Medical fallout: RFK Jr. is dismantling American healthcare

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Layoff plans

In March, the U.S. Department of Health and Human Services (HHS) announced it would cut around 10,000 employees by the end of May. Another 10,000 workers have already resigned voluntarily. As a result, the department’s total staff will shrink from 82,000 to 62,000 people. In addition, more than 5,000 probationary employees were dismissed in March — these workers were either hired or promoted within the past couple of years. Most of them are currently on administrative leave while their dismissals remain under court review.

Who is slated for dismissal:

• 3,500 employees of the Food and Drug Administration (FDA);
• 2,400 staff at the Centers for Disease Control and Prevention (CDC);
• 1,200 employees of the National Institutes of Health (NIH). The layoffs will affect procurement, human resources, and communications departments across 27 NIH institutes and centers conducting research on cancer, aging, infections, allergies, kidney disease, and hearing and vision disorders;
• 300 staff at the Centers for Medicare & Medicaid Services (CMS). According to a former Health Department official, the cuts will primarily affect teams that work with customers and insurers. The former assist Americans with enrolling in Affordable Care Act and Medicare Advantage programs, while the latter liaise with insurance companies and ensure their plans comply with federal law.

The number of HHS divisions is set to shrink from 28 to 15. Five of the agency’s ten regional offices will be closed: those in New York, Boston, Chicago, Seattle, and San Francisco. These offices funded programs across 22 states, including child care services, utility bill assistance for low-income households, and the Meals on Wheels program that delivers hot food to people with limited mobility.

The restructuring at HHS is being overseen by Brad Smith, a member of Elon Musk’s Department of Government Efficiency (DOGE). During the first Trump administration, Smith headed the Centers for Medicare & Medicaid Services (CMS). He previously co-founded the telemedicine startup CareBridge and the venture capital fund Russell Street Ventures. He is also linked to the healthcare provider Main Street Health, which is regulated by CMS.

The downsizing has been opposed by the National Treasury Employees Union, which represents HHS workers, and by the American Public Health Association, the largest nonprofit organization in the public health sector. The American College of Physicians, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists have warned that the layoffs could deprive the population of access to adequate medical care.

Cutting into the flesh

New HHS Secretary Robert F. Kennedy Jr. insisted that the restructuring would affect only the department’s bureaucratic apparatus. However, it soon became clear that entire institutions were being slashed — institutions responsible for medical research, food and drug quality control, assistance to vulnerable populations, and disease prevention.

The entire team working on the National Survey on Drug Use — the primary source of data on substance abuse in the United States — was dismissed. Also cut were all staff from the Health Department’s Low Income Home Energy Assistance Program, which annually allocated billions of dollars to help low-income Americans pay their heating bills.

About 700 people were laid off from the Food and Drug Administration (FDA), including chemists, physicians, and robotics experts who were directly involved in inspecting medical devices. FDA laboratories in San Francisco, San Juan, Detroit, and Chicago that tested the safety of food, drugs, and cosmetics were shut down. Staff at other research centers were banned from using departmental credit cards to purchase supplies for testing.

FDA committees that had helped uncover a deadly bacteria at an Abbott Nutrition infant formula plant — shut down in 2022 — as well as listeria-causing pathogens at a Boar’s Head facility in 2024, were disbanded. Only 433 inspectors remain at the FDA — out of the 2,000 required. Those remaining are now responsible for overseeing 36,000 food production facilities.

Due to the mass layoffs, hotlines for reporting unsafe food and cosmetics have been suspended, as have counseling services for women with postpartum depression and for those trying to quit smoking.

FDA Chief Medical Officer Hilary Marston and Director of the Office of New Drugs Peter Stein were placed on involuntary leave. Julia Tierney lost her position as acting head of the Center for Biologics Evaluation and Research, a role she took on after the forced departure of its former director, Peter Marks.

During Trump’s first term, Marks was one of the key figures in Operation Warp Speed — the initiative to accelerate the development of coronavirus vaccines. In his resignation letter, Marks wrote that he had been willing to work with Robert F. Kennedy Jr., but “it became clear that the Secretary has no need for truth or transparency — he seeks only fawning validation of his misinformation and lies.” In an interview with The Wall Street Journal, Marks commented on the layoffs at the department:

“They took the place apart without having an instruction manual of how to put it back together.”

At the FDA’s Center for Veterinary Medicine, nearly the entire administrative staff and leadership were laid off, including the agency’s top veterinary expert, Tristan Colonius. He had overseen efforts to combat the spread of avian flu and led vaccine development against the disease. The cuts also affected the Veterinary Laboratory Investigation and Response Network, which monitors for viruses in food and animal feed. Although the scientific staff remained, their work ground to a halt without administrative support.

Major layoffs also hit the Centers for Disease Control and Prevention (CDC). The Center for Birth Defects was dismantled, retaining only programs that monitor autism and maternal and child health. The National Center for HIV, Viral Hepatitis, STDs, and TB Prevention lost about a quarter of its staff, with the HIV division facing the deepest cuts — half of its personnel were dismissed.

A wave of dismissals swept through the leadership of the National Institutes of Health (NIH), which conducts medical research. The heads of at least five of the NIH’s 27 institutes lost their positions.

After facing media criticism, Kennedy Jr. acknowledged that around 20% of the layoffs were made in error and promised to reinstate those employees who had been wrongly dismissed. However, ministry sources say the leadership is unlikely to follow through: some staff were reinstated only temporarily, with notice of an impending re-dismissal by summer, while others could not be brought back due to cuts in HR departments.

Employees at HHS and its affiliated agencies describe the situation as “chaos.” “It is going to take us more than a generation to recover, not just with the science but with the cuts to training grants and supporting mentees,” said one NIH staffer.

State aid (revoked)

In addition to the cuts at HHS, the Trump administration also announced the cancellation of more than $12 billion in CDC grants to states and municipalities. These funds had been allocated by Congress under COVID-era legislation — some passed during Trump’s first term, some under Joe Biden. In 2024, the use of such funds was expanded to include not only COVID-related measures but also prevention of other respiratory diseases, vaccination of uninsured children and adults, and preparedness for future epidemics. DOGE has now deemed the grants a misuse of taxpayer money and counted their cancellation as an achievement of efficiency — currently making up more than a third of the total amount the Musk-led agency claims to have saved.

Many states are now preparing to lay off thousands of employees, including epidemiologists and data scientists. Some estimates suggest that about 90% of personnel working on infectious disease research will lose their jobs. All grants issued to states in 2021 for prevention and treatment under the Substance Abuse and Mental Health Services Administration (SAMHSA) will also be revoked.

Of the 1,200 grants canceled by HHS, more than a hundred had been awarded to universities conducting vaccine development and coronavirus research. The Fred Hutchinson Cancer Research Center and the Memorial Sloan Kettering Cancer Center, both focused on cancer studies, lost subsidies worth tens of millions of dollars. HIV research grants were canceled at more than two dozen institutes.

Authorities in the District of Columbia and 23 states have already challenged the funding cuts in court. During the hearings, a representative of the Rhode Island Attorney General submitted over 4,000 pages of documents outlining the damage the states would suffer due to the elimination of grant programs. As a result, federal judge Mary McElroy, appointed during Trump’s first term, temporarily blocked the cancellation of the grants, citing the extent of documented harm.

Measles backlash

The mass layoffs in the healthcare sector and the termination of vaccination programs are unfolding amid the worst measles outbreak in the U.S. in years. In Texas alone, more than 500 cases have already been reported. Around 50 people have been hospitalized, and two children have died — neither had been vaccinated against measles.

The epicenter of the outbreak is Gaines County, where in 2024 more than 13% of schoolchildren went unvaccinated due to parental refusal. In the county’s preschools, 82% of children are vaccinated against measles, mumps, and rubella — nearly 10% below the state average. According to CDC estimates from October 2024, around 280,000 children in the U.S. are unvaccinated against measles.

Reports of the first death during the current outbreak emerged on Feb. 26, 2025, but HHS acknowledged the event only two days later, prompting frustration in the White House. An official statement from Kennedy Jr. appeared only on March 2, with information about vaccine efficacy placed at the very end of the text. The CDC, which is overseen by HHS, prohibited staff from publishing expert commentary on the high risk of measles transmission in areas with low vaccination rates — or from urging people to get vaccinated.

In his initial public comments on the outbreak in Texas, Kennedy said it was “not unusual” and that children were being hospitalized “for quarantine purposes.” In one interview, he claimed vaccines “cause new deaths every year and themselves lead to measles, encephalitis, blindness, and so on.” The HHS Secretary urged people to “make their own decisions” about vaccination — this despite studies showing the vaccine’s effectiveness is 95%. As an alternative, Kennedy suggested taking vitamin A and fish oil. Following this, some hospitals in Texas reported an increase in patients turning up with vitamin A overdose.

Only after the death of a second child in Texas did the head of HHS visit the state and acknowledge that vaccination is the most reliable means of preventing the spread of measles. However, he later posted on social media that he had met with two doctors — ”extraordinary healers” — who were treating children with the asthma drug budesonide and the antibiotic clarithromycin. Experts emphasize that using these medications is an unconventional and unproven method for treating measles.

Fighting vaccines

Under Robert Kennedy’s leadership, HHS plans to conduct a study on the link between autism and vaccination — a connection he has repeatedly claimed exists without presenting evidence to support it. The research will be overseen by David Geier, whose publications Kennedy has often cited in support of his arguments about the dangers of vaccines. Together with his father, Mark Geier, David published articles warning about the mercury-based preservative thimerosal, which was once used in some vaccines. One of their papers was later retracted due to numerous errors. Other studies have found no link between thimerosal and autism in children, and in any case, the compound has long been phased out of vaccines.

The Geiers administered puberty blockers to children as part of an experimental autism treatment aimed at removing mercury from the body. The younger Geier had no medical license or formal qualifications — only a bachelor’s degree in biology. To give their experiments a veneer of legitimacy, the Geiers created a fake institutional review board. When this became known in 2011, the Maryland state medical board suspended Mark Geier’s medical license.

For several months, Mark Geier was prohibited from practicing medicine in Washington, Virginia, California, Illinois, Missouri, and Hawaii. Medical boards cited unethical treatment protocols, a lack of scientific evidence, threats to patient health, and improper use of hormonal medications. In June 2012, David Geier was also accused of practicing medicine illegally.

This is not the only instance in which Robert Kennedy Jr. has undermined trust in vaccines. The new leadership of the NIH recommended that scientists remove all mentions of mRNA vaccines from their grant applications. This technology is being studied at NIH for the prevention and treatment of infectious diseases, including the flu and AIDS, as well as cancer. It was also used to combat the coronavirus: in 2023, American scientists Katalin Karikó and Drew Weissman were awarded the Nobel Prize in Medicine for their work, which received support from NIH, among other backers.

Acting NIH Director Matthew Memoli sent an email to the department’s divisions instructing them to report all grants and contracts related to mRNA vaccines so that this information could be directly forwarded to Robert Kennedy Jr. and the White House. Memoli also sent similar messages prior to the cancellation of other studies, such as those investigating the reasons behind declining vaccination rates. In that email, he explicitly stated that NIH was not interested in studying the reasons people avoid vaccines, nor ways to promote vaccination.

Stop words

In addition to “mRNA vaccines,” other terms have also been banned. It was previously reported that the list of “stop words” appeared in government memos, official and unofficial guides of federal agencies, and other documents. If a grant or contract application contains a word from the blacklist, it is either automatically rejected or else sent for additional review.

Many words and phrases were ordered to be removed from government websites and various documents. As a result, over eight thousand pages were deleted, including information on scientific research, vaccines, hate crimes, and veteran assistance. After media backlash, some of the materials were restored (some in edited form), while others remain inaccessible.

In February, FDA employees were instructed to stop using an entire list of “prohibited words” in external communications. A file with this name circulated in the agency's official work chats. The list included terms like “woman,” “gender,” “identity,” “elderly,” “disabled,” and “continuum.” Two agency scientists stated that neither they nor their management knew who made the decision or why these words were chosen. The White House suggested it was a mistake and that the FDA leadership had misinterpreted Trump's directive against “gender ideology.”

However, this is far from the only case. In March, employees from the scientific division of the Department of Agriculture also received a letter with a list of expressions banned in research proposals. The list included “climate change,” “solar and nuclear energy,” “biofuels,” “affordable housing,” “soil pollution,” “microplastics,” and “safe drinking water.”

The National Science Foundation (NSF), which funds about a quarter of all federally supported basic research in areas like mathematics, computer science, economics, and social sciences. Its “stop list” included words such as “prejudice,” “gender,” “hate speech,” “polarization,” “segregation,” and “trauma.”

According to sources familiar with the grant review process, NSF employees will have to analyze the context in which these words are used and determine whether they violate the directive on “gender ideology.” The document also clarifies that the phrase “socio-economic status” violates the directive, while “geographic diversity” does not, provided it refers to rural areas of the country.

Experts warn that such restrictions could have a detrimental impact on the advancement of science in the United States. In 2022, approximately 18% of U.S. scientific research and experimental development was funded by the federal government. For basic research, the share rises to nearly 40%. Most scientists who received Nobel Prizes in medicine, physics, or chemistry between 2000 and 2008 received funding from the federal government, including support from the National Science Foundation and the National Institutes of Health.