The New Message to the Federal Health Workforce

It was during the Presidency of George W. Bush in 2006 that the Department of Health and Human Services (HHS) asserted that “the foundation of HHS and the key to our future success rests with our workforce.” When I came to the US Food and Drug Administration (FDA) in 2009 to work for President Obama, I found programs already in place to accelerate hiring of scientific experts, boost employee morale, and make the FDA a welcome place to work.

These efforts were not in the least bit political. During President Trump’s first term, HHS centered employee engagement as a “foundational operating principle” in a campaign branded as “It Takes You.” The materials explained that “[e]ngagement is demonstrated by how personally connected and committed workers feel to their organization and is measurable by an employee’s willingness to recommend their organization as a place to work and a place to do business.” A key goal was to avoid turnover, which was seen as “especially damaging to small organizations because departing workers are more likely to be the only ones possessing a skill or knowledge set.”

It was at the start of President Trump’s second term in 2025 when the Government Accountability Office (GAO) emphasized the importance of recruiting more highly skilled workers to federal service as one of 38 high risk areas across the government. Included among the categories of needed employees were FDA food and drug inspectors, medical emergency responders, and the toxicologists, biologists and other professionals at the Environmental Protection Agency who assess the health risks of chemicals.

The abrupt dismissals of 10,000 HHS employees on April 1 has made clear that something fundamental has changed. Staff members with decades of service found out they were being let go when their badges did not work and had to wait for escorts to clear their belongings. Supervisors scrambled to figure out who was still around by emailing and calling their direct reports. Entire divisions were eliminated without the opportunity to plan for the continuation of critical functions.

One employee at the National Institutes of Health told a reporter, “The stress level—it’s horrible for everybody. It’s almost like waking up saying, am I going to get cancer today? It’s like going through every single day thinking, ‘Is today going to be the day I get the diagnosis?’”

The rapidity and scale of workforce actions in early 2025 have made it easy to forget that enhancing the federal workforce once was long seen as a policy challenge with constructive and nonpartisan solutions.

A major focus had been the need to speed up the hiring process. A 2020 report on the federal workforce by a working group of the nonpartisan National Academy of Public Administration gave this assessment:

“[S]ome agencies with critical missions, like FEMA and Customs and Border Protection, can barely hire new employees fast enough to keep up with departures. The Department of Veterans Affairs reports it has tens of thousands of vacancies, many of them frontline physicians, nurses and other medical staff. Other agencies struggle with managing the technology they need to accomplish their work. In the face of growing threats, the government struggles to hire cybersecurity professionals. As more missions depend on partnerships with private contractors and state and local governments, the federal government has too often proven a weak partner because it struggles to hold up its side of the relationship.”

The working group called for flexible pay and job classifications, a less burdensome security clearances process, modern assessment processes for job candidates, and a streamlined hiring process. It also supported more autonomy and flexibility for agencies, within a common federal framework, so they can handle their own human resource needs effectively. Another recommendation was to invest in recruiting younger employees because “with twice as many employees over 60 years old as under 30, the federal government faces a ticking time bomb that will create workforce issues for years to come.”

The new administration’s initial workforce actions read like the working group report in negative relief. In many agencies, hiring is effectively frozen. Employees in needed fields have been let go. Key personnel decisions are the purview of the Department of Government Efficiency, or, in some cases, HHS—but not the agencies themselves. Pipeline programs for early career employees have been abruptly ended, burning young graduates who chose to pursue federal service.

In 2018, the first Trump Administration released a report entitled “Delivering Government Solutions in the 21^st Century.” Intended to be a “cornerstone to build productive, bipartisan dialogue,” the report emphasized the need for thoughtful reform informed by evidence. Under the headline of “Avoiding one-size-fits-all approaches,” the report advocated assessing ideas based on “factors including impact on mission, service, and stewardship in order to account for programs’ and agencies’ unique roles and requirements and inform appropriate strategies.”

One of the major proposals in the 2018 report was to reorganize the Office of Personnel Management (OPM) in the White House, turning it from a service delivery organization to a policy shop, so that it could focus on updating and upgrading the federal workforce. The report explained:

“This new office would also modernize the approach to human resources policy, with a core focus on: strategy and innovation; workforce and mission achievement; senior talent and leadership management; and, total compensation and employee performance. Each of these units would be informed by data analytics and human resources standards.”

The report emphasized, “Like any large corporation, the Government is only as effective as its people.”

It is difficult to square these sentiments with the new administration’s actions—or tone. OPM has asked everyone in the federal workforce to summarize five accomplishments each week, but not in a way that could create a problem if read by “malign foreign actors.” Reports indicate that managers have had no input into recent personnel decisions, unaware of their purpose, let alone having a chance to provide input. Rather than become a policy office that uses data to modernize the workforce, OPM has turned into quite the opposite: an operational arm that launches one-size-fits-all actions, leaving those who are left in place to scramble to assess the damage.

In short, the recent changes at health agencies are much more than a human interest story about federal staff and their families. They are upending a common set of assumptions about how the government can best meet the changing needs of the nation. Where the discussion once centered on recruitment, engagement, and thoughtful reform, so far, today’s federal workers are hearing a very different message, with the consequences to be felt in the federal government’s ability to protect and promote the health of the American people.

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