HHS Restructures Programs for Dually Eligible Adults
Washington DC, Thursday, 3 April 2025.
On 2 April 2025, the Department of Health and Human Services announced a major restructuring to improve Medicare and Medicaid services coordination, impacting over 10,000 employees.
Sweeping Organizational Changes
The restructuring represents one of the most significant overhauls in HHS history, with the department planning to reduce its workforce from 82,000 to 62,000 employees [2]. As part of this transformation, the Medicare-Medicaid Coordination Office will be relocated under the Center for Medicare and Medicaid Innovation (CMMI), affecting care coordination for millions of dually eligible beneficiaries [1]. The reorganization has already resulted in the dismissal of twelve staff members from the Models, Demonstrations and Analysis Group within CMS’ Medicare-Medicaid Coordination Office [1].
Formation of New Health Administration
A cornerstone of the restructuring is the creation of the Administration for a Healthy America (AHA), which will consolidate several existing agencies including the Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) [4]. This consolidation is part of Secretary Kennedy’s broader vision to emphasize prevention over treatment, though concerns have been raised about the impact on essential health services [1][2].
Impact on Critical Programs
The reorganization has sparked significant concern among healthcare advocates, with over 450 organizations signing a letter to Congress opposing the elimination of key departments [5]. Of particular concern is the dissolution of the Administration for Community Living (ACL) and the restructuring of the Office for Civil Rights (OCR), which could affect services for older adults and individuals with disabilities [5]. The changes are set to take effect by June 30, 2025 [3].
Workforce and Service Delivery Implications
Implementation of the restructuring began on April 1, 2025, with thousands of employees receiving termination notices [6]. The FDA alone is facing 3,500 job cuts, including its entire communications team, while the NIH expects approximately 1,200 positions to be eliminated [6]. Healthcare experts, including former COVID-19 Response Coordinator Dr. Ashish Jha, have expressed concerns about potential negative impacts on public health infrastructure and disease outbreak response capabilities [6].