New Administration PGOV Update

Agency Update: On March 27, 2025, the Department of Health and Human Services (HHS), under Secretary Kennedy, announced a large-scale reorganization of the agency to reduce the size and scope of the federal government in line with President Trump's Executive Order related to government efficiency. This week the restructuring has started and is likely to result in a reduction of force (RIF) of about 10,000 full-time HHS employees, the closure of 50% of regional offices, and the consolidation 28 divisions, including the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH).  

Alongside the consolidation, a new Administration for Healthy America (AHA) will be created to improve the coordination of chronic care and disease prevention programs. The goal is to streamline operations and focus on priorities aligned with the "Make America Healthy Again" initiative. However, there is concern that these massive RIFs will impact essential programs and services across the country. The Senate HELP Committee will be holding a hearing on April 10 with Secretary Kennedy about the reorganization and RIFs.  

The Trump administration continues to move nominees through Senate confirmation, with a total of 42 Cabinet members confirmed to date, to include Marty Makar, MD as Commissioner of the Food and Drug Administration and Jay Bhattacharya, MD as Director of the National Institutes of Health. Mehmet Oz, MD has been voted out of the Finance Committee and is awaiting a full Senate floor vote for confirmation. 

Congressional Update: Senate Republicans introduced a new budget plan, aiming to pass it before the House leaves for a two-week Easter break. Both the House and Senate must agree on the same budget before they can move forward with a bill covering taxes, border security, energy, and defense. The plan allows for $1.5 trillion in spending cuts, which has raised concerns about Medicaid reductions, and increases the debt limit by $5 trillion to last through the 2026 midterms. Republicans also plan to use a budgeting trick to make Trump's 2017 tax cuts appear cost-free, skipping a formal approval process that could lead to issues later (this is not partisan conjecture, this budget gimmick has never been used before and some deficit hawks are balking at the idea, especially Conservatives in the House). 

Critics, including Democrats, argue that Republicans are using accounting gimmicks to hide the true cost of their tax cuts. The Senate has given committees until May 9 to draft their portions of the bill, with a separate deadline of May 16 for the Senate Finance Committee to address the debt limit. Speaker Mike Johnson wants to send a final bill to Trump by Memorial Day, but disagreements among Republicans over spending cuts could delay the process. 

Influencing the Budget Reconciliation Process. The American Nurses Association (the association) continues to meet with congressional offices to advocate for the inclusion of nursing priorities in the budget reconciliation bill. Specifically, including a bill to provide tax credits to nurses who agree to serve as nurse preceptors (PRECEPT Nurses Act) and one to provide an income tax exemption to recipients of scholarships and loan repayments through the Nurse Corps Scholarship and Loan Repayment Program (Nurse Corp Tax Parity Act). The association also continues to meet with offices to explain the impact that potential Medicaid reforms could have on vulnerable patients and nurses.   

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Robyn Matthews-Peacher
Associate Director, State Government Affairs
robyn.matthews@ana.org