Health and Human Services will lay off 10,000 workers and close agencies in a major restructuring

"I want to promise you now that we're going to do more with less," Kennedy said in the video, posted to social media.

The restructuring plan caps weeks of tumult at the nation's top health department, which has been embroiled in rumors of mass firings, the revocation of $11 billion in public health funding for cities and counties, a tepid response to a measles outbreak, and controversial remarks about vaccines from its new leader.

Still, Kennedy said a "painful period" lies ahead for HHS, which is responsible for monitoring infectious diseases, inspecting foods and hospitals, and overseeing health insurance programs for nearly half the country.

Overall, the department will downsize to 62,000 positions, losing nearly a quarter of its staff — 10,000 jobs through layoffs and another 10,000 workers who took early retirement and voluntary separation offers encouraged by President Donald Trump's administration.

The staffing cuts were first reported by The Wall Street Journal.

Public health experts, doctors, current and former HHS workers and congressional Democrats quickly panned Kennedy's plans, warning they could have untold consequences for millions of people.

"These staff cuts endanger public health and food safety," said Brian Ronholm, director of food policy at Consumer Reports, in a statement. "They raise serious concerns that the administration's pledge to make Americans healthy again could become nothing more than an empty promise."

But Kennedy, in announcing the restructuring, blasted HHS for failing to improve Americans' lifespans and not doing enough to drive down chronic disease and cancer rates.

"All of that money," Kennedy said of the department's $1.7 trillion yearly budget, "has failed to improve the health of Americans."

Cancer death rates have dropped 34% over the past two decades, translating to 4.5 million deaths avoided, according to the American Cancer Society. That's largely due to smoking cessation, the development of better treatments — many funded by the National Institutes of Health, including groundbreaking immunotherapy — and earlier detection.

The reorganization plan also underscores Kennedy's push to take more control of the public health agencies — the NIH, the Food and Drug Administration, and the Centers for Disease Control and Prevention — which have traditionally operated with a level of autonomy from the health secretary. Under the plan, external communications, procurement, information technology and human resources will be centralized under HHS.

FDA and CDC face the deepest cuts

Federal health workers — stationed across the country at agencies including at the NIH and FDA, both in Maryland — described shock, fear and anxiety rippling through their offices Thursday. Workers were not given advance notice of the cuts, several told The Associated Press, and many remained uncertain about whether their jobs were on the chopping block.

"It's incredibly difficult and frustrating and upsetting to not really know where we stand while we're trying to keep doing the work," said an FDA staffer who spoke on condition of anonymity out of fear of retaliation. "We're being villainized and handicapped and have this guillotine just hanging over our necks."

HHS on Thursday provided a breakdown of some of the cuts.

• 3,500 jobs at the FDA, which inspects and sets safety standards for medications, medical devices and foods.

• 2,400 jobs at the CDC, which monitors for infectious disease outbreaks and works with public health agencies nationwide.

• 1,200 jobs at the NIH, the world's leading public health research arm.

• 300 jobs at the Centers for Medicare and Medicaid Services, which oversees the Affordable Care Act marketplace, Medicare and Medicaid.

HHS said it anticipates the changes will save $1.8 billion per year but didn't give a breakdown or other details.

The cuts and consolidation go far deeper than anyone expected, an NIH employee said.

"We're all pretty devastated," said the staff member, who spoke on condition of anonymity for fear of retaliation. "We don't know what this means for public health."

Union leaders for CDC workers in Atlanta said they received notice from HHS on Thursday morning that reductions will focus on administrative positions including human resources, finance, procurement and information technology.

At CMS, where cuts focus on workers who troubleshoot problems that arise for Medicare beneficiaries and Affordable Care Act enrollees, the result will be the "lowest customer service standards" for thousands of cases, said Jeffrey Grant, a former deputy director at the agency who resigned last month.

Kennedy plans to shutter some agencies, even those created by Congress

Beyond losing workers, Kennedy said he will shut down entire agencies, some of which were established by Congress decades ago. Several will be folded into a new Administration for a Healthy America, he said.

Those include the Health Resources and Services Administration, which oversees and provides funding for hundreds of community health centers around the country, as well as the Substance Abuse and Mental Health Services Administration, which funds clinics and oversees the national 988 hotline. Both agencies pump billions of dollars into on-the-ground work in local communities.

SAMHSA was created by Congress in 1992, so closing it is illegal and raises questions about Kennedy's commitment to treating addiction and mental health, said Keith Humphreys, a Stanford University addiction researcher.

"Burying the agency in an administrative blob with no clear purpose is not the way to highlight the problem or coordinate a response," Humphreys said.

The Administration for Healthy America will focus on maternal and child health, environmental health and HIV/AIDS work, HHS said.

The Administration for Strategic Preparedness and Response, created by a law signed by then-Republican President George W. Bush and responsible for maintaining the national stockpile that was quickly drained during the COVID-19 pandemic, will also be eliminated and moved into the CDC.

Republican Sen. Mike Rounds of South Dakota said the ramifications of Kennedy's plans for HHS are unclear.

"We'll just wait and see what it is, and then we'll go back and try to fix if there is something broken," Rounds said. "That's the approach we've taken so far."

But Democratic Sen. Patty Murray of Washington warned that the fallout is clear.

"It does not take a genius to understand that pushing out 20,000 workers at our preeminent health agencies won't make Americans healthier," Murray said in a statement. "It'll just mean fewer health services for our communities, more opportunities for disease to spread, and longer waits for lifesaving treatments and cures."