Trump's HHS Overhaul Faces Legal Blowback From States Over Deep Staffing Cuts, Slashed Health Programs

In March, the U.S. Department of Health and Human Services (HHS) unveiled a sweeping restructuring plan to cut costs, streamline operations, and refocus priorities.

Congress has long considered HHS vital to national well-being, appropriating $2.5 trillion for Fiscal Year 2024 to support its broad mandate across medicine, public health and social services.

The changes, aligned with President Donald Trump's executive order on government efficiency, will reduce the agency’s workforce, consolidate divisions and emphasize efforts to combat chronic illness.

The restructuring will reduce the HHS workforce by 10,000 full-time employees, leading to annual savings of $1.8 billion.

• Through early retirements and other initiatives, the total number of employees will shrink from 82,000 to 62,000.

Multiple states have filed legal challenges to Secretary Robert F. Kennedy Jr.’s reorganization, arguing that the moves violate constitutional mandates and congressional intent.

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The states claim the administration's efforts have dismantled the agency in defiance of established laws, severely disrupting health programs critical to Americans nationwide.

In a lawsuit filed on Monday, the states said the sudden layoffs brought HHS operations to a near standstill.

Laboratories stopped testing for infectious diseases, FDA vaccine reviews were missed and vital programs such as Head Start and the Low-Income Home Energy Assistance Program were left unsupported.

The World Trade Center Health Program could no longer certify illnesses and maternal health initiatives were shut down. Meanwhile, grantees and state partners were left without contacts or guidance as key portals and support channels went dark.

Although the terminations affected many employees, the cuts disproportionately targeted specific agencies, including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Administration for Children and Families (ACF), and the Administration for Community Living (ACL).

20,000 positions—almost a quarter of the HHS workforce—are slated for elimination. Despite the scale, Kennedy reportedly acknowledged that up to 20% of the layoffs were known to be mistakes even before execution.

Kennedy admitted that the decision to forgo a detailed review was driven by a desire to preserve "political momentum."

Importantly, the downsizing was not necessitated by budget constraints—congressional funding has remained stable or increased.

States argue the move was a deliberate effort to sideline the department's role, defying the very laws and mandates that created and funded it. The chaotic restructuring has left the remaining staff unable to process grants, issue funds, review policies, or manage public health emergencies.

In response, Plaintiff States are pursuing declaratory and injunctive relief to halt what they describe as the unlawful dismantling of one of the federal government's most complex and essential departments.

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