Nineteen states and Washington, D.C., have filed a lawsuit seeking to block the Trump administration's restructuring of the Department of Health and Human Services, claiming the federal government's push to reshape the agency is "unconstitutional and illegal."
As part of the Department of Government Efficiency (DOGE)-led restructuring that HHS announced in March, the agency detailed plans to lay off at least 10,000 full-time employees and pare the agency down from 28 divisions to 15. The new plan combines the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health into a single entity.
HHS also intends to close half of its regional offices, reducing the total number from 10 to five.
The new lawsuit claims that in making these moves, the federal government has violated "hundreds" of laws and circumvented Congressional approval, calling the impacts "immediate and disastrous."
Programs serving children and low-income families have been particularly devastated, it said, with Head Start centers at risk of closing due to the freezing of grant funding and the closure of HHS' regional offices.
The administration also fired staff responsible for maintaining the federal poverty guidelines, which the attorneys general said states rely on to determine eligibility for food assistance like the Supplemental Nutrition Assistance Program (SNAP), housing support, Medicaid and Temporary Assistance for Needy Families (TANF).
Mental health and substance use services have been negatively impacted as well, the lawsuit claims, largely due to the termination of roughly half the workforce at the Substance Abuse and Mental Health Services Administration (SAMHSA), as well as the closure of its regional offices.
The attorneys general said reproductive health and disability services have also been strained, with the recent firing of the Centers for Disease Control and Prevention's maternal health team and the shuttering of the federal fertility tracking program, which provided information on access to IVF and family planning services.
"This administration is not streamlining the federal government; they are sabotaging it and all of us," said New York Attorney General Letitia James in a statement. "When you fire the scientists who research infectious diseases, silence the doctors who care for pregnant patients, and shut down the programs that help firefighters and miners breathe or children thrive, you are not making America healthy – you are putting countless lives at risk."
The coalition accused the administration of trampling the constitutional separation of powers by ignoring congressional laws. ""The terminations and reorganizations happened quickly, but the consequences are severe, complicated, drawn-out, and potentially irreversible," the lawsuit claims.
Plaintiffs in the lawsuit include the attorneys general of Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Michigan, Maryland, Minnesota, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, Wisconsin and Washington, D.C.
THE LARGER TREND
When HHS' restructuring plan was announced, it drew strong reactions from healthcare organizations that work with senior Medicare beneficiaries, including Campaigns and Advocacy at Caring Across Generations, with chief Nicole Jorwic saying in March that her group was "deeply worried that organizational changes and workforce reductions will only exacerbate our country's patchwork care infrastructure that millions of families are already struggling from."
Under Secretary Robert F. Kennedy Jr., HHS said the layoffs would save about $1.8 billion annually from the department's $1.7 trillion budget. That's roughly 0.1%. Most of that money is spent on Medicare and Medicaid coverage for Americans.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.