The place is AHA? RFK Jr.’s Administration for a Wholesome America would not exist but : NPR

Robert F. Kennedy Jr. was only a few weeks into his new job as well being secretary in March 2025 when he unveiled a dramatic plan to remake the Division of Well being and Human Companies.

Kennedy shortly decided that the dimensions and construction of his company — which incorporates the Facilities for Illness Management and Prevention, the Meals and Drug Administration, the Nationwide Institutes for Well being — was “incomprehensible.” He mentioned it was bloated and that defined why federal well being officers had failed to enhance People’ well being.

“We will eradicate a complete alphabet soup of departments and businesses whereas preserving their core features,” he mentioned in a social media video. These “core features” could be preserved, he defined, “by merging them into a brand new group referred to as the Administration for a Wholesome America or AHA.”

The identify performs off of Kennedy’s “Make America Wholesome Once more” slogan.

Weeks into the second 12 months of the second Trump time period, many employees and departments of HHS have been eradicated in chaotic cuts handed down on April 1, 2025, however the Administration for a Wholesome America doesn’t but exist.

There is no public details about when AHA is perhaps created, and little or no about what employees and packages it could embrace.

Not a standard course of

The latest public doc from HHS about AHA was a funds request printed in June. It says that the brand new company will “concentrate on areas together with main care, environmental well being, HIV/AIDS, maternal and baby well being, psychological and behavioral well being, and workforce improvement.”

These packages are unfold out throughout well being businesses, together with on the Workplace of the Assistant Secretary for Well being, the Well being Assets and Companies Administration, the Substance Abuse and Psychological Well being Companies Administration and a number of other facilities at CDC.

Congress did not embrace any cash for AHA within the newest HHS funding invoice. Staffers on committees with jurisdiction over HHS inform NPR there haven’t even been conferences with Kennedy’s employees to assist safe assist for brand spanking new funding or authorization to face up the brand new company sooner or later.

As a substitute, political appointees at HHS are holding secretive planning conferences about AHA, in line with seven present and former staff at federal well being businesses who spoke to NPR.

HHS wouldn’t reply NPR’s questions for this story, however in an announcement mentioned that planning for AHA was nonetheless underway.

Behind the scenes, rushed and secretive conferences

At CDC in Atlanta, a senior official describes a continuing demand for details about budgets, employees and public well being work. It isn’t even clear who’s asking for the information or what they plan to do with it, they are saying, however they perceive it’s associated to AHA planning.

“All that you simply’re advised is that ‘they’ are asking for this data and so they need it now — or they needed it yesterday.” The official requested NPR to not use their identify due to fears {of professional} retribution for talking publicly with out authorization. “‘They’ can check with a small circle of individuals round Kennedy that he trusts, who’re both unnamed, otherwise you’ll obtain a distinct identify every time, so that you’re by no means actually fairly certain the place the ask is coming from.”

A unique senior official at HHS, who additionally requested that NPR to not use their identify for worry {of professional} retribution, echoed that description of political appointees linked to Kennedy holding “fixed conferences in secret about what this new AHA is meant to appear like, however they do not share with anybody within the civil service.” The supply provides there are rumors that Kennedy’s group is “going to face up AHA within the subsequent few months, like within the spring.”

There is no public details about who’s in control of planning to create the company, and HHS didn’t make anybody accessible to interview for this story.

“What does this imply?”

Dr. Karen Hacker says the method of restructuring HHS has been “like constructing and flying the aircraft on the similar time,” she says. When Kennedy started as secretary, Hacker was the director of CDC’s Nationwide Middle for Power Illness Prevention and Well being Promotion. She was placed on administrative depart on April 1 — together with 1000’s of others at HHS — then retired from CDC. She now works as an adjunct professor and well being coverage fellow at Emory College.

She says regardless that her heart labored on persistent illnesses, a central precedence of AHA, her group was sidelined by the political appointees executing Kennedy’s imaginative and prescient. “We by no means have been requested about methods for reductions, or about what could be finest to maneuver, or whether or not any of those packages have been licensed [by Congress],” she says. “My heart alone had over 40 line objects with particular appropriations language.”

None of that appeared to matter. A 3rd of the employees in her heart have been reduce through the April 1 discount in pressure, and the complete heart was slated to be eradicated in President Trump’s 2026 funds, printed in Could. “I do keep in mind having conversations about — ‘What does this imply? Wait a second, are we not going to AHA?'”

Then and now, there are massive logistical questions on how a middle in Atlanta with tons of of employees members and a $1.4 billion funds may develop into a part of a brand new company, presumably in Maryland or Washington, D.C.

In relation to AHA, Hacker says: “The query stays — what are their plans? Are they planning to roll out a giant reorg? Are they planning to contemplate different alternate options?”

A former secretary is “baffled”

If Kennedy and his group at HHS needed to reorganize the Division of Well being and Human Companies and enlist Congress to authorize a brand new company, the general public could be seeing a really totally different course of unfold.

In relation to AHA, “there isn’t a funds authority to create a brand new company, there is not any congressional framework for what that appears like, there is not any employees numbers,” says Kathleen Sebelius, the previous governor of Kansas who served as well being secretary below President Obama.

That lack of engagement with Congress, she says, additionally exhibits in Kennedy’s disregard for lawmakers’ intent when he eradicated employees and packages through the DOGE-fueled firings in April 2025.

“What I discovered once I was [secretary] is that a variety of the entities that appeared to me to be redundant had underlying congressional authorization — they handed a selected invoice, it had particular appropriations — and in my day, with my president, we paid a variety of consideration to that,” she says. The firings directed by Kennedy and DOGE included many workplaces required by Congress that haven’t been reconstituted elsewhere at HHS, regardless of his promise that the “core features” of the well being businesses could be preserved.

“Numerous what I see a minimum of in these restructuring paperwork below Secretary Kennedy simply completely are baffling to me,” Sebelius says. She mentions the plan to dismantle the Administration for Strategic Preparedness and Response (ASPR), which responds to pure disasters and pandemic threats, and the elimination of a number of HHS regional workplaces that states depend on.

Sebelius additionally has the attitude of getting created a brand new company throughout her tenure: the Administration for Neighborhood Dwelling, which helps seniors and folks with disabilities reside at house.

“We took a 12 months to have listening classes to essentially deliver a agency proposal,” Sebelius says. “It in the end was in a funds doc, and had employees suggestions and jurisdiction suggestions.”

She says by that point, “we had buy-in from — not solely key members on the Hill — however key members within the communities throughout the nation.”

In relation to the Administration for a Wholesome America, “I do not see any of that happening,” she says.

By the way, the Administration for Neighborhood Dwelling is likely one of the entities slated to be dismantled as an impartial company and built-in into AHA.

Employees numbers confusion

Whereas Trump administration officers work quietly on a plan to create an AHA entity on the company with out enter or funding from Congress, the American public is left with well being businesses diminished by a 12 months of personnel cuts.

Precisely how a lot HHS has shrunk due to Kennedy’s restructuring, DOGE-led buyouts, and retirements, is troublesome to pin down. HHS has declined a number of requests from NPR to offer the present variety of employees, however the said purpose when the reorganization was introduced in March was to scale back the employees by 20,000 folks or about 20% of the workforce.

When Kennedy took workplace, 88,731 employees labored throughout HHS, in line with an official staffing plan from November 2024. The most recent model of that plan, dated September 2025, exhibits 79,717 HHS staff, which represents a reduce of solely 10%.

It isn’t clear if that headcount consists of employees whose firings have been blocked by the courts and are on administrative depart. Hacker, the previous CDC heart director, is aware of of staff who’ve been in that state of affairs since April. “They’re getting a paycheck, they’re getting their advantages, they’re simply not working of their jobs,” she says. Different employees who have been fired have been introduced again.

Simply this week, 400 occupational security employees at CDC who had been on administrative depart have been abruptly ordered again to work with out rationalization. And about thousand HHS employees fired through the shutdown have been introduced again as a part of a deal to reopen the federal government. They surprise if they will be re-fired on the finish of January when that deal expires.

All the businesses which might be slated to develop into a part of AHA have had deep RIFs, or reductions in pressure, particularly CDC and SAMHSA, the psychological well being and substance abuse company. “There have been folks in my heart [at CDC] that obtained riffed a number of occasions — some have been introduced again after which some have been riffed once more,” says Hacker. “It is a very chaotic state of affairs.”

An train in branding?

The present CDC official predicts that Kennedy and his allies will create a pilot or initiative at HHS “one way or the other” to have the ability to declare success in creating the Administration for a Wholesome America. “They need issues quick, they need it to be vivid and glossy, they need to seize the eye of the general public, and so they need it to appear like successful up entrance.”

The official doesn’t assume it will likely be an precise new company funded and backed by Congress. They assume Kennedy will discover groups and initiatives that have been already taking place at HHS associated to diet, health and persistent illness prevention and “model” them as “MAHA wins” to claim that the secretary completed the targets of the brand new AHA company, with out having to interact with Congress.

Sebelius is skeptical of the concept that Kennedy can create something near a brand new company on his personal. “You are able to do rather a lot on paper and play musical chairs all you need, however on the finish of the day, they’re gonna must have some funding and a few jurisdiction.”

She says lawmakers in Congress are both going to purchase into Kennedy’s plan to create AHA or reject it. “It is actually unclear to me what they’re gonna do.”