HHS Shake-Up Sends Shockwaves Through Aging Network

Published on April 31, 2025

Taking a page from President Donald J. Trump’s to “Make America Great Again,” last week the U.S. Department of Health and Human Services (HHS) announced a major restructuring of the federal agency to “Make America Healthy Again.” The dramatic restructuring in accordance with Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”

The U.S. Department of Health and Human Services (HHS), under management of HHS Secretary Robert F. Kennedy, Jr., last week announced a major restructuring and renaming of the federal agency under the initiative “Make America Healthy Again.” This dramatic reorganization follows Trump’s Executive Order, Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” said HHS Secretary Robert F. Kennedy, Jr. in a statement announcing the massive overhaul. “This Department will do more—much more—at a lower cost to taxpayers.”

“Over time, bureaucracies like HHS become wasteful and inefficient, even when most of their staff are dedicated and competent civil servants,” Kennedy added. “This overhaul will be a win-win for taxpayers and those HHS serves. That’s the entire American public, because our goal is to Make America Healthy Again.”

During the Biden administration, HHS’s budget increased by 38%, and its staffing grew by 17%, prompting the new HHS chief to place the federal agency on the budgetary chopping block.

According to HHS, this restructuring will not impact critical services while saving taxpayers $1.8 billion per year through a reduction of approximately 10,000 full-time employees. When combined with other cost-cutting initiatives, including early retirement, and the Fork in the Road program, the total downsizing will reduce HHS’s workforce from 82,000 to 62,000 employees.

HHS also plans to streamline departmental functions. Currently, the agency’s 28 divisions contain redundant units. Under the restructuring plan announced on March 27, 2025, these units will be consolidated into 15 new divisions, including a newly created Administration for a Healthy America (AHA). Additionally, core organizational functions—such as Human Resources, Information Technology, Procurement, External Affairs, and Policy—will be centralized. The number of regional offices will be cut from 10 to five.

As part of the restructuring, several agencies will see workforce reductions. The U.S. Food and Drug Administration (FDA) will cut approximately 3,500 full-time employees, focusing on streamlining operations and centralizing administrative functions, though HHS asserts these reductions will not affect drug, medical device, or food reviewers, nor inspectors.

Similarly, the U.S. Centers for Disease Control and Prevention (CDC) will downsize by approximately 2,400 employees, refocusing its efforts on epidemic and outbreak response. The National Institutes of Health (NIH) will eliminate 1,200 positions by centralizing procurement, human resources, and communications across its 27 institutes and centers. Meanwhile, the Centers for Medicare and Medicaid Services (CMS) will cut around 300 positions, targeting minor duplication within the agency. HHS insists these changes will not impact Medicare or Medicaid services, but improve them.

Restructuring HHS to Focus on Chronic Illness Prevention

HHS’s overhaul aligns with the agency’s new priority of ending America’s chronic illness epidemic by focusing resources on ensuring safe, wholesome food, clean water, and the elimination of environmental toxins.

The Administration for a Healthy America (AHA) will consolidate five agencies—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. This unification aims to enhance health resource coordination for low-income Americans, emphasizing primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development.

Additionally, the Administration for Strategic Preparedness and Response, responsible for national disaster and public health emergency response, will be transferred to the CDC to strengthen its core mission of protecting Americans from health threats.

To combat waste, fraud, and abuse, HHS will create a new Assistant Secretary for Enforcement, overseeing the Departmental Appeals Board, the Office of Medicare Hearings and Appeals, and the Office for Civil Rights.

Furthermore, HHS will merge the Assistant Secretary for Planning and Evaluation with the Agency for Healthcare Research and Quality to form the Office of Strategy, enhancing research to inform policy decisions.
Critical programs under the Administration for Community Living (ACL), which supports older adults and people with disabilities, will be integrated into other HHS agencies, including the Administration for Children and Families, the Office of the Assistant Secretary for Planning and Evaluation, and the Centers for Medicare and Medicaid Services (CMS). HHS assures that these changes will not impact Medicare or Medicaid services.

Sounding the Alarm

Following the announcement of HHS’s restructuring plans, which would broad without a lot of detail, aging advocacy groups quickly released statements to voice strong concerns.

“For decades, the federal health programs that retirees and people with disabilities depend on have been ably administered under both Democratic and Republican administrations. However, the radical cutbacks proposed by the Trump administration place the delivery of these programs in jeopardy,” warned Dan Adcock, Director of Government Relations & Policy at the National Committee to Preserve Social Security and Medicare (NCPSSM).

Adcock also noted that HHS plans to eliminate the ALC and divide its responsibilities between two offices with no prior experience in this area. “This administration has already demonstrated a reckless disregard for public interests in favor of slashing operations and staff under the guise of ‘efficiency,’” he added. “So far, all they have done is create chaos and confusion, disrupting essential programs for seniors and the disabled. We view Secretary Kennedy’s plans with alarm.”

Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer at AARP, also urged HHS to prioritize older Americans’ health needs. “HHS must ensure access to senior centers, community health centers, nutritious meals, Medicare assistance, and other vital services that countless older Americans rely on. Health is central to the lives, well-being, and financial security of AARP’s members and the more than 100 million Americans over age 50,” she emphasized.

Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, echoed these concerns. “The announcement of workforce cuts at HHS comes at a time of unprecedented growth in America’s aging population. The proposed reorganization of ACL and its integration into other agencies requires careful consideration.”

Fulmer stressed that ACL administers programs essential to older adults’ daily lives, such as meal delivery, transportation to medical appointments, and chronic disease management. Absorbing these functions with far fewer staff demands careful planning. The government’s commitment to older adults requires a cautious approach, she said.

The Center for Medicare Advocacy also expressed deep concerns, particularly regarding plans to restructure ACL and consolidate oversight of Medicare appeals. “Given what we have seen with Social Security Administration cuts and restructuring, HHS’s claim that these changes won’t impact critical services rings hollow,” said Co-Director David Lipschutz.

LeadingAge, a national association representing nonprofit aging services providers, called for HHS to ensure older adults and their caregivers are not overlooked. “Cutting staff responsible for critical agency functions raises serious concerns. How will the work our members rely on get done? How will this impact quality care for older adults?” asked President and CEO Katie Smith Sloan.

Sloan also cautioned that reducing HHS’s field offices from 10 to five could impact CMS’s ability to oversee nursing home surveys and provider compliance. “A 25% workforce reduction must be undertaken with extreme care—especially given the millions of older adults who depend on these services,” she emphasized.

For a fact sheet on the HHS restructuring, visit https://www.hhs.gov/about/news/hhs-restructuring-doge-fact-sheet.html

Seniors in hock over credit card debt. Cap attempt a rare tri-partisan (D), (I), (R) effort

Published in RINewsToday on March 24, 2025

Over two weeks ago, a new AARP survey revealed that 47% of respondents who carry credit card debt use their credit cards to pay for basic living expenses that they do not have enough money to cover.  Seventeen percent of these individuals relied on using their credit card to cover month to month expenses of daily living over the last year.

These findings, detailed in the 47-page report, “Credit and Debt and Adults Age 50 Plus,” put a spot light on credit card debt as now the most common type of debt held by adults age 50 plus, including many at all income levels. The survey results drive home the point that rising costs of basic expenses for food, housing and utilities, along with skyrocketing health care costs and unexpected financial burdens, are quickly chipping away at the financial well-being of older Americans in their retirement years.

AARP’s credit card survey also found that 37% of older adults with credit card debt report that they have more credit card debt than a year ago. Nearly half (48%) of older adults who carry a credit card balance from month-to-month owe $5,000 or more, and 28% carry a balance of $10,000 or more. Almost 9 in 10 respondents (87%) say that unexpected expenses contribute to their credit card debt.

“A concerning number of older adults carry credit card debt today just to make ends meet,” said Indira Venkat, AARP Senior Vice President of Research in a statement released on March 10, 2025 announcing the findings of this survey. “Credit card debt can jeopardize retirement security. For many retirees, who often live on a fixed income, it’s a real challenge to pay down debt without significant trade-offs,” she says.

The survey also found that older adults are the most likely to carry a monthly balance, including people ages 50-64, those with incomes under $40,000, as well as Black and Hispanic/Latino older adults. More than half (52%) of adults ages 50-64 have credit card debt. Significant portions of those ages 65-74 (42%) and 75 and older (35%) also carry credit card debt.

Credit card debt results in long-term financial strain of the older card holder. Among those who are worried about their credit card debt, the survey found that 43% are very worried about how long it will take to pay off their debt. Roughly 1 in 5 expect to take more than five years to pay it off. The top drivers of credit card debt include everyday expenses, including vehicle costs, housing costs, and health care.

Fifty percent of the respondents say that health care expenses have contributed to their credit card debt, noted the survey findings. Among this group, the biggest medical expenses contributing to debt are dental expenses (46%), prescription drugs (35%), and vision care (19%)

And, twenty-three percent say they are still paying off balances on cancelled credit cards. As a result, forty-six percent say credit cards have hurt their ability to save for the future.

Bipartisan efforts on Capitol Hill to cap high credit card interest rates

With credit card interest at an all-time high, carrying high-interest credit card debt month-to-month can be risky for those who struggle with paying of the balance as the interest accrues.

This financial issue brings together two strange bedfellows— Sen. Bernie Sanders (I-Vt.)  a democratic socialist advocating for progressive policies like universal healthcare and wealth redistribution, and Sen. Josh Hawley (R-Mo.), a conservative populist focused on nationalism, traditional values, and limiting government intervention—to cap high credit interest rates.

On Feb. 4, 2025, the Senators introduced their bipartisan legislation, S. 381, the 10 percent Credit Interest Rate Cap Act, that caps credit card interest rates at 10% for five years to provide financial relief to consumers facing high interest debt.  Later, Sen. Jeff Merkley (D-OR) would become a cosponsor.

S. 381 was referred to the Senate Banking, Housing, and Urban Affairs for consideration.  A companion measure, H.R. 1944 was introduced by Rep. Alexandria Ocasio-Cortez and referred to the House Committee on Financial Services.

The legislation responds to concerns about rising credit card debt, which reached a record $1.17 trillion in the third quarter of 2024. At that time, the average credit card interest rate was approximately 28.6%, significantly higher than the proposed 10% cap.

Capping high interest rates can easily help credit older adults, burdened by credit card debt.  According to Sander’s statement, “If a consumer has a $5,000 credit card balance with a 28% interest rate and can only afford to make the minimum payment of $166 a month it would take that person over 24 years to pay off and would cost nearly $11,000 in interest. If credit card interest rates were capped to 10%, that same consumer would save over $7,000 in interest.

“During the campaign, President Donald J. Trump pledged to cap credit card interest rates at ten percent,” Sanders said. “When large financial institutions charge over 25 percent interest on credit cards, they are not engaged in the business of making credit available. They are engaged in extortion and loan sharking. We cannot continue to allow big banks to make huge profits ripping off the American people. This legislation will provide working families struggling to pay their bills with desperately needed financial relief,” he says.

“Working Americans are drowning in record credit card debt while the biggest credit card issuers get richer and richer by hiking their interest rates to the moon. It’s not just wrong, it’s exploitative. And it needs to end,” said Hawley. “Capping credit card interest rates at 10%, just like President Trump campaigned on, is a simple way to provide meaningful relief to working people. Let’s do it,” he said.

While the bill aims to alleviate the financial burden on consumers, the American Bankers Association (ABA) argues that such a cap would have a devastating effect on access to credit for individuals and small business owners who use their personal credit cards as a form of liquidity by imposing an all-in annual percentage rate cap at 10 percent.  A cap on credit card interest rates is a price control on credit that will lead to credit shortages for consumers, charges ABA.

Reaching across the aisle 

On Sept. 18, 2024, at Uniondale, New York, at a campaign rally GOP presidential nominee, President Trump, then candidate Trump, promised to cap interest rates at 10% to provide temporary and immediate relief for hardworking Americans who are struggling to make ends meet and cannot afford hefty interest payments on top of the skyrocketing costs of mortgages, rent, groceries and gas.

As duly elected President, now Trump has the opportunity to work with Senators Sanders and Hawley and Rep. Ocasio-Cortez to put an end to hefty interest payments as he promised over six months ago on the campaign trail.  Trump now can put partisan politics behind, urging the Republican-controlled Senate and House to S. 381 and H.R. 1944 a fair committee hearing and floor vote.

Hopefully, the Rhode Island legislative delegation will quickly support the bipartisan proposals in both chambers, signing on as cosponsors.

Capping high credit card interest rates might just be one way to bring the two warring political parties together on behalf of American consumers.  Let’s see.

NOTE:  The findings of AARP’s Credit Card Debit Survey are based on a survey of 4,846 adults ages 50-plus who carry over credit card debt from a previous month, whether on active cards or cancelled cards.

To read AARP’s latest Credit Card Debt Report, to go www.aarp.org/content/dam/aarp/research/topics/work-finances-retirement/financial-security-retirement/credit-card-debt-survey.doi.10.26419-2fres.00929.001.pdf

To watch former president and GOP presidential nominee, Donald J. Trump, calling for capping high interest rates on Sept. 18, 2024, go to www.c-span.org/program/campaign-2024/former-president-trump-campaigns-in-uniondale-new-york/648902

Learn more about AARP’s resources for managing money. go to  https://www.aarp.org/tools/money/?cmp=RDRCT-TOOLS-MONEYTOOLS-09262024.

New study gives Congress a road map to fix Social Security 

Published in RINewsToday on February 17, 2025

As Social Security celebrates its 90th anniversary on Aug. 14, 2025, this essential retirement program has long been facing a significant long-term financing gap.  According to the 2024 Social Security trustees report, unless Congress acts the trust funds will be depleted by 2035, forcing the program to reduce benefits by 17%.

With over 70 million retirees and individuals with disabilities receiving Social Security benefits, it is time for Congress to get serious about hammering out a viable bipartisan solution to resolving Social Security’s funding gap.  And a recently released report provides the groundwork for a policy that a partisan Congress might just consider.   

Last month, the National Academy of Social Insurance (NASI), AARP, the National Institute on Retirement Security (NIRS), and the U.S. Chamber of Commerce (USCC) released the results of a qualitative analysis study, on Jan. 29, 2025, detailing American views on Social Security, a federal “social safety net” program that provides income to people who are retired, disabled, or have dependents, helping them to plan for retirement and other life events.   

The new, recently released, 72-page report, entitled, Social Security at 90: A Bipartisan Roadmap for the Program’s Future, is a must read for the White House and Congressional lawmakers as they begin to debate specific policies that would make long-term fixes to ensure the long-term solvency of the America’s retirement program.  

The NASI survey, fielded by NORC at the University of Chicago, a nonprofit research organization, surveyed 2,243 Americans ages 21 and over. 

Unlike most public opinion research on Social Security, which asks about each policy option individually, NASI says that this survey, conducted in partnership with the Washington, DC-based Greenwald Research, a firm having extensive experience in public opinion and consumer preference research, features a unique trade-off analysis that examine which combination of product features – or in this case policy changes- that consumers prefer and are willing to pay for.

The study’s findings are also largely consistent with previous NASI 2012 and 2014 studies, Strengthening Social Security: What Do American’s Want? and Americans Make Hard Choices: A Survey with Trade-off Analysis

Sending a clear message to Washington

The NASI study’s findings indicate that Americans (across party lines, generations, income and education), strongly support Social Security and see it as the lynchpin for retirement security.  Only four percent state that they do not consider it to be an important income to draw on during retirement. 

Rather than ensuring the solvency of Social Security through cutting benefits, the survey respondents strongly support strengthening the program’s finances by raising revenues, noting the study’s findings.  Eighty-five percent of the respondents call for benefits not being reduced, even if this means raising taxes on some or all Americans.

According to the survey’s findings, the most strongly favored option is eliminating the cap on payroll tax contributions for those earning more than $400,000 per year and their employers, who would contribute to Social Security via payroll taxes on wages above that amount. Those affected would not receive additional benefits.

Additionally, respondents across all groups, including a majority of Republicans, say they are willing to pay more themselves by gradually increasing the payroll tax rate from 6.2 percent to 7.2 percent, to strengthen the program’s finances.  Workers earning less than $50,000 per year would not take financial hits. They would only contribute an additional $42 per month.

Don’t touch our benefits!

Given a broad set of policy options available to address Social Security’s financing gap, the respondents also reject benefit reductions such as keeping the full retirement age at 67 instead of further raising. Those surveyed also called for adjusting the annual cost-of-living adjustment (COLA) to more accurately reflect inflation and spending habits of older adults.

The NASI study also found that Americans want to strengthen Social Security benefits by adding a caregiver credit for workers who take time out of the workforce to care for young children and a “bridge benefit” to protect from the early claiming reduction of those in physically demanding jobs who may be unable to continue working up to full retirement age.

Finally, the study’s findings indicate that overwhelming majority of Americans (90 percent) see the need and valuable of Social Security’s disability benefits, too.  These respondents say that they will need Social Security’s disability benefits if they become disabled and unable to support themselves through work, and only four percent support cutting disability benefits. The survey also finds strong bipartisan support for updating outdated rules in Supplemental Security Income, including its $2,000 asset limit.

Statements from NASI and core partners

“At a time when our country is deeply divided, Social Security remains a powerful unifying force,” said Rebecca Vallas, NASI’s Chief Executive Officer. “This survey shows there is strong bipartisan agreement on how the American people want to secure the program’s future, and we urge policymakers to listen,” she says.

“It is rare in today’s political climate to see people unite around anything,” adds AARP Chief Public Policy Officer Deb Whitman, noting that all Americans want their Social Security benefits to be preserved. They are willing to do what it takes to ensure the program continues to provide meaningful support for future generations, she says.

“Social Security is the foundation of retirement security in the United States. This report clearly indicates both the important role that Social Security plays as a source of retirement income for older Americans as well as the priority the American people place on resolving the financing gap so that benefits are not cut indiscriminately,” said Tyler Bond, NIRS’s Research Director. “This research continues a long history of finding strong support for Social Security among the public,” he says.

Finally, stated: “These survey results show that Americans value Social Security and their private sector retirement benefits because they were unwilling to cut those benefits to finance Social Security,” says Chantel Sheaks, USCC’s Vice President of Retirement Policy. “Americans think of these together, and policymakers should as well,” he suggests.

Adding their two cents

“This survey shows that Americans — Democrats, Republicans, and independents alike — absolutely do not want to see cuts to Social Security’s modest benefits,” says Nancy Altman, President of the Washington, DC-based Social Security Works.

“Instead, they want the wealthy to finally start contributing their fair share. If necessary, they are even willing to pay more themselves. Any DC politician who supports benefit cuts is wildly out of step with the American people,” she notes.

“While the study’s findings are consistent with other major surveys on Social Security during the previous years, it is remarkable that despite the current tumultuous political environment, American voters have a deep emotional bond with the program and want to ensure that Congress protects and improves their benefits without cutting them,” says Dan Adcock, director of government relations and policy at the Washington, DC-based National Committee to Preserve Social Security and Medicare.

The NASI poll sends a strong signal to members of Congress that they should support legislation, like Rep. John Larson (D-CT) and Sen. Richard Blumenthal’s Social Security 2100 Act, that would extend solvency and improve benefits by having the wealthy pay their fair share of payroll taxes,” says Adcock. 

In one of President Trump’s rolling press conferences, he touched upon Social Security saying there were no cuts being proposed – if anything he would make the program stronger.

Social Security and the Ocean State 

In 2022, there were more than 233,000 Social Security beneficiaries in Rhode Island, including more than 172,000 retirees, 32,000 disabled workers, and almost 14,000 children,” says NIRS’s Tyler Bond, noting that all of these Rhode Islanders face the prospect of an indiscriminate benefit cut in a decade unless Congress acts to shore up Social Security’s financing. 

“This report has one clear takeaway: the American people do not want Social Security benefit cuts, and they are willing to pay more themselves to avoid those potential benefit cuts,” adds Bond.

In conclusion, the NASI report cites 84-year-old Elizabeth R. Virginia, about her personal views on America’s retirement program. “Social Security is one of the most dependable things that we have. You know that it will come again at the same time. Right now, I know the second day of every month, it is there,” she says.

As Virginia knows, she can count on receiving her monthly Social Security check.  The program has never missed a payment in nine decades.  Congress must now work together to ensure that this never will happen.

For a copy of NASI’s Social Security report, go to www.nasi.org/wp-content/uploads/2025/01/NASI_SocialSecurityat90.pdf

For copy of NASI’s issue brief, “America’s View on Social Security,” go to www.nirsonline.org/wp-content/uploads/2024/07/FINAL-Views-on-SS-July-2024.pdf/

For statistics on RI Social Security beneficiaries, go to Source for RI statistics, go to www.ssa.gov/policy/docs/statcomps/oasdi_zip/2022/ri.pdf.