MICHEL MARTIN, HOST:
The Trump administration plans to restructure the Department of Health and Human Services and cut 20,000 employees.
A MARTÍNEZ, HOST:
HHS is the umbrella agency that includes the Centers for Disease Control and Prevention, Medicare and Medicaid, the National Institute of Health, and a lot more.
MARTIN: NPR's Selena Simmons-Duffin has been reporting on these plans and what they mean, and she is with us now. Good morning.
SELENA SIMMONS-DUFFIN, BYLINE: Good morning, Michel.
MARTIN: So Health Secretary Robert F. Kennedy Jr. announced this plan yesterday. What's he trying to do?
SIMMONS-DUFFIN: Well, Secretary Kennedy says HHS is a huge bureaucracy filled with silos, and that he wants to streamline things. Here he is in a video he posted to social media.
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ROBERT F KENNEDY JR: We have two goals. The first is obvious - to save the taxpayer money by making our department more efficient. And the second is to radically improve our quality of service.
SIMMONS-DUFFIN: He says they'll do that by consolidating administrative work like IT and human resources, but that the restructuring won't affect the work the agencies do. Kennedy draws a direct line between the problems with America's overall health and the way HHS has been set up.
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KENNEDY: I think most Americans would agree with me that throwing more money at health care isn't going to solve the problem, or it would have solved it already. Obviously, what we've been doing hasn't worked. That's why we're making this dramatic overhaul.
MARTIN: OK, so, Selena, these plans were just announced, but what's been the reaction so far?
SIMMONS-DUFFIN: My inbox was flooded with shocked responses yesterday from democratic lawmakers, nurses groups, public health groups, advocates for seniors. They say this isn't an overhaul. It's a wrecking ball. I asked former HHS Secretary Kathleen Sebelius for her reaction. She was incredulous that Kennedy thinks he can cut HHS staff so steeply and not affect services.
KATHLEEN SEBELIUS: Well, that's what I find so incredibly insulting. To me, what they're saying is there are 20,000 people working for HHS who do nothing.
SIMMONS-DUFFIN: She was especially critical of the plan to cut the number of regional offices from 10 to 5 and to combine certain agencies. Like, she questioned how it would help efficiency to combine CDC, which is in Atlanta, with the Strategic Preparedness Agency, which is in D.C.
MARTIN: Do we know yet which agencies are going to be the most affected?
SIMMONS-DUFFIN: It looks like the steepest cuts are coming from CDC and FDA. Also, a lesser known agency called the Administration for Community Living, which helps seniors and people with disabilities live independently. They do work like meal delivery, transportation, support for caregivers. Under the plans, that agency will be dismantled and it's, quote, "critical services" will get spread out over a few different agencies. So employees whose jobs are getting cut could get notices as soon as today with the cuts effective in May. And HHS did not respond to NPR's request for an interview with Secretary Kennedy or give answers to a list of questions about the plans.
MARTIN: So, presumably, some people do support these plans. So what do Kennedy's supporters or supporters of these plans say?
SIMMONS-DUFFIN: Republican lawmakers have been fairly quiet so far, especially compared to Democratic members of Congress, who have quickly put together press conferences, quote, "sounding the alarm" about this plan. Senator Bill Cassidy of Louisiana, the Republican chair of the Health Committee, did not respond to NPR's request for comment. What Republicans have said is that the details aren't out yet, that they believe there is administrative sprawl at HHS, and that it can be streamlined and that they trust Kennedy.
MARTIN: That is NPR health correspondent Selena Simmons-Duffin. Selena, thank you.
SIMMONS-DUFFIN: You're welcome. Transcript provided by NPR, Copyright NPR.
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