Nearly a year after Health Secretary Robert F. Kennedy Jr. announced plans for the Administration for a Healthy America, the new agency does not exist. Despite promises to merge existing health departments into AHA to address chronic diseases and addiction, the process remains secretive with no congressional support. Officials describe chaotic planning amid staff cuts at the Department of Health and Human Services.
In March 2025, shortly after taking office as health secretary in the second Trump administration, Robert F. Kennedy Jr. outlined a major overhaul of the Department of Health and Human Services. He criticized the agency's structure as bloated and incomprehensible, blaming it for failures in improving public health. Kennedy proposed eliminating various departments and agencies while preserving their core functions by merging them into a new entity called the Administration for a Healthy America, or AHA—a nod to his "Make America Healthy Again" slogan.
By April 1, 2025, HHS underwent chaotic reductions in force, eliminating many staff and departments, but AHA has yet to materialize. A June 2025 budget request described AHA's intended focus on primary care, environmental health, HIV/AIDS, maternal and child health, mental and behavioral health, and workforce development. These programs currently span agencies like the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration. However, Congress provided no funding for AHA in recent HHS appropriations, and there have been no discussions with congressional committees to authorize or fund the agency.
Planning for AHA occurs behind closed doors, with political appointees holding secretive meetings, according to seven current and former federal health employees who spoke to NPR. A senior CDC official in Atlanta described relentless demands for budget and staff data from an unclear "they"—likely a small circle around Kennedy—without explanation. Another HHS official noted constant secret meetings excluding civil service staff, with rumors of AHA launching in the spring.
Dr. Karen Hacker, former director of CDC's National Center for Chronic Disease Prevention and Health Promotion, called the restructuring "like building and flying the plane at the same time." Placed on administrative leave on April 1 before retiring, she said her team, focused on chronic diseases, was sidelined despite AHA's priorities. A third of her center's staff was cut, and the center faces elimination in the 2026 budget.
Former Health Secretary Kathleen Sebelius expressed bafflement at the lack of congressional engagement. "There is no budget authority to create a new agency, there's no congressional framework," she said, contrasting it with her successful creation of the Administration for Community Living, which involved a year of listening sessions and stakeholder buy-in. Sebelius noted that many eliminated offices had specific congressional authorizations not reconstituted elsewhere.
HHS staffing has shrunk from 88,731 in November 2024 to 79,717 by September 2025, falling short of the 20% reduction goal. Layoffs have been chaotic, with some employees fired multiple times, others on administrative leave or reinstated amid court challenges and a government reopening deal. Agencies slated for AHA integration, like CDC and SAMHSA, have faced deep cuts.
A current CDC official predicts Kennedy's team may rebrand existing nutrition and chronic disease initiatives as AHA successes without creating a true new agency, bypassing Congress. Sebelius doubts this approach, emphasizing the need for funding and jurisdiction from lawmakers.
