Statement: CHLP Condemns the Irresponsible and Deadly Decision to Restructure HHS
CHLP emphatically condemns the decision by the Department of Health and Human Services (HHS) and the so-called Department of Government Efficiency to dramatically restructure HHS, eliminating tens of thousands of necessary jobs and consolidating several departments – including Health Resources and Services Administration (HRSA) and Substance Abuse and Mental Health Services Administration (SAMHSA) – into a new, unified entity: The Administration for a Healthy America. We further condemn any additional attempts to reorganize, eliminate, or reduce personnel of other essential departments, such as the CDC’s Division of HIV Prevention.
The proposed restructuring includes massive cuts in staffing and questionable merging of departments. These reductions and consolidations will disrupt healthcare and services, leading to more people testing positive for HIV, more people facing increased barriers to vital services, more people losing access to treatment, and ultimately more people dying. And a time when 32 states have laws that criminalize people living with HIV, more people will be criminalized and swept into the criminal legal system.
The administration’s choices about which departments and services they are willing to defund and/or restructure (and which they are not) make it clear that saving money and reducing fraud are merely a pretext and not the intended goal. Neither an objective nor neutral budget-balancing exercise, this new agenda rolls back much hard-won progress that will directly impact people living with HIV. For example:
- HRSA is the sole administrator of the Ryan White HIV/AIDS Program, a public health program exclusively for low-income people living with HIV that provides medical care, medications, and supportive services. The implications of combining HRSA under this new entity are far-reaching and especially alarming coming from a secretary who is well known as a borderline AIDS denialist. It is absurd to propose that relocating the program and reducing the workforce will improve the quality of services and support for people living with HIV around the country. How exactly will fewer regional offices make PLHIV healthier?
- The hard-fought-for Administration for Community Living (ACL) – the only federal program created to improve the quality of life for older adults and people of all ages with disabilities – will be abolished and instead scattered into several other programs, including the Administration for Children and Families and Centers for Medicaid and Medicare Services. In the name of efficiency, structural ableism strikes again. What does it mean that older adults and people with disabilities will now have to navigate through multiple other departments, all of which will have less staff?
- It is emphatically smoke and mirrors to say that you are combatting waste, fraud, and abuse by installing a new Assistant Secretary for Enforcement to provide oversight of the Departmental Appeals Board (DAB), Office of Medicare Hearings and Appeal (OMHA), and the Office for Civil Rights (OCR). It should be no surprise that these three departments are entities where people can address grievances about potential civil rights violations to their access to healthcare and supportive services, as well as appeal certain healthcare decisions. Is it really combatting abuse, or is the intent to make it harder for our communities to advocate for ourselves by seeking redress?
While the elimination of any successful public health agency is deeply concerning, it is critical to acknowledge the important role that HRSA, ACL, OCR, and other essential departments play in improving the lives of millions of people. Without them, our ability to truly end the HIV epidemic will be lost. And the cost to our most vulnerable communities – Black, brown, LGTBQ+, and rural – will be unbearable.
While we are intentionally overwhelmed with a deluge of news about departments and services that impact our lives, the restriction of free speech and the right to protest, and the deadly assault on transgender and gender non-conforming children and adults, it is important to also acknowledge a red herring meant to distract us from this everrising authoritarianism: the myth of government efficiency.
When uninformed and unaccountable officials use language like “combatting abuse and fraud” to carry out their deadly agendas, it is important that we have the utmost clarity about what is actually happening: these cuts and restructuring are deliberate public health austerity measures meant to ensure the least access to critical services for the greatest number of people.
CHLP will continue working with our allies and partners in the HIV advocacy and broader community to counter these harmful government actions. With the constant onslaught, it is easy to feel so overwhelmed that we stay in a permanent state of inaction – which is precisely what this administration hopes we will do.
As we lay out our analysis of this current political moment, we also want to provide some tools to stay the course.
Get Informed: It is important to truly gain clarity about what is happening. Not just the executive orders, but the larger socio-political context in which they are being released and how they ultimately fit into a bigger picture of authoritarianism. We recommend:
Engage: Let us use our clarity of understanding as a catalyst for action, not a reason for stasis. There are so many ways to engage, on a large scale and on a neighborhood scale – all are necessary and valuable.
- Stay updated on action alerts from our partner, AIDS United
- Remember the importance of engaging locally. Now is the moment to learn about mutual aid and other community efforts near you. Even as we do this larger-scale political work, the importance of ensuring PLHIV in your area have access to what they need – ride sharing, community fridges, advocacy with local legislators – can’t be understated.
Sustainability: We must be prepared to stay the course. While the deluge of executive orders and policies attempting to curtail our rights is certainly coming at rapid speed, that is precisely the reason we must remember this is a marathon, not a sprint. We must be able to sustain ourselves in whatever level of work we are engaging.
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