the Washington Post explains. The firings were part of HHS Secretary Robert F. Kennedy, Jr.’s stated goal of combating chronic disease and “returning to [HHS’] core mission of preparing for and responding to epidemics and outbreaks.

But “epidemics” doesn’t refer to sexually transmitted infections under the Kennedy HHS, either. STAT notes that the CDC also shuttered the sexually transmitted diseases (STDs) laboratory, sending shockwaves throughout the global health research community. The CDC lab was one of three international reference laboratories that worked with the World Health Organization to conduct surveillance for infection rates and drug-resistance patterns in STDs. From David C. Harvey, executive director of the National Coalition of STD Directors:

The loss of this lab is a huge deal to the American people. Without that lab, we would not have been able to appropriately diagnose and monitor drug-resistant gonorrhea.

The departmental overhaul will also eliminate certain positions in the Medicare-Medicaid Coordination Office, namely those responsible for working with states to wrap up the Financial Alignment Initiative that covers certain dual eligible beneficiaries in several states, Modern Healthcare reports.

Some of the workers in these layoffs may not be gone forever, as the 20,000-person reduction-in-force (RIF) is challenged in court. Labor experts and legal analysts are unsure if the government officials followed the rules and processes required by law to fire the employees. STAT says that the procedures facilitate making wise cuts, but it remains unclear who made the RIF determinations and how they were conducted.

Contracts are already being resurrected as the department removed a list of hundreds of consulting agreements that it had claimed were cut since the beginning of the Trump administration, but many of the contractors listed reported continuity of work with no lost funding thus far. Some of these included work that helped agencies analyze quality data, research health topics and complete projects with agency support services, IHP reports.