By CARLA K. JOHNSON, Associated Press Medical Writer

Employees across the massive U.S. Health and Human Services Department began receiving notices of dismissal on Tuesday in an overhaul ultimately expected to lay off up to 10,000 people. The notices come just days after President Donald Trump moved to strip workers of their collective bargaining rights at HHS and other agencies throughout the government.

At the National Institutes of Health, the world’s leading health and medical agency, the layoffs occurred as its new director, Dr. Jay Bhattacharya, began his first day of work.

Health Secretary Robert F. Kennedy Jr. announced a plan last week to remake the department, which, through its agencies, is responsible for tracking health trends and disease outbreaks, conducting and funding medical research, and monitoring the safety of food and medicine, as well as for administering health insurance programs for nearly half of the country.

Health and Human Services Secretary Robert F. Kennedy Jr. speaks during an event announcing proposed changes to SNAP and food dye legislation, Friday, March 28, 2025, in Martinsburg, W. Va. (AP Photo/Stephanie Scarbrough)

The plan would consolidate agencies that oversee billions of dollars for addiction services and community health centers under a new office called the Administration for a Healthy America.

The layoffs are expected to shrink HHS to 62,000 positions, lopping off nearly a quarter of its staff — 10,000 jobs through layoffs and another 10,000 workers who took early retirement and voluntary separation offers.

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At the NIH, the cuts included at least four directors of the NIH’s 27 institutes and centers who were put on administrative leave, and nearly entire communications staffs were terminated, according to an agency senior leader, speaking on condition of anonymity to avoid retribution.

An email viewed by The Associated Press shows some senior-level employees of the Bethesda, Maryland, campus who were placed on leave were offered a possible transfer to the Indian Health Service in locations including Alaska and given until end of Wednesday to respond.

Democratic Sen. Patty Murray of Washington predicted the cuts will have ramifications when natural disasters strike or infectious diseases, like the ongoing measles outbreak, spread.

“They may as well be renaming it the Department of Disease because their plan is putting lives in serious jeopardy,” Murray said Friday.

Beyond layoffs at federal health agencies, cuts are beginning to happen at state and local health departments as a result of an HHS move last week to pull back more than $11 billion in COVID-19-related money. Local and state health officials are still assessing the impact, but some health departments have already identified hundreds of jobs that stand to be eliminated because of lost money, “some of them overnight, some of them are already gone,” said Lori Tremmel Freeman, chief executive of the National Association of County and City Health Officials.

Union representatives for HHS employees received a notice Thursday that 8,000 to 10,000 employees will be terminated. The department’s leadership will target positions in human resources, procurement, finance and information technology. Positions in “high cost regions” or that have been deemed “redundant” will be the focus of the layoffs.

Kennedy criticized the department he oversees as an inefficient “sprawling bureaucracy” in a video Thursday announcing the restructuring. He said the department’s $1.7 trillion yearly budget, “has failed to improve the health of Americans.”

“I want to promise you now that we’re going to do more with less,” Kennedy said.

The department on Thursday provided a breakdown of some of the cuts:

3,500 jobs at the Food and Drug Administration, which inspects and sets safety standards for medications, medical devices and foods.
2,400 jobs at the Centers for Disease Control and Prevention, which monitors for infectious disease outbreaks and works with public health agencies nationwide.
1,200 jobs at the NIH.
300 jobs at the Centers for Medicare and Medicaid Services, which oversees the Affordable Care Act marketplace, Medicare and Medicaid.

At the CDC, most employees have not been unionized, but interest rose sharply this year as the Trump administration took steps to reduce the federal workforce. Roughly 2,000 CDC employees in Atlanta belonged to the American Federation of Government Employees local bargaining unit, with hundreds more who had petitioned to join in recent days being added.

But on Thursday night, Trump signed an executive order that would end collective bargaining for a large number of federal agencies, including the CDC and other health agencies.

The erosion of collective bargaining rights was decried by some Democratic lawmakers.

“President Trump’s brazen attempt to strip the majority of federal employees of their union rights robs these workers of their hard-fought protections,” Reps. Gerald Connolly and Bobby Scott, both of Virginia, said in a joint statement Friday.

“This will only give Elon Musk more power to dismantle the people’s government with as little resistance from dedicated civil servants as possible — further weakening the federal government’s ability to serve the American people.”

Associated Press writers Lauran Neergaard, Amanda Seitz and Matthew Perrone in Washington and Mike Stobbe in New York contributed.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

By MATTHEW PERRONE, Associated Press Health Writer

WASHINGTON (AP) — The Food and Drug Administration’s chief tobacco regulator has been removed from his post amid sweeping cuts at the agency and across the federal health workforce handed down Tuesday, according to people familiar with the matter.

In an email to staff, FDA tobacco director Brian King said: “It is with a heavy heart and profound disappointment that I share I have been placed on administrative leave.”

King was removed from his position and offered reassignment to the Indian Health Service, according to a person familiar with the matter who did not have permission to discuss the matter publicly and spoke on the condition of anonymity.

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Dozens of staffers in FDA’s tobacco center also received notices of dismissal Tuesday morning, including the entire office responsible for enforcing tobacco regulations.

King, who joined the agency in 2022, has been vigorously criticized by vaping lobbyists for ordering thousands of companies to remove their fruit and candy-flavored e-cigarettes from the market. During his time at FDA, teen vaping has fallen to a 10-year low.

His removal comes just days after FDA vaccine chief Dr. Peter Marks was forced out, citing health secretary Robert F. Kennedy Jr.’s support for vaccine “misinformation and lies” in his resignation letter.

The latest changes mean that nearly all of FDA’s top leaders overseeing drugs, food, vaccines, medical devices and now tobacco products have resigned or retired in recent months.

The leadership vacuum comes as Kennedy moves to fire 3,500 FDA staffers and pushes ahead with plans to scrutinize ultra-processed foods, childhood vaccines, antidepressants and other long-established products.

The wave of departures means incoming FDA commissioner Marty Makary — who was confirmed last week— will inherit an agency without many of its top experts and a beleaguered workforce that has been rocked by weeks of layoffs and a chaotic return-to-office process. Only a handful of FDA employees are political appointees, with nearly all of the agency’s scientific reviews and decisions overseen by career officials.

Neither Makary nor Kennedy have said much about how tobacco policy fits into their plan to “Make America Healthy Again.” Despite historically low rates of smoking, tobacco-related diseases remain the nation’s leading preventable cause of death, blamed for more than 490,000 annually.

In recent years, the FDA’s tobacco center has been besieged by criticism from all sides including congressional lawmakers, anti-smoking advocates, and tobacco and vaping companies.

Politicians, parents and anti-tobacco groups want the FDA to do more to stamp out unauthorized vaping products that can appeal to teens, many of which are imported from China. Tobacco and vaping companies say the FDA has been too slow to approve newer products for adult smokers — including e-cigarettes — that generally carry much lower risks than traditional cigarettes.

Under King, the FDA rejected applications for millions of flavored e-cigarettes, citing insufficient data that the products would help adult smokers while not becoming popular with underage kids. Those rejections have resulted in multiple lawsuits against FDA from vape makers, including one that was argued before the Supreme Court in December.

The Vapor Technology Association, an industry group, has been running ads urging Trump to follow through on a campaign pledge he made to “save the flavored vaping industry.”

The FDA has authorized a handful of e-cigarettes for adults, mostly from major vaping brands owned by legacy tobacco companies, including R.J. Reynold’s Vuse and Altria’s Njoy.

Other recent FDA departures include:

Deputy commissioner for foods, Jim Jones, who resigned in February after dozens of his staffers were fired.
Director of FDA’s drug center, Dr. Patrizia Cavazzoni, who stepped down days before President Donald Trump took office.
The agency’s second-ranking official. Dr. Namandje Bumpus, who resigned late last year.
FDA’s longtime medical devices director, Dr. Jeffrey Shuren, who retired last summer.

Many deputies and senior scientists have also retired or stepped down in recent weeks.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

By STEPHEN GROVES, Associated Press

WASHINGTON (AP) — With President Donald Trump’s so-called “Liberation Day” of tariff implementation fast approaching, Senate Democrats are putting Republican support for some of those plans to the test by forcing a vote to nullify the emergency declaration that underpins the tariffs on Canada.

Republicans have watched with some unease as the president’s attempts to remake global trade have sent the stock market downward, but they have so far stood by Trump’s on-again-off-again threats to levy taxes on imported goods.

Even as the resolution from Democratic Sen. Tim Kaine of Virginia offered them a potential off-ramp to the tariffs levied on Canadian imports, Republican leaders were trying to keep senators in line by focusing on fentanyl that comes into the U.S. over its northern border. It was yet another example of how Trump is not only reorienting global economics, but upending his party’s longtime support for ideas like free trade.

Sen. Tim Kaine, D-Va., left, and Sen. Patty Murray, D-Wash., confer as the Health, Education, Labor and Pensions (HELP) Committee meets to consider President Donald Trump’s nominations for the director of the National Institutes of Health, and the commissioner of the Food and Drug Administration, on Capitol Hill in Washington, Thursday, March 13, 2025. (AP Photo/J. Scott Applewhite)

“I really relish giving my Republican colleagues the chance to not just say they’re concerned, but actually take an action to stop these tariffs,” Kaine told The Associated Press in an interview last week.

Kaine’s resolution would end the emergency declaration that Trump signed in February to implement tariffs on Canada as punishment for not doing enough to halt the flow of illegal drugs into the U.S. If the Senate passes the resolution, it would still need to be taken up by the Republican-controlled House.

A small fraction of the fentanyl that comes into the U.S. enters from Canada. Customs and Border Protection seized 43 pounds of fentanyl at the northern border during the 2024 fiscal year, and since January, authorities have seized less than 1.5 pounds, according to federal data. Meanwhile, at the southern border, authorities seized over 21,000 pounds last year.

Kaine warned that tariffs on Canadian goods would ripple through the economy, making it more expensive to build homes and military ships.

“We’re going to pay more for our food products. We’re going to pay more for building supplies,” he said. “So people are already complaining about grocery prices and housing costing too much. So you raise the cost of building supplies and products. It’s a big deal.”

Still, Trump has claimed that the amount of fentanyl coming from Canada is “massive” and pledged to follow through by executing tariffs Wednesday.

“There will never have been a transformation of a Country like the transformation that is happening, for all to see, in the United States of America,” the president said on social media Monday.

Republican leaders in the Senate have signaled they aren’t exactly fans of tariffs, but argued that Trump is using them as a negotiating tool.

“I am supportive of using tariffs in a way to accomplish a specific objective, in this case ending drug traffic,” Senate Majority Leader John Thune, R-S.D., told reporters last month. He said this week that his “advice remains the same.”

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While Trump’s close allies in the Senate were standing steadfastly by the idea of remaking the U.S. economy through tariffs, others have begun openly voicing their dissatisfaction with trade wars that could disrupt industries and raise prices on autos, groceries, housing and other goods.

“I’m keeping a close eye on all these tariffs because oftentimes the first folks that are hurt in a trade war are your farmers and ranchers,” said Sen. Steve Daines, a Montana Republican.

Sen. John Kennedy, a Louisiana Republican, said he would prefer to see the U.S. and its trading partners move to remove all tariffs on each other, but he conceded that Trump’s tariff threats had injected uncertainty into global markets.

“We’re in uncharted waters,” Kennedy told reporters. “Nobody knows what the impact of these tariffs is going to be.”

By TARA COPP, Associated Press

WASHINGTON (AP) — President Donald Trump’s pick to be the next chairman of the Joint Chiefs of Staff, retired Air Force Lt. Gen. Dan “Razin” Caine, will face questions from senators during his confirmation hearing Tuesday about his qualifications to become the top U.S. military officer.

Caine is a decorated F-16 combat pilot who served in leadership positions in multiple special operations commands and in some of the Pentagon’s most classified programs. He does not, however, meet the prerequisites for Joint Chiefs chairman, although they can be waived by the president.

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Caine was nominated by Trump in February, one day after the president fired the former chairman, Gen. CQ Brown Jr., in a purge of general officers whom he and Defense Secretary Pete Hegseth viewed as endorsing diversity, equity and inclusion in the ranks.

Caine met Trump when the president visited troops in Iraq in 2018 during his first term. Trump has told political supporters the encounter left an impression on him — and that Caine put on a red “Make America Great Again” hat at the time, something Caine’s inner circle has said is not true.

Caine has been described by former military colleagues as a deeply serious career officer who has spent the past few weeks meeting with both Democratic and Republican lawmakers, said a former U.S. official who has helped Caine prepare for the confirmation process and spoke on the condition of anonymity to provide details on Caine’s nomination. Hegseth notably refused to meet with many Democrats when he was going through the confirmation process.

Because he retired in December, Caine would need to be sworn back into active duty. That would take place after he is confirmed, and then he would be promoted to four-star general, the official said.

Caine’s nomination following the ouster of Brown is likely to raise questions from some Democrats on the Senate Armed Services Committee about whether he will remain independent of Trump.

During Trump’s first term, his relationship with then-Chairman Gen. Mark Milley soured as Milley pushed back and took steps to try to prevent what he saw as an attempt to politicize the office, such as by reminding military service members they take an oath to the Constitution, not to a president.

The relationship soured to the extent that within hours of Trump being sworn in office in January, Milley’s portrait as chairman of the Joint Chiefs was removed from the Pentagon. Trump and Hegseth have subsequently stripped Milley of his security clearance and security detail.

Caine does not meet prerequisites laid out in a 1986 law, such as being a combatant commander or service chief. The law, however, allows presidents to waive those requirements to fill the position with someone they are most comfortable with.

While Caine would be the military’s top uniformed officer, his chief duty would be serving as the president’s top military adviser.

But Caine has spent time inside the Pentagon, leading its Special Access Programs Central Office, which oversees what classified information on weapons programs is shared with foreign governments.

He also served as the commander of the joint special operations task force in Iraq in 2008 and as the assistant commanding general of joint special operations command at Fort Bragg. From 2018 to 2019, he was the deputy commanding general of the special operations joint task force for Operation Inherent Resolve, countering the Islamic State group in Iraq and Syria.

He also was associate director for military affairs at the CIA from 2021 until he retired in December.

Caine transferred into the National Guard in 2009 and began working in the private sector, including as an adviser at an investment firm run by the brother of Jared Kushner, Trump’s son-in-law.

He has more than 2,800 flying hours in the F-16 and has earned the Distinguished Flying Cross and Bronze Star Medal with bronze oak leaf cluster, among other awards.