President Donald Trump\u2019s firings at the Department of Health and Human Services included the entire office that sets federal poverty guidelines, which determine whether tens of millions of Americans are eligible for health programs such as Medicaid, food assistance, child care, and other services, former staff said.<\/p>\n
The small team, with technical data expertise, worked out of HHS\u2019 Office of the Assistant Secretary for Planning and Evaluation, or ASPE. Their dismissal mirrored others across HHS, which came without warning and left officials puzzled as to why they were \u201cRIF\u2019ed\u201d \u2014 as in \u201creduction in force,\u201d the bureaucratic language used to describe the firings.<\/p>\n
\u201cI suspect they RIF\u2019ed offices that had the word \u2018data\u2019 or \u2018statistics\u2019 in them,\u201d said one of the laid-off employees, a social scientist whom KFF Health News agreed not to name because the person feared further recrimination. \u201cIt was random, as far as we can tell.\u201d<\/p>\n
Among those fired was Kendall Swenson, who had led development of the poverty guidelines for many years and was considered the repository of knowledge on the issue, according to the social scientist and two academics who have worked with the HHS team.<\/p>\n
The sacking of the office could lead to cuts in assistance to low-income families next year unless the Trump administration restores the positions or moves its duties elsewhere, said Robin Ghertner, the fired director of the Division of Data and Technical Analysis, which had overseen the guidelines.<\/p>\n
The poverty guidelines are \u201cneeded by many people and programs,\u201d said Timothy Smeeding, a professor emeritus of economics at the La Follette School of Public Affairs at the University of Wisconsin. \u201cIf you\u2019re thinking of someone you fired who should be rehired, Swenson would be a no-brainer,\u201d he added.<\/p>\n
Under a 1981 appropriations bill, HHS is required annually to take Census Bureau poverty-line figures, adjust them for inflation, and create guidelines that agencies and states use to determine who is eligible for various types of help.<\/p>\n
There\u2019s a special sauce for creating the guidelines that includes adjustments and calculations, Ghertner said. Swenson and three other staff members would independently prepare the numbers and quality-check them together before they were issued each January.<\/p>\n
Everyone in Ghertner\u2019s office was told last week, without warning, that they were being put on administrative leave until June 1, when their employment would officially end, he said.<\/p>\n
\u201cThere\u2019s literally no one in the government who knows how to calculate the guidelines,\u201d he said. \u201cAnd because we\u2019re all locked out of our computers, we can\u2019t teach anyone how to calculate them.\u201d<\/p>\n
ASPE had about 140 staff members and now has about 40, according to a former staffer. The HHS shake-up merged the office with the Agency for Healthcare Research and Quality, or AHRQ, whose staff has shrunk from 275 to about 80, according to a former AHRQ official who spoke on the condition of anonymity.<\/p>\n
HHS has said it laid off about 10,000 employees and that, combined with other moves, including a program to encourage early retirements, its workforce has been reduced by about 20,000. But the agency has not detailed where it made the cuts or identified specific employees it fired.<\/p>\n
\u201cThese workers were told they couldn\u2019t come into their offices so there\u2019s no transfer of knowledge,\u201d said Wendell Primus, who worked at ASPE during the Bill Clinton administration. \u201cThey had no time to train anyone, transfer data, etc.\u201d<\/p>\n
HHS defended the firings. The department merged AHRQ and ASPE \u201cas part of Secretary Kennedy\u2019s vision to streamline HHS to better serve Americans,\u201d\u00a0 spokesperson Emily Hilliard said. \u201cCritical programs within ASPE will continue in this new office\u201d and \u201cHHS will continue to comply with statutory requirements,\u201d she said in a written response to KFF Health News.<\/p>\n
After this article published, HHS spokesperson Andrew Nixon called KFF Health News to say others at HHS could do the work of the RIF\u2019ed data analysis team, which had nine members. \u201cThe idea that this will come to a halt is totally incorrect,\u201d he said. \u201cEighty million people will not be affected.\u201d<\/p>\n
Secretary Robert F. Kennedy Jr. has so far declined to testify about the staff reductions before congressional committees that oversee much of his agency. On April 9, a delegation of 10 Democratic members of Congress waited fruitlessly for a meeting in the agency\u2019s lobby.<\/p>\n
The group was led by House Energy and Commerce health subcommittee ranking member Diana DeGette (D-Colo.), who told reporters afterward that Kennedy must appear before the committee \u201cand tell us what his plan is for keeping America healthy and for stopping these devastating cuts.\u201d<\/p>\n
Matt VanHyfte, a spokesperson for the Republican committee leadership, said HHS officials would meet with bipartisan committee staff on April 11 to discuss the firings and other policy issues.<\/p>\n
ASPE serves as a think tank for the HHS secretary, said Primus, who later was Rep. Nancy Pelosi\u2019s senior health policy adviser for 18 years. In addition to the poverty guidelines, the office maps out how much Medicaid money goes to each state and reviews all regulations developed by HHS agencies.<\/p>\n
\u201cThese HHS staffing cuts \u2014 20,000 \u2014 obviously they are completely nuts,\u201d Primus said. \u201cThese were not decisions made by Kennedy or staff at HHS. They are being made at the White House. There\u2019s no rhyme or reasons to what they\u2019re doing.\u201d<\/p>\n
HHS leaders may be unaware of their legal duty to issue the poverty guidelines, Ghertner said. If each state and federal government agency instead sets guidelines on its own, it could create inequities and lead to lawsuits, he said.<\/p>\n
And sticking with the 2025 standard next year could put benefits for hundreds of thousands of Americans at risk, Ghertner said. The current poverty level<\/a> is $15,650 for a single person and $32,150 for a family of four.<\/p>\n \u201cIf you make $30,000 and have three kids, say, and next year you make $31,000 but prices have gone up 7%, suddenly your $31,000 doesn\u2019t buy you the same,\u201d he said, \u201cbut if the guidelines haven\u2019t increased, you might be no longer eligible for Medicaid.\u201d<\/p>\n The 2025 poverty level for a family of five is $37,650.<\/p>\n As of October, about 79 million people were enrolled in Medicaid or the related Children\u2019s Health Insurance Program, both of which are means-tested and thus depend on the poverty guidelines to determine eligibility.<\/p>\n Eligibility for premium subsidies for insurance plans sold in Affordable Care Act marketplaces is also tied to the official poverty level.<\/p>\n One in eight Americans rely on the Supplemental Nutrition Assistance Program, or food stamps, and 40% of newborns and their mothers receive food through the Women, Infants, and Children program, both of which also use the federal poverty level to determine eligibility.<\/p>\n Former employees in the office said they were not disloyal to the president. They knew their jobs required them to follow the administration\u2019s objectives. \u201cWe were trying to support the MAHA agenda,\u201d the social scientist said, referring to Kennedy\u2019s \u201cMake America Healthy Again\u201d rubric. \u201cEven if it didn\u2019t align with our personal worldviews, we wanted to be useful.\u201d<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n