On March 27, 2025, the U.S. Department of Health and Human Services (HHS) announced plans to facilitate a “dramatic restructuring” in compliance with President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” The restructuring plan would reduce HHS workforce by an additional 10,000 full-time employees and consolidate the 28 HHS divisions into 15 new divisions, aiming to save $1.8 billion annually.
In a statement announcing the plan, HHS has explicitly committed to “ensuring that Medicare, Medicaid, and other essential health services remain intact.” In a fact sheet including additional details on the restructuring plan, HHS specified that “the consolidation and cuts are designed not only to save money, but to make the organization more efficient and more responsive to Americans’ needs, and to implement the Make America Healthy Again goal of ending the chronic disease epidemic.” Despite these stated commitments, the implementation of a reduction in force and consolidation may still have negative effects on the quality and accessibility of healthcare services.
Quality and accessibility is a critical driver of health outcomes in America. HHS plays a critical role in ensuring that all individuals, regardless of race, ethnicity, national origin, or disability status, have access to high-quality healthcare services free from discrimination. The specific contents of HHS restructuring plan may negatively impact the public’s ability to access high-quality, effective health services. Further, the statement announcing the plan failed to specify how restructuring may impact other critical HHS divisions, such as the Office of Minority Health (OMH) and the National Institute on Minority Health and Health Disparities (NIMHD).
This overhaul threatens to undermine critical offices dedicated to minority health and civil rights, potentially exacerbating health disparities among racial and ethnic minority populations, including Middle Eastern or North African (MENA) communities.
Impact on the Office for Civil Rights (OCR)
The restructuring plan proposes the creation of a new Assistant Secretary for Enforcement to oversee the Office for Civil Rights (OCR), among other entities. OCR plays a pivotal role in enforcing civil rights laws, ensuring non-discriminatory access to health services, and addressing health disparities. Placing OCR under an enforcement umbrella primarily focused on combating waste, fraud, and abuse may divert attention from its core mission of protecting individuals’ civil rights in healthcare settings. This shift could lead to reduced oversight and enforcement of anti-discrimination policies, adversely affecting minority communities that rely on OCR’s advocacy and intervention.
Impact on the National Institute on Minority Health and Health Disparities (NIMHD)
NIMHD is instrumental in leading scientific research to improve minority health and eliminate health disparities. While the restructuring plan does not explicitly mention the fate of NIMHD, the overall reduction in the workforce and consolidation of divisions raise concerns about potential cuts to research funding and support. Diminished resources for NIMHD could hinder progress in understanding and addressing the unique health challenges faced by minority populations, including MENA communities. Such setbacks would impede efforts to achieve health equity and reduce disparities that have long plagued these groups.
Impact on the Office of Minority Health (OMH)
OMH provides national leadership to improve the health of racial and ethnic minority populations and works to eliminate health disparities. The restructuring plan’s consolidation efforts may lead to the merging or downsizing of OMH, jeopardizing its ability to effectively coordinate minority health initiatives. A weakened OMH could result in reduced support for community-based programs, decreased dissemination of vital health information, and a lack of targeted strategies to address the specific needs of minority populations, including the MENA community.
The Necessity for Targeted and Culturally Competent Health Services
Arab American organizations emphasize the critical need for HHS to continue providing targeted and effective health services for racial and ethnic minority populations. The recent recognition of MENA populations as a distinct racial and ethnic population underscores the importance of developing health policies and programs that address their unique needs. This includes ensuring culturally competent and linguistically accessible health services that respect and understand the cultural nuances of MENA communities.
Cultural competence in healthcare is essential for effective communication, patient support, and improved health outcomes. Language barriers and cultural misunderstandings can lead to misdiagnoses, non-adherence to treatment plans, and overall poorer health status. Therefore, it is imperative that HHS maintains and strengthens initiatives that promote cultural competence among healthcare providers and ensure the availability of translation and interpretation services.
Conclusion
It is crucial that the efforts aimed at enhancing efficiency do not come at the expense of the health and well-being of our populations. Arab American community-based organizations urge the administration to reconsider aspects of the restructuring plan that may weaken offices dedicated to civil rights and minority health. Ensuring that HHS continues to provide robust, culturally competent, and linguistically accessible health services is vital to advancing health equity and protecting the rights of all communities, including the MENA population.