Podcast Summary: Tangle – Episode: The HHS Layoffs (April 8, 2025)

Host: Isaac Saul
Producer: John Lowell
Duration: Approximately 35 minutes

Introduction

In this episode of Tangle, host Isaac Saul delves into the significant layoffs at the Department of Health and Human Services (HHS) initiated by the Trump administration. The episode breaks down the scope of these cuts, explores arguments from both the left and the right, and offers Isaac’s personal take on the matter.

Background: HHS Layoffs Initiated

Timestamp [04:56] – John Lowell: The Trump administration commenced large-scale layoffs at the Department of Health and Human Services starting April 1st. HHS Secretary Robert F. Kennedy Jr. announced plans to eliminate approximately 10,000 jobs, in addition to previous resignations and leaves. Key agencies affected include the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), with entire offices and divisions being dissolved.

Timestamp [05:13] – Mitch Zeller: Kennedy characterized the layoffs as part of a "dramatic restructuring" aligned with the Department of Government Efficiency's Workforce Optimization initiative. He emphasized reducing bureaucratic overhead and realigning the department with its core mission to combat chronic diseases, aiming to enhance efficiency and save taxpayers $1.8 billion annually.

Affected Areas:

• CDC: Thousands of positions cut, including divisions focused on workplace health, HIV prevention, reproductive health, and violence prevention.
• FDA: Significant layoffs in the Offices of New Drugs Policy, International Engagement, and Regulatory Programs.
• Other Programs: Terminations in the Low Income Home Energy Assistance Program and the Administration for Children and Families.

Impact on Services: The layoffs have disrupted critical services, including government hotlines for reporting adverse events related to foods, supplements, and cosmetics.

Timestamp [07:30] – HHS Defense: HHS officials defend the cuts as necessary for efficiency, asserting that core functions like drug approvals will remain unaffected. However, critics argue that the reduction in staff will hinder public health and scientific research capabilities.

Reactions from the Left

Overview: The left vehemently opposes the HHS cuts, arguing they are poorly planned and executed, threatening public health and scientific progress.

Key Points:

• Economic Impact: The Washington Post editorial board highlighted that the $1.8 billion savings are negligible compared to potential economic damages resulting from weakened public health infrastructure.
• Public Health Concerns: Former FDA officials and experts warn that losing institutional knowledge and expertise will degrade the agency’s ability to conduct vital research and maintain public health standards.
• Reorganization Critique: KFF’s Drew Altman notes that previous HHS reorganizations aimed to build capabilities, whereas the current overhaul seeks to shrink the department. The magnitude of staff cuts (from 82,000 to 62,000) is expected to have profound negative effects.
• Media Perspective: Bloomberg’s Lisa Jarvis emphasizes the indispensable role of agencies like the CDC and FDA, arguing that their downsizing endangers public health achievements and future preparedness.

Notable Quotes:

• "Slashing the Public Health workforce hurts the US economy." – Washington Post Editorial Board ([06:00])
• "This turmoil comes amid the administration's attempt to slash funding that NIH provides to outside research institutes." – Mitchell Zeller ([06:20])

Reactions from the Right

Overview: Conversely, the right largely supports Kennedy’s restructuring, viewing it as a necessary step to eliminate government bloating and enhance efficiency.

Key Points:

• Efficiency and Cost-Cutting: Proponents argue that HHS has become inefficient and overly bureaucratic, and that reducing its size will streamline operations and reduce waste.
• Comparative Justification: Michael F. Cannon from Cato Institute compares the current cuts to historical reductions under previous administrations, labeling them as substantial yet reasonable.
• Critique of HHS Operations: Claims are made that HHS agencies, particularly the FDA, have been inefficient, citing the administration’s handling of COVID-19 testing as an example of institutional incompetence.
• Waivers and Streamlining: National Review's Ryan Long supports the consolidation of overlapping agencies to focus on mission-oriented outcomes rather than bureaucratic expansion.

Notable Quotes:

• "Downsizing HHS is the right thing to do. Many HHS employees deserve to lose their jobs." – Michael F. Cannon ([10:15])
• "A course correction, one that consolidates overlapping agencies with the intent of a more streamlined, mission focused department puts mission before empire and outcomes before bureaucracy is long overdue." – Ryan Long, National Review ([10:45])

Isaac Saul’s Take

Timestamp [19:49] – Isaac Saul: Isaac critiques the administration’s rationale for the layoffs, questioning the assumption that reducing staff inherently leads to greater efficiency. He contends that eliminating experts necessary for critical functions like drug approvals will likely result in slower processes and harm public health outcomes.

Key Points:

• Inefficiency of Cuts: Isaac argues that eliminating staff in key areas such as drug approvals contradicts the goal of increasing efficiency and may lead to decreased effectiveness in delivering essential health services.
• Budgetary Arguments Flawed: He disputes the notion that the $1.8 billion savings will significantly impact the national debt, especially in the context of proposed increases in military spending and other federal expenditures.
• Impact on Public Health: Highlighting past failures during the COVID-19 pandemic, Isaac emphasizes that the current public health agencies are still vital in maintaining health standards and responding to crises.
• Personal Perspective: While acknowledging some of Kennedy’s valid concerns about chronic diseases and public health challenges, Isaac believes that the approach of large-scale layoffs is misguided and counterproductive.

Notable Quotes:

• "If you fire people, efficiency goes up. That doesn't make any sense to me." – Isaac Saul ([20:30])
• "These challenges to me are not solvable by firing a bunch of scientists and communications directors at HHS." – Isaac Saul ([24:15])

Questions Answered: Federal Judiciary and Judge Shopping

Timestamp [27:54] – Isaac Saul: A listener question from Richard in Sacramento addresses how federal courts permit judge shopping despite procedural rotations. Isaac explains that while procedural rotation aims to assign judges randomly, litigants exploit loopholes by incorporating organizations in jurisdictions with favorable judges, targeting specific specialized divisions, and leveraging knowledge of district and circuit court leanings.

Key Points:

• Judge Assignment Loopholes: Strategies include incorporating in jurisdictions with friendly judges and targeting specific divisions with limited judges.
• Case Example: The Northern District of Texas is highlighted for its non-randomized judge assignments, allowing litigants to target Judge Matthew Kaczmarek for abortion-related cases.
• Potential Solutions: Proposals include increasing randomization, closing incorporation loopholes, and restructuring court districts to prevent biased case assignments.

Numbers and Data

Timestamp [26:44] – John Lowell: Key statistics related to the HHS layoffs and departmental structure are presented:

• Fiscal Year 2024 HHS Budget: Approximately $1.7 trillion.
• Pre-Layoff Workforce: 80,000 employees.
• CDC Layoffs: 2,400 employees (18% of staff).
• FDA Layoffs: 3,500 employees (20% of staff).
• NIH Directors Removed: 5 out of 27.
• Workforce Growth (1996-2023): 42% increase.
• Workforce Growth During Administrations:
  • Obama: 21%
  • Trump: 3%
  • Biden: 8%
• Public Trust in HHS: 55% of US adults express trust in HHS to make appropriate health recommendations (January 2025 KFF poll).

Conclusion

The episode concludes with a reflection on the profound implications of the HHS layoffs. While the administration claims the cuts are a move towards greater efficiency and reduced taxpayer burden, critics argue that the reductions will severely undermine public health infrastructure and scientific research. Isaac Saul emphasizes the complexity of public health challenges and questions whether large-scale layoffs are the appropriate solution to these problems.

Final Thoughts: Isaac acknowledges the need for reform within HHS but advocates for more targeted and strategic changes rather than broad workforce reductions. He underscores the essential role that agencies like the CDC and FDA play in safeguarding public health and contends that maintaining a robust and knowledgeable workforce is crucial for effective health governance.

Notable Quotes from Isaac Saul:

• "If we want to get experimental drugs to the market faster and at a lower cost without sacrificing safety, one way to do that would be to increase the number of scientists at the FDA working on drug approval." ([20:45])
• "Running the Doge playbook at HHS doesn't make me feel like a great American health renaissance is coming." ([24:30])

Additional Resources: For more insights and discussions on political developments, visit Tangle’s website and consider subscribing to their newsletter for regular updates.

End of Summary