The Department of Health and Human Services is the primary federal agency responsible for protecting the health of all Americans. With a budget exceeding $1.7 trillion, HHS oversees Medicare and Medicaid coverage for more than 140 million Americans, regulates the nation's food and drug supply through the FDA, leads public health surveillance and emergency preparedness through the CDC, funds the National Institutes of Health's biomedical research enterprise, and administers critical programs through HRSA, SAMHSA, and dozens of other constituent agencies. The department touches every dimension of American health: from the safety of the food on American tables to the affordability of insulin, from the integrity of vaccine science to the survival rates of mothers giving birth.
- Dismantled the CDC: Cut 2,400 CDC employees, eliminated divisions for infectious disease prevention and immunization programs, collapsed the pandemic preparedness agency (ASPR) back into CDC, censored research on vaccine hesitancy and health disparities, and undermined childhood vaccination confidence -- triggering measles outbreaks in communities with declining vaccination rates.
- Politicized the FDA: Launched a politically motivated safety review of mifepristone (used safely by 5+ million women since 2000), cut 3,500 FDA positions (former Commissioner: "The FDA as we've known it is finished"), proposed giving political appointees veto power over scientific drug approval decisions, and weakened dietary supplement oversight.
- Sabotaged Healthcare Coverage: Declined to extend enhanced ACA premium tax credits (projected 4.2 million coverage losses), imposed Medicaid work requirements that reduce coverage without increasing employment, proposed Medicaid block grants, eliminated staff responsible for calculating federal poverty guidelines affecting tens of millions, and cut Medicaid enrollment by 3.4 million.
- Assaulted Reproductive Healthcare: Froze $65.8 million in Title X family planning grants (preventing an estimated 822,000 unintended pregnancies annually), expanded conscience clause protections to permit patient abandonment, proposed renaming HHS the "Department of Life," weaponized abortion data surveillance, and signaled potential Comstock Act use to block mifepristone shipment nationwide.
- Gutted NIH Research: Terminated 5,844 NIH research grants totaling $2.7 billion based on ideological screening -- targeting vaccine research, health disparities, and diversity studies. Proposed cutting NIH by 40%. Halted clinical trials mid-enrollment, placing research participants in medical jeopardy. Issued 24% fewer grants than the prior decade's average.
- Abandoned Mental Health: Cut approximately $1 billion from SAMHSA, terminated $88 million in DOJ substance abuse treatment grants, announced non-enforcement of the Mental Health Parity and Addiction Equity Act, and abandoned the youth mental health crisis response while 80,000+ Americans died of drug overdoses in 2024.
Reinstate all terminated CDC employees. Propose the CDC Independence and Scientific Integrity Act: fixed six-year term for CDC Director (removal only for cause), merit-based scientific advisory committee selection, and prohibition on political alteration of public health guidance. Rebuild immunization, environmental health, and pandemic preparedness infrastructure. Fund 50,000 new public health positions.
Withdraw the politically motivated mifepristone safety review on Day One. Restore all 3,500 terminated FDA positions. Establish a Senate-confirmed FDA Scientific Integrity Officer. Clarify that the Comstock Act does not prohibit interstate shipment of FDA-approved medications. Strengthen medical device safety by eliminating the 510(k) loophole for high-risk devices.
Make enhanced premium tax credits permanent (21.4 million enrollees depend on them). Create a federal public option at 110% of Medicare rates available on all marketplaces. Close the Medicaid coverage gap for 1.9 million Americans in non-expansion states through a direct federal fallback program. Reduce the uninsured rate from 8% to below 4%.
Add dental, vision, and hearing coverage for 65 million beneficiaries (68% currently lack dental insurance). Expand drug price negotiation from 10 to 50 drugs, with first-round savings of 38-79% on targeted medications for 9 million beneficiaries. Establish a federal long-term care benefit with living wage requirements for care workers.
Restore all Title X funding and increase to $750 million over four years. Propose the Medication Abortion Access Act preempting state telehealth and mail restrictions. Enforce EMTALA's emergency obstetric care requirement regardless of state abortion laws. Reform conscience clauses to prevent patient abandonment in emergencies. Expand OTC contraception access.
Reinstate all 5,844 terminated grants. Increase NIH funding by 20% annually to reach $77 billion by year four. Codify that grant decisions are made exclusively through peer review under 42 U.S.C. Section 289. Protect NIH institute directors with fixed five-year terms. Expand health disparities research through NIMHD.
Implement the Black Maternal Health Momnibus Act: mandatory 12-month postpartum Medicaid coverage in all states, community-based doula programs (10,000 trained doulas in underserved communities), mandatory implicit bias training for all federally funded obstetric providers, and rural maternal care infrastructure grants. Reduce Black maternal mortality from 50.3 to below 25 per 100,000 live births.
Resume full MHPAEA enforcement on Day One with civil penalties up to $100/day per affected beneficiary. Restore $1 billion in SAMHSA funding plus $2 billion in new annual appropriations. Expand opioid treatment to 2,000 new sites nationally. Declare youth mental health a national emergency. Fund 50,000 school-based mental health counselors.
- Withdraw FDA's politically motivated mifepristone safety review
- Restore all frozen Title X family planning grants
- Direct NIH to reinstate all grants terminated without peer review after January 20, 2025
- Resume full enforcement of the Mental Health Parity and Addiction Equity Act
- Begin reinstatement of all 20,000 HHS employees terminated in March 2025
- Withdraw the "Department of Life" designation and anti-abortion task force
- Restore staff responsible for federal poverty guideline calculations
- Direct DOJ to clarify Comstock Act does not prohibit mifepristone shipment
- Restore ASPR to independent operating status and order Strategic National Stockpile assessment
- Reinstate CDC Office of Health Equity and all immunization communications positions
- 335 million: Americans who depend on HHS programs and regulations
- 140 million+: Americans covered by Medicare and Medicaid
- 21.4 million: Record ACA marketplace enrollees at risk if subsidies expire
- 5,844: NIH research grants terminated on ideological grounds ($2.7 billion)
- 20,000: HHS employees terminated in March 2025 restructuring
- 50.3 per 100,000: Black maternal mortality rate -- more than 3x the rate for white women
- 80,000+: Americans who died of drug overdoses in 2024
- 1.9 million: Americans in the Medicaid coverage gap in non-expansion states
- 822,000: Unintended pregnancies prevented annually by Title X (now at risk)
- 30 million: Low-income Americans served by community health centers
- CDC Independence and Scientific Integrity Act -- Fixed six-year term for CDC Director, prohibition on political alteration of health guidance
- NIH Independence and Research Integrity Act -- Peer-review-only grant decisions, fixed terms for institute directors, civil penalties for interference
- Permanent ACA Subsidy and Public Option Act -- Permanent enhanced tax credits, federal public option on all marketplaces
- Medicare Comprehensive Benefits Expansion Act -- Add dental, vision, and hearing for 65 million beneficiaries
- Black Maternal Health Momnibus Act -- 12-month postpartum Medicaid, doula programs, implicit bias training, maternal care desert grants
- Medication Abortion Access Act -- Federal preemption of state restrictions on telehealth and mail for FDA-approved abortion medications
- Mental Health Parity Enforcement Act -- Civil penalties for insurer violations, private right of action for beneficiaries
- Pandemic Preparedness Permanent Funding Act -- Guaranteed multi-year appropriations, 80% domestic medical manufacturing target
- Community Health Center Expansion Act -- $2 billion increase, 600 new sites, priority for maternal care deserts and rural areas
- Day 1: Withdraw mifepristone review, restore Title X, reinstate NIH grants, resume MHPAEA enforcement, begin employee reinstatement
- First 100 Days: Submit CDC/NIH independence acts, ACA subsidy/public option bill, Medicare expansion bill, Black Maternal Health Momnibus
- Year 1: Permanent ACA subsidies enacted, Medicaid coverage gap closed for 1.9 million Americans, MHPAEA enforcement against 20 largest insurers, all 50 states with maternal mortality review committees
- Years 2-4: Medicare dental/vision/hearing operational, 50-drug negotiation target reached ($100B savings), NIH at $77 billion, uninsured rate below 4%, Black maternal mortality below 25 per 100,000
- Spending Clause (Art. I, Section 8, cl. 1): Plenary authority for healthcare spending; South Dakota v. Dole (1987)
- Commerce Clause (Art. I, Section 8, cl. 3): Healthcare markets, pharmaceutical commerce; Gonzales v. Raich (2005)
- Public Health Service Act (42 U.S.C. Section 201 et seq.): Foundation for CDC, NIH, Title X
- Affordable Care Act (42 U.S.C. Section 18001 et seq.): Marketplace, subsidies, essential benefits; NFIB v. Sebelius (2012)
- Social Security Act (42 U.S.C. Sections 1395, 1396 et seq.): Medicare and Medicaid statutory framework
- Read the full chapter: Chapter 14: Department of Health and Human Services
- Contact your representatives: Demand permanent ACA subsidies, NIH funding restoration, mental health parity enforcement, and reproductive healthcare access
- Share this one-pager: Help others understand how HHS cuts directly threaten their health, their families, and their communities
- Join the movement: Support organizations defending public health, reproductive rights, scientific integrity, and healthcare access
Project 2029 | Section 3: The General Welfare | Last Updated: February 28, 2026 Full chapter: ../../../Section3_The_General_Welfare/Chapter_14_HHS.md