Employees across the U.S. Department of Health and Human Services (HHS) began receiving dismissal notices Tuesday as part of a sweeping overhaul expected to eliminate up to 10,000 jobs, days after President Donald Trump revoked collective bargaining rights for workers at HHS and other federal agencies. The cuts coincide with the first day of Dr. Jay Bhattacharya as director of the National Institutes of Health (NIH), where four institute directors were placed on administrative leave and nearly all communications staff were terminated, according to an anonymous senior agency leader.

Health Secretary Robert F. Kennedy Jr. unveiled the restructuring plan last week, aiming to consolidate agencies managing addiction services and community health funding under a new office, the Administration for a Healthy America. The layoffs and voluntary departures will reduce HHS staffing from 82,000 to 62,000—a 24% reduction. Kennedy criticized the department as a “sprawling bureaucracy” with a $1.7 trillion annual budget that “has failed to improve the health of Americans,” vowing in a Thursday video to “do more with less.”

Specific cuts include 3,500 positions at the Food and Drug Administration, 2,400 at the Centers for Disease Control and Prevention (CDC), 1,200 at NIH, and 300 at the Centers for Medicare and Medicaid Services. An email obtained by The Associated Press revealed senior NIH employees in Bethesda, Maryland, were offered transfers to the Indian Health Service in Alaska and given until Wednesday to respond.

Democratic Sen. Patty Murray of Washington warned the cuts would endanger lives during disease outbreaks or disasters. “They may as well be renaming it the Department of Disease because their plan is putting lives in serious jeopardy,” she said Friday. The layoffs follow HHS’s withdrawal of $11 billion in COVID-19 funds, forcing state and local health departments to slash hundreds of jobs, according to Lori Tremmel Freeman of the National Association of County and City Health Officials.

Union representatives confirmed 8,000–10,000 terminations targeting roles in HR, procurement, finance, IT, and “high cost regions.” Trump’s Thursday executive order eliminating collective bargaining rights for many federal workers drew sharp rebukes. Reps. Gerald Connolly and Bobby Scott (D-VA) called the move a “brazen attempt to strip protections” that would “give Elon Musk more power to dismantle the people’s government with as little resistance as possible.”

CDC employees in Atlanta had recently unionized, with 2,000 joining the American Federation of Government Employees and hundreds more pending. The administration’s restructuring has intensified fears over the government’s capacity to address health crises, with critics arguing the cuts undermine critical services during ongoing measles outbreaks and pandemic recovery efforts.