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    ‘No guidance and no leadership’: chaos and confusion at CDC after mass firings

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    For the past two months, members of the Elon Musk-led “department of government efficiency” (Doge) have stalked the halls of the Center for Disease Control’s (CDC) Atlanta headquarters.Several employees told the Guardian that if a Doge staffer walked through their offices and saw a badge at an untended workstation, its owner would be fired promptly. Firing someone for a security violation gave Doge an excuse to circumvent the defenses of civil service protection, or performance reviews, or seniority.Loose badge. Gone.If being fired for leaving a badge at a bathroom break seemed arbitrary to those working at the CDC – some for decades – then the mass firings on 1 April made it brutally so. On that day thousands of federal workers at the US Department of Health and Human Services (HHS) all of its branches and related agencies across the country were let go in a culling indicative of Donald Trump’s second term.Roughly 10,000 people lost their jobs at agencies including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration and the National Institutes of Health in a continuation of one of the largest mass firings in American history.Among the cuts to the CDC: the entire Freedom of Information Act team, the Division of Violence Prevention, laboratories that test antibiotic resistance and a team that determines recalls for dangerous baby products.“There’s been no guidance and no leadership,” said one CDC scientist who still has a job, speaking on condition of anonymity. “This week has just been looking through the wreckage for survivors.”A week of chaos and confusionThe scope of the cuts remains a mystery to federal health workers, including it seems the Department of Health and Human Services secretary, Robert F Kennedy Jr, who said as much as 20% of the cuts may be mistakes, and moved to reinstate some staff fired in error. Kennedy said that “was always the plan”.In the hours after the cuts, an aqua-green dry erase board in a library at the CDC headquarters in Atlanta tallied the losses Tuesday morning like a casualty board for earthquake victims.View image in fullscreenThe words “DO NOT ERASE” topped a constellation of acronyms like NCCDPHP for the National Center for Chronic Disease Prevention and Health Promotion, or NCICP for the National Center for Injury Prevention and Control. Under each top line followed a second set of acronyms showing the branches of each department that had been pruned, like the Women’s Health and Fertility Branch (WHFB) of the Division of Reproductive Health, or the Violence Prevention Practice and Translation Branch (VPTB) in the Division of Violence Prevention.No real warning had been given about who would keep their job and who could expect to be fired. Right up until Doge sent reduction-in-force notices to inboxes early Tuesday morning, even supervisors had no idea who would be left.People gathered around the board for updates as word drifted in from colleagues about cuts, as it was the only planning document staff leaders had. Health workers circulated updated pictures of it through informal group chats and Discord servers.Scientists began breaking down in tears in the library stacks.An inquiry to the CDC about the scope of the cuts and its plan was routed to HHS.“All statutorily required positions and offices will remain intact, and as a result of the reorganization, will be better positioned to execute on Congress’s statutory intent,” said Emily G Hilliard, a deputy press secretary for the department. Hilliard claimed the “collaborative” process “included three rounds of feedback from each division”, and that “HHS leaders focused personnel cuts on redundant or unnecessary administrative positions”.The fact sheet Hilliard provided contained no references to the scientific functions lost in the purge.Heartbreak and warnings of dangerShelby Hutton, a biologist working on HIV research, learned she had been fired on 1 April. “We had until the end of the day to pack up our personal belongings before we lost all access,” she said at a press conference with Nikema Williams, the Democratic congresswoman representing Atlanta, on Friday.“We were given no time to conduct an orderly shutdown of the laboratories to ensure that our sensitive equipment and priceless biohazardous specimens were protected and stored properly.”Fired staffers like Hutton found themselves mourning not just for their lost jobs, but because they are acutely aware that without their research some people will die who would have otherwise lived, but for the research they had been conducting.View image in fullscreenLaboratories around the world submit biological samples and testing data to the CDC, which maintains a repository of historical information for research references.In critical areas like antibiotic-resistant infection surveillance, no one is left at the labs to take those samples, one scientist said.Hospitals also ask the CDC for advice when seeing a novel illness. But the process of examining those requests and answering them has been disrupted, said Kevin Pettus, a 30-year-old veteran scientist at the agency who lost his job last week.“I think when they decided to cut our branch, they didn’t think this through,” he said. “If the agenda was to make America healthy again, all Elon Musk and 47 have done is make this country in a worse position than it already was.“What has occurred has put everybody in danger, not just our families, but their families as well. Some of this needs to be addressed and addressed immediately and reversed.”Kennedy, the US health secretary, said at a press availability Wednesday that administrative roles, not research, was the Doge target. But as healthcare workers piece together the scope of the cuts, it’s clear that the cuts struck bone, not fat.“The US had incredible research infrastructure and was doing incredible research to identify the next cure, to prevent the next disease, and that’s what’s being cut,” said Carmen Marsit, executive associate dean at Emory University’s Rollins School of Public Health.“I mean, the government has made enormous investments in many of these drugs, in many of the programs that have been developed, and now we’re ready to move them over the finish line and really get them to act. And that’s being stopped.”Widespread cuts impact health and safetyAs federal workers learn of the work that has been stalled and teams have been cut, the impact is slowly becoming clear.Among the cuts are almost everyone at the National Institute for Occupational Safety and Health, which among other things, monitors air quality around fracking drill sites, tests personal protective technology and provides injury data to government agencies for recalling consumer products like defective baby cribs.The office of Smoking and Health at the National Center for Chronic Disease Prevention and Health Promotion saw its public health work disrupted. As did the division of violence prevention, injury prevention and informatics at the National Center for Injury Prevention and Control. Among other things, the division researches gun violence and domestic violence, which both spiked during the pandemic, with the goal of reducing sexual assault and gun deaths.Cuts hit the laboratories researching viral hepatitis and sexually transmitted diseases at National Center for HIV, Viral Hepatitis, STD, and TB Prevention, as well as the Division of HIV Prevention’s communication, surveillance and research branches.The Global Health Center at the CDC saw health informatics, scientific integrity and special initiatives for HIV and tuberculosis decimated.View image in fullscreenAnd amid a larger effort to dismantle environmental protection, workers were cut at the asthma and air quality monitoring and childhood lead prevention teams in the CDC’s environmental health division.Other CDC reductions include the technology branch of the Center for Forecasting and Outbreak Analytics, housing the software engineers and computer scientists supporting a new center created amid the Covid-19 pandemic to help predict disease outbreaks.CDC staff had already been navigating the impact of a deluge of executive orders raining from Trump’s pen since January. At one point, research databases had been taken off line to comply with an order to replace all references to “gender” with “sex,” even in scientific research documentation.But at least then, the CDC had staff ready to fix a problem. Now workers say the problems will emerge and the people who understand how to solve those problems are gone.Insiders say only a skeleton staff remains in dozens of departments and branches, capable only of performative gestures toward the work mandated by law and congressional budgets.Looking forwardStanding across the street from the CDC headquarters on a busy street near Emory University, Atlanta drivers honked in support as congresswoman Williams stood with fired CDC workers at a press conference.Williams called the CDC the “pride of the fighting fifth”, a reference to Trump’s disrespect for the city that began with his conflict with the late congressman John Lewis and Georgia’s fifth congressional district.“It is in these moments of public transgressions against our communities that our reaction in the name of justice and prosperity must be loud and clear,” she said, describing the firings as illegal and unconstitutional. “We fight for the health and decency of our country.“We fight in our communities.” More

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      Second child dies of measles in Texas amid rising outbreak

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      A second child with measles has died in Texas amid a steadily growing outbreak that has infected nearly 500 people in that state alone.The US health and human services department confirmed the death to NBC late Saturday, though the agency insisted exactly why the child died remained under investigation. On Sunday, a spokesperson for the UMC Health System in Lubbock, Texas, said that the child had been hospitalized before dying and was “receiving treatment for complications of measles” – which is easily preventable through vaccination.The family of the child in question had chosen to not get the minor vaccinated against the illness.Michael Board, a news reporter at Texas’s WOAI radio station, wrote on Sunday that official word from the state’s health and human services department was that the child died from “measles pulmonary failure” while having had no underlying conditions.Citing records it had obtained, the New York Times described the child as an eight-year-old girl.That marked the second time a child with measles had died since 26 February. The first was a six-year-old girl – also hospitalized in Lubbock – whose parents had not had her vaccinated.The Trump administration’s health secretary, Robert F Kennedy Jr, on Sunday identified the two children to have died with measles as Kayley Fehr and Daisy Hildebrand. Daisy was the one who died more recently, and Kennedy said in a statement that he traveled to her funeral on Sunday to be with her family as well as the community in its “moment of grief”.Kennedy for years has baselessly sowed doubt about vaccine safety and efficacy. He sparked alarm in March among those concerned by the US’s measles outbreak when he backed vitamins to treat the illness and stopped short of endorsing protective vaccines, which he minimized as merely a “personal choice” rather than a safety measure that long ago was proven effective.In his statement on Sunday, Kennedy said: “The most effective way to prevent the spread of measles is the MMR vaccine,” which also provides protection against mumps and rubella. He also said he would send a team to support Texas’s local- and state-level responses to the ongoing measles outbreak.A third US person to have died after contracting measles was an unvaccinated person in Lea county, New Mexico, officials in that state announced in early March.Dr Peter Marks, who recently resigned as the Food and Drug Administration’s vaccine while attributing that decision to Kennedy’s “misinformation and lies”, blamed the US health secretary and his staff for the death of the child being buried on Sunday.“This is the epitome of an absolute needless death,” Marks said Sunday during an interview with the Associated Press. “These kids should get vaccinated – that’s how you prevent people from dying of measles.”Marks also told the AP that he had warned US senators that the country would endure more measles-related deaths if the Trump administration did not more aggressively respond to the outbreak. The Senate health committee has called Kennedy to testify before the group on Thursday.One of that committee’s members is the Louisiana Republican and medical doctor Bill Cassidy, who frequently speaks about the importance of getting vaccinates against diseases but joined his Senate colleagues in voting to confirm Kennedy as the US health secretary.Cassidy on Sunday published a statement saying: “Everyone should be vaccinated.”There is “no benefit to getting measles”, Cassidy’s statement added. “Top health officials should say so unequivocally [before] another child dies.”Measles, which is caused by a highly contagious, airborne virus that spreads easily when an infected person breathes, sneezes or coughs, had been declared eliminated from the US in 2000. But the virus has recently been spreading in undervaccinated communities, with Texas and New Mexico standing among five states with active outbreaks – which is defined as three or more cases.The other states are Kansas, Ohio and Oklahoma. Collectively, as of Friday, the US had surpassed 600 measles cases so far this year – more than double the number it recorded in all of 2024. Health officials and experts have said that they expect the measles outbreak to go on for several more months at least – if not for about a year.Texas alone was reporting 481 cases across 19 counties as of Friday, most of them in the western region of the state. It registered 59 previously unreported cases between Tuesday and Friday. There were also 14 new hospitalizations, for a total of 56 throughout the outbreak.More than 65% of Texas’s measles cases are in Gaines county, which has a population of just under 23,000, and was where the virus started spreading in a tightly knit, undervaccinated Mennonite community.Gaines has logged 315 cases – in just over 1% of the county’s residents – since late January.The Associated Press contributed reporting More

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      Trump makes sweeping HIV research and grant cuts: ‘setting us back decades’

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      The federal government has cancelled dozens of grants to study how to prevent new HIV infections and expand access to care, decimating progress toward eliminating the epidemic in the United States, scientists say.The National Institutes of Health (NIH) terminated at least 145 grants related to researching advancements in HIV care that had been awarded nearly $450m in federal funds. The cuts have been made in phases over the last month.NIH, a division of the Department of Health and Human Services, is the largest funding source of medical research in the world, leaving many scientists scrambling to figure out how to continue their work.“The loss of this research could very well result in a resurgence of HIV that becomes more generalized in this country,” said Julia Marcus, a professor at Harvard Medical School who recently had two of her grants cancelled. “These drastic cuts are rapidly destroying the infrastructure of scientific research in this country and we are going to lose a generation of scientists.”In 2012, the FDA approved pre-exposure prophylaxis (PrEP), an antiviral drug taken once a day that is highly successful at preventing new HIV infections. While the drug has been a powerful tool to contain the virus, inequities remain in accessing those drugs and sustaining a daily treatment. Despite major progress, there are still 30,000 new infections each year in the US.Many of the terminated HIV-related studies focused on improving access to drugs like PrEP in communities that have higher rates of infections – including trans women and Black men. One of Marcus’s projects was examining whether making PrEP available over the counter would increase the use of the drug in vulnerable communities.“The research has to focus on the populations that are most affected in order to have an impact and be relevant,” said Marcus.Yet, this may be the justification for defunding so many HIV-related studies. A termination letter reviewed by the Guardian dated 20 March cited that “so-called diversity, equity and inclusion (DEI) studies are often used to support unlawful discrimination on the basis of race and other protected characteristics, which harms the health of Americans.”The National Institutes of Health did not expand on why the grants were terminated in response to questions from the Guardian. In a statement it said it is “taking action to terminate research funding that is not aligned with NIH and HHS priorities. We remain dedicated to restoring our agency to its tradition of upholding gold-standard, evidence-based science.”Many researchers were left stunned by the scale of the cancellations since in 2019, Donald Trump announced in his State of the Union address a commitment to eliminate the HIV epidemic in the country over the next 10 years. As part of this initiative, his administration negotiated a deal with drug companies to provide free PrEP for 200,000 low-income patients.“Scientific breakthroughs have brought a once-distant dream within reach,” said Trump in his address. “Together we will defeat Aids in America.”Amy Nunn, a professor at the Brown University School of Public Health, said she had even tailored grant proposals to fit the policy goals of the initiative, which included geographically targeting HIV prevention efforts. One of her studies that was terminated focused on closing disparities of PrEP use among African American men in Jackson, Mississippi.“They finally adopted those policies at the federal level,” Nunn said, noting that Trump was the first president to make ending the epidemic a priority. “Now they’re undercutting their own successes. It’s so strange.”Though hundreds of millions of dollars in federal funds had been awarded for the grants, the terminations will not recoup all of that money for the administration, since many are years into their work. Some are even already finished.Nathaniel Albright learned earlier this month that an NIH grant supporting his doctoral research was cancelled even though his project had already been completed. A PhD candidate at Ohio State University, Albright is defending his dissertation at the end of the month. Still, Albright is concerned how the cuts impact the future of the field.“It’s created an environment in academia where my research trajectory is now considered high risk to institutions,” said Albright, who is currently struggling to find postdoctorate positions at universities.Pamina Gorbach, an epidemiologist who teaches at University of California, Los Angeles, had been following hundreds of men living with HIV in Los Angeles for 10 years to learn their needs. She had been awarded an NIH grant to better facilitate their treatment through a local clinic. Her funding was cancelled earlier this month as well.“It’s really devastating,” said Gorbach. “If you’re living with HIV and you’re not on meds, you know what happens? You get sick and you die.”Clinic staff in Los Angeles will likely be laid off as a result of the cuts, said Gorbach. Others agreed one immediate concern was how to pay their research staff, since the funds from a grant are immediately frozen once it is terminated. The NIH funds also often make up at least a portion of university professor’s salaries, all said they were most alarmed by the impact on services for their patients and the loss of progress toward ending the epidemic.“This is erasing an entire population of people who have been impacted by an infectious disease,” said Erin Kahle, the director of the Center for Sexuality and Health Disparities at the University of Michigan who lost an NIH grant.Scrapping an entire category of disease from research will have innumerable downstream effects on the rest of healthcare, she added.“This is setting us back decades,” said Kahle. More

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      Democrats train fire on Musk as unelected billionaire dips in popularity

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      For most of the 17-minute interview, Elon Musk stuck to a script. He was just a tech guy on a mission to “eliminate waste and fraud” from government.His slash-and-burn cost-cutting crusade was making “good progress actually”, he told the Fox Business commentator Larry Kudlow on Monday, despite sparking a backlash that has reverberated far beyond Washington.“Really, I just don’t want America to go bankrupt,” he said.But then Kudlow asked Musk to look forward. Would the so-called “department of government efficiency” (Doge) still be in place in a year? He thought so – his assignment wasn’t quite complete. Musk, the world’s richest man, then pointed to social security, a widely popular federal program that provides monthly benefits to retirees and people with disabilities, and other social safety net programs: “Most of the federal spending is entitlements. That’s the big one to eliminate.”For weeks, Donald Trump and Republicans have insisted that social security, Medicaid or Medicare would not “be touched”. Now Musk was suggesting the programs would be a primary target. Almost as soon as the words left his mouth, Democrats pounced.“The average social security recipient in this country receives $65 a day. They have to survive on $65 a day. But you want to take a chainsaw to social security, when Elon Musk and his tens of billions of dollars of government contracts essentially makes at least $8m a day from the taxpayers,” Hakeem Jeffries, the US House minority leader, said in a floor speech the following day. “If you want to uncover waste, fraud or abuse, start there.”As the second Trump era comes into focus, Democrats have found a new villain: an “unelected billionaire” whose bravado – and sinking popularity – they believe may offer their party a path out of the political wilderness.“There’s nowhere in America where it is popular to cut disease research, to gut Medicaid and to turn off social security,” said Jesse Ferguson, a Democratic strategist. “So it’s hard to see a place where what Musk is doing for Trump doesn’t become an albatross for Republicans.”The White House has championed Doge’s work while reiterating that Trump would “protect” social security and other entitlement programs. Musk did not respond to a request for comment.The Social Security Administration , which serves more than 70 million Americans, has announced plans to reduce its workforce by more than 10% and close dozens of offices nationwide as part of Doge’s federal overhaul. Officials with the group have been installed at the agency since early last month.Despite mounting criticism of Musk, the president has embraced his beleaguered ally, who spent close to $300m helping elect him to the White House. This week, Trump hailed Musk as a “patriot” as he showcased Teslas from the south lawn of the White House. The president selected a red sedan, hoping to boost the electric car company, which has suffered a sharp decline in sales and stock prices since its chief executive launched his Doge operation. The White House has said that if conflicts of interest arise, “Elon will excuse himself from those contracts”.But Musk and his chainsaw-wielding approach to downsizing government is playing a starring role in early Democratic ads and fundraising appeals. Progressive activists have staged “nobody elected Elon” protests across the country while other groups are targeting Tesla showrooms and dealerships. On a “fighting oligarchy” tour across the country, Senator Bernie Sanders pointed to Musk’s growing political influence as a central threat to American democracy.“Most American people, they can’t name us. They don’t know who Chuck Schumer is, but they do know what this administration and Elon Musk and the GOP are planning for them,” Katherine Clark, the House minority whip, said on Friday. “It’s why you’re seeing this uproar in town halls.”While Democrats have much to say about Musk, they are less sure of how to stop him.Many of Doge’s actions have been halted or stopped in the courts. This week two federal judges ordered government agencies to rehire tens of thousands of probationary employees who were fired as part of Doge’s purge of the federal workforce.Locked out of power in Washington, Democrats are under enormous pressure to use any leverage they have to block Trump and Musk. A Republican-authored bill to fund federal agencies through September and avert a shutdown fiercely divided Democrats this week. House Democrats and progressive activists erupted in anger at Chuck Schumer, the Senate minority leader, who ultimately relented and helped pass the measure rather than risk a funding lapse and, in his words, give Musk and Doge an opportunity to “exploit the crisis for maximum destruction”.Public polling underlines Democrats’ interest in Musk. A new CNN survey found that just 35% of Americans held a positive view of the billionaire Trump adviser, a full 10 percentage points lower than the president. The poll also found that he is notably better known and more unpopular than the vice-president, JD Vance.More than six in 10 Americans said Musk had neither the right experience nor the judgment to carry out a unilateral overhaul of the federal government, though views broke sharply along partisan lines. Roughly the same share said they were worried the reductions would go “too far”, resulting in the loss of critical government programs.A survey conducted by the left-leaning Navigator Research polling firm late last month found that views of Doge as a standalone cost-cutting initiative were marginally favorable, in line with other polls that have found Americans are broadly supportive of its stated mission to root out waste and improve efficiency. But there are signs Americans don’t like the approach or implementation so far.When the effort was framed as “Elon Musk’s Doge”, views turned sharply more negative. The poll also captured the far-reaching impact of the cuts: 20% say they or someone they know has lost access to a federal service, 19% say they or someone they know has lost access to a federal grant, and 17% say they or someone they know has quit or been laid off from a federal government job.skip past newsletter promotionafter newsletter promotion“Musk is the face of everything that people are worried about in the Trump administration,” Ferguson said, adding: “To a lot of people, putting Elon Musk in charge of protecting the middle class is like putting Jeffrey Dahmer in charge of protecting a morgue.”Democrats believe Musk’s comments on entitlement programs are particularly potent – the world’s wealthiest man advocating for steep cuts to programs designed to help retirees and vulnerable Americans.In the Fox Business interview, Musk claimed the programs were rife with waste and fraud, suggesting as much as $600bn to $700bn – or nearly a quarter of their budget – could to be cut. Federal watchdogs have long identified improper spending as a problem, but Musk’s figure exceeds their estimates.Musk has derided social security as “the biggest Ponzi scheme of all time”. As evidence of widespread fraud, Musk repeated a debunked theory, favored by Trump, that social security benefits are being paid to dead centenarians. The head of the agency has rejected the premise. Democrats have warned that Trump and Musk were using false or exaggerated claims of fraud as a “prelude” to slash the program or privatize it, as many conservatives have long desired.After Musk’s comments aired, the White House swiftly issued a “fact check” insisting that Musk had only advocated for eliminating waste and highlighted several occasions in which Trump has vowed to protect Americans’ benefits.Republicans also rushed to clarify Musk’s comments. “Look, Elon Musk is a brainiac with an IQ that I cannot even fathom. He is not a master of artful language,” Mark Alford, a Republican representative of Missouri, said on CNN. “We are not going to eliminate social security, Medicare and Medicaid. That’s sheer nonsense.”It was a rare break with Musk, whom Republicans have been loath to cross, well aware that he not only has the president’s full support and ear but a fortune to squash any dissent within the ranks. During Trump’s address to Congress earlier this month, Republicans gave Musk a standing ovation as the president heaped praise on his work. They publicly warn that Democrats oppose Musk’s fraud-and-waste removal efforts at their own political peril.Yet there are signs that Republicans are beginning to worry. Despite Trump’s close alliance with Musk, even he seemed to indicate it was time to rein him in. “We say the ‘scalpel’ rather than the ‘hatchet’,” the president wrote in a social media post.House Republicans have reportedly been advised not to hold in-person town halls after several widely publicized confrontations with constituents furious over loss of government jobs and services. At the few meetings that did take place this weekend, constituents confronted Republican members of Congress with their concerns about possible cuts to social security.Republicans are weighing deep cuts to entitlement programs as a way to offset the cost of extending Trump’s sweeping tax cuts aimed largely at the wealthy. Trump has praised the House plan.“The Republican party at this point has wrapped both arms around the third rail and is holding on as the electricity flows,” said Ben Wikler, the chair of the Democratic party in Wisconsin, where a contest next month will provide an early test of the party’s anti-Musk strategy.On Thursday night, Wikler hosted a People v Musk grassroots event to discuss the billionaire’s impact on the 1 April state supreme court race, which will determine the balance of power between conservative and liberal justices on Wisconsin’s highest bench. Musk has spent millions of dollars through his America Pac in an effort to tip the scales in favor of Brad Schimel, a county judge and former Republican attorney general. Democrats are supporting Susan Crawford, a county judge and former attorney for Planned Parenthood.Wikler said Musk’s ascendancy in Washington – and his influence in the race – has turned liberal voters in the state from “concerned to panicked to outraged with the heat of 1,000 suns”.“If Susan Crawford wins this race, and Musk and Schimel lose,” he said, “then that will be a big bat signal in the sky to Democrats everywhere that fighting back is not only the right thing to do, it’s good politics.” More

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      Oz vows to make Americans healthier but dodges questions on Trump cuts

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      Dr Mehmet Oz promised senators on Friday to fight healthcare fraud and push to make Americans healthier if he becomes the next leader of the Centers for Medicare and Medicaid Services.But the former heart surgeon and TV personality dodged several opportunities to say broadly whether he would oppose cuts to Medicaid, the government-funded program for people with low incomes.Oz, Donald Trump’s pick to be the next CMS administrator, also said technology such as artificial intelligence and telemedicine can be used to make care more efficient and expand its reach.“We have a generational opportunity to fix our healthcare system and help people stay healthy for longer,” he said in his opening remarks.He faced over two and a half hours of questioning before the Republican-controlled Senate finance committee, which will vote later on whether to forward his nomination to the full Senate for consideration.Leading the Centers for Medicare and Medicaid Services presents a “monumental opportunity” to make the country healthier, Oz told senators on Friday morning.“We don’t have to order people to eat healthy, we have to make it easier for people to be healthy,” adding that he considered maintaining good health a “patriotic duty”.Republicans, who have coalesced around Trump’s nominees for the health agencies, asked Oz about his plans for eliminating fraud from the $1tn programs.Democrats, meanwhile, tried to pin him down on potential cuts to the state and federally funded Medicaid program that Republicans are considering.The 64-year-old was a respected heart surgeon who turned into a popular TV pitchman. Now he has his sights on overseeing health insurance for about 150 million Americans enrolled in Medicare, Medicaid or Affordable Care Act coverage.Republicans, who have coalesced around Trump’s nominees for the health agencies, are likely to ask Oz about his plans for Medicare and Medicaid, including the Trump administration’s focus on eliminating fraud from the $1tn programs.Democrats, meanwhile, will question Oz’s tax filings, which they say show he has used a tax code loophole to underpay taxes by thousands of dollars on Medicare, the program he will oversee. They will also grill Oz on any cuts he would make to the health insurance coverage as well as comments on his TV show supporting privatized Medicare.The US office of government ethics has done an “extensive review” of Oz’s finances, a spokesperson, Christopher Krepich, said in a statement about Oz’s taxes. He added that the office had indicated “any potential conflicts have been resolved and he is in compliance with the law”.Oz has hawked everything from supplements to private health insurance plans on his former TV series, The Dr Oz Show, which ran for 13 seasons and helped him amass a fortune.Oz’s net worth is between $98m and $332m, according to an analysis of the disclosure, which lists asset values in ranges but does not give precise dollar figures. His most recent disclosure shows he also holds millions of dollars’ worth of shares in health insurance, fertility, pharmaceutical and vitamin companies. He has promised to divest from dozens of companies that would pose conflicts for him as the CMS administrator.In the job, he could wield significant power over most health companies operating in the US because he can make decisions about who and what are covered by Medicare and Medicaid.Oz’s hearing comes as the Trump administration seeks to finalize leadership posts for the nation’s top health agencies. On Thursday, Senate committees voted to advance the nominations of Marty Makary, poised to lead the Food and Drug Administration, and Jay Bhattacharya, set to helm the National Institutes for Health, for a full Senate vote. The nomination of Dave Weldon to the Centers for Disease Control and Prevention was abruptly withdrawn on Thursday.Those men have all leaned into Robert F Kennedy Jr’s call to “Make America healthy again”, a controversial effort to redesign the nation’s food supply, reject vaccine mandates and cast doubt on some long-established scientific research.“Americans need better research on healthy lifestyle choices from unbiased scientists,” Oz wrote late last year in a social media post praising Kennedy’s nomination to be health secretary.This is not Oz’s first time testifying before senators. In 2014, several senators scolded him during a hearing about the questionable weight loss products he hawked on his television show. More

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      Medicaid recipients fear ‘buzzsaw cuts’ for Trump’s agenda: ‘We’re not going to be alive forever’

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      At the age of 62, Marya Parral knows that her, and her husband’s, years of being able to care for their two developmentally disabled sons are numbered, and so they have done everything they can to ensure their children can continue to live independently.For their oldest, Ian, that’s meant placing him in a program on an organic farm that caters to people diagnosed with autism. For Joey, their youngest, who has both autism and Down syndrome, Parral has found a caregiver who can help him deliver newspapers and run errands around their community of Ocean City, New Jersey.Parral said none of this would be affordable without help from Medicaid, the federal government’s insurance program for poor and disabled Americans. But this week, the Republican-controlled House of Representatives approved a budget framework that would make deep cuts to the program, and Parral worries her sons will lose what she has worked so hard to build.“We’re not going to be alive forever. We’re trying to set up a life for them, but that entire life that we’re working so hard to set up for them is dependent on Medicaid,” Parral said. “So it’s really devastating to think about cuts.”Producing a budget is the first step in the Republican-controlled Congress’s drive to enact legislation that will pay for Donald Trump’s priorities. House lawmakers will now spend weeks working to write and pass a bill that is expected to approve $4.5tn in extended tax cuts, as well as funding for Trump’s plan for mass deportations of undocumented immigrants.To pay for it, Republicans are considering a rollback of the federal social safety net, particularly Medicaid, which has nearly 80 million enrollees in all 50 states. The budget plan proposes an $880bn reduction in funding for the insurance over the next 10 years, an amount that experts warn would hollow out the program and have ripple effects across the entire American healthcare system.Megan Cole Brahim, a professor at Boston University School of Public Health and an expert on Medicaid, said the cut was the largest ever proposed, and if enacted would “have far-reaching impacts not just for those who rely on Medicaid, but for entire communities and economies”.“These changes mean millions of Americans – including the low-income, elderly, persons with disabilities, children – will lose health insurance coverage,” she said. “Others may see significant reductions in benefits or limited access to care. The impact on hospitals and health systems will be significant, particularly for safety-net and rural hospitals, which are already on the brink of closure. Patient revenues will fall, uncompensated care will rise. There will be staff layoffs and site closures.”John Driscoll, a healthcare executive and chair of the board of UConn Health in Connecticut, said: “The scale of the buzzsaw cuts to Medicaid would undermine every hospital’s ability to actually support its mission to care for the community, and would be a dangerous cut to the nursing-home infrastructure in the country.”Republican leaders backed the cuts to Medicaid, as well as to similar programs such as one that helps poor Americans afford food, as a way to mollify lawmakers in their party who want the US’s large budget deficit addressed. Still, not everyone is pleased. As the budget was being debated, eight Republican representatives, some of whom Democrats are keen to unseat in next year’s midterm elections, wrote to the House speaker, Mike Johnson, warning that their districts’ large Hispanic populations would be harmed.“Slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities where hospitals and nursing homes are already struggling to keep their doors open,” they said.All eight ultimately voted for the resolution, but the dissent may be a warning sign for the budget’s prospects of enactment, particularly in the House, where the GOP has a mere three-seat majority. It also remains unclear whether Republicans will try to pass all of Trump’s priorities in one bill, or split them into two.The GOP has made clear they want to fully pay for the extension of Trump’s tax cuts, and Elyssa Schmier, vice-president of government relations for advocacy group MomsRising, said Medicaid and social safety programs are the party’s prime targets for cost savings.“If you’re not going to go after, say, the Pentagon budget, if they’re only going to go to some of these big mandatory spending programs, there’s only so many places that Republicans feel that they can go,” she said.In the days since the budget’s approval, Johnson and Trump have scrambled to downplay the possibility of slashing Medicaid, insisting they intend only to root out “fraud, waste and abuse.”“The president said over and over and over: ‘We’re not going to touch social security, Medicare or Medicaid.’ We’ve made the same commitment,” Johnson told CNN in an interview.Democrats have little leverage to stop the budget, which can be passed with simple majorities in both chambers. But the Democratic senator Ruben Gallego warned that gutting the social safety net to extend tax cuts that have mostly benefited the rich will alienate voters who sided with the GOP last November.“It will be on Donald Trump and Republicans, the fact that he’s going to side with the ultra-rich versus the working poor,” said Gallego, who won election to his seat in Arizona even as Trump captured the state’s electoral votes. “Families that are barely making a living, scratching a living, they’re now going to get kicked off healthcare to give tax cuts to the mega-rich.”The proposed cut to Medicaid would remove billions of dollars in funding from congressional districts nationwide that are represented by lawmakers from both parties, according to an analysis by the liberal Center for American Progress.In California’s San Joaquin valley, the Democratic representative Jim Costa’s district would lose the third-largest amount of funding, according to the data, and Medicaid coverage would be imperiled for more than 450,000 residents.“This reckless budget prioritizes the wealthy while devastating those who need help the most,” Costa said. “I voted no because this resolution is bad for our valley and a threat to the wellbeing of the people I represent.” More

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      ‘I feel betrayed’: federal health workers fired by Trump tell of ‘nightmare’

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      As protesters gathered outside the headquarters of US health agencies to call attention to mass layoffs devastating the federal service in recent days, more employees at health agencies were terminated on Wednesday, including employees with years of experience and stellar performance reviews who were not probationary.Thousands of terminated employees across the federal government are appealing the decision. Some former employees are struggling to apply for unemployment or understand when their benefits expire in the chaotic termination process.At the US Centers for Disease Control and Prevention (CDC), the layoffs included all public health fellows stationed at state, local and regional health departments, as well as staff working on global health and outbreak response – even as the bird flu outbreak ramps up and the CDC suspends its seasonal flu vaccine campaign.The Guardian spoke to four employees at the CDC who were terminated in recent days. Three requested anonymity to avoid retribution from the Trump administration. All of them recently received satisfactory or outstanding performance reviews, and none of them had been placed on performance review plans.Mack Guthrie was part of the Public Health Associate Program at the CDC – until everyone in the program was let go over the weekend. He worked in Minneapolis public schools to help prevent STIs and unintended pregnancies by educating students, testing and counseling patients in clinics, and tracking STI rates and trends.All of these layoffs are “a major hit to America’s health infrastructure”, said Guthrie, who had an outstanding performance review so was stunned to see his performance listed as the reason for termination.While all of the public health fellows were told they were being laid off, some never received letters, Guthrie said, adding: “The whole process has been dominated by chaos and confusion.”The state, tribal, local and territorial departments where they were deployed “are already starting to feel the effect of our absence”, Guthrie said.“For some of my colleagues, they are filling gaps at host sites that would simply not get filled otherwise,” he said. “These organizations simply don’t have the funds to hire people.”When one CDC employee attempted to log into their laptop on Wednesday morning, they received an error message and realized they were locked out of the system, unable to communicate with their team or even say goodbye. They’d been laid off overnight and because they have not yet received a letter, they don’t know the reason for their termination. This employee had years of experience and excellent performance reviews, and was not probationary.Employees in probationary periods were especially hard-hit in this round of layoffs. That status has nothing to do with their performance, unlike employees who may be put on probation in the private sector. Rather, it usually means they have been in their current position for less than two years, and thus they don’t have the same legal protections as other federal workers.One terminated employee who has been in the same position for four and a half years was surprised to receive notice that their job was considered probationary and they were being let go, despite high praise on performance reviews. They are appealing the decision to human resources, but have not received responses yet.Form letters sent to terminated employees say that they “are not fit for continued employment” because their “ability, knowledge and skills do not fit the agency’s current needs”, and their performances have “not been adequate to justify further employment at the agency”.Former CDC employees told the Guardian they are now part of a class-action wrongful termination appeal to the US Merit Systems Protection Board – joining other federal employees represented by the Washington law firm James & Hoffman.The leader of the merit board was herself reinstated by a judge on Wednesday after the Trump administration tried to fire her.“If you’re going to terminate my position, don’t tell me it’s because of my performance,” said another employee who worked as a CDC contractor for four years before entering a probationary period after being hired permanently.View image in fullscreenEmployees who were locked out of their systems with little or no notice are now scrambling to collect their final paychecks, apply for unemployment, return equipment, and understand their benefits.The longtime employee who was locked out on Wednesday told the Guardian they were not given the proper documentation in order to apply for unemployment.“When I called HR, the team simply did not know what to do and I was left with, ‘Please call back tomorrow, we will have better guidance,’” the employee said. “Folks don’t even have essential documents to properly separate from the agency.”The employees said they haven’t been offered details on whether their annual leave will pay out, or even how long their health insurance will last.“I still need to communicate with my center in terms of what is happening with my final paycheck, how do I return my equipment, and I have no idea how they intend to do that,” said the employee who worked at the CDC for five years.The so-called “department of government efficiency,” known as Doge, has targeted certain agencies for layoffs in a purported bid to cut back on government spending, despite representing a very small portion of the federal budget.“They feel fake,” the employee said. “It seems like a giant scam that they were trying to see if it would work, and it did … I can’t believe that I lost my job as a result of this group of people.”The layoffs cap a stressful month for CDC staffers rushing to implement Trump’s flurry of executive orders.“We were working around the clock. If not working, I couldn’t sleep – for weeks, since the administration came in – thinking of all the things we had to do to meet those orders,” said the employee who was at the CDC for four and a half years.All the while, they were waiting to learn if they would keep their job – a “dream job” that has become “a nightmare”.“It was really part of my identity – I lived and ate it around the clock,” the employee said. “That was such a big part of my life … I feel betrayed.”The employee urged former supervisors and teammates to check in on the wellbeing of terminated staffers, some of whom report experiencing depression and anxiety.“All of us have always looked at CDC as being the final goalpost for a public career,” said the longtime employee.“It feels like I worked so hard to be where I’m at, only to look back and see an empty space. I know I did the work, but it’s rapidly being taken away.”Send us a tipIf you have information you’d like to share securely with the Guardian about the impact of cuts to federal programs or the federal workforce, please use a non-work device to contact us via the Signal messaging app at (646) 886-8761. More

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      From weather apps to taxes: the trickle-down effects of Trump’s federal worker firings

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      You wake up to dark clouds outside, so you check the weather on your phone: a storm is coming.That weather app uses data from the National Weather Service, a part of the National Oceanic and Atmospheric Administration, a small organization which could see as much as 10% of its workforce cut this week.You grab food to make breakfast: eggs, meat, formula for your baby. The safety of your food is regulated and inspected by a host of federal employees, who flag and investigate when items shouldn’t be eaten.The former head of the Food and Drug Administration’s food division resigned this week because he thought firings and layoffs at the agency would hinder its work. “I didn’t want to spend the next six months of my career on activities that are fundamentally about dismantling an organization, as opposed to working on the stated agenda,” he told Stat News.You check your flight reservations for an upcoming trip to a national park. The safety of that flight is overseen by the Federal Aviation Administration, which experienced layoffs this month despite recent high-profile aviation accidents. The national park will probably see its staff gutted, leaving it more vulnerable to wildfires and without search and rescue capabilities. “I honestly can’t imagine how the parks will operate without my position,” a park ranger who was cut wrote on Instagram. “I mean, they just can’t. I am the only EMT at my park and the first responder for any emergency. This is flat-out reckless.”You keep an eye on the bird flu levels and a measles outbreak – the winter has been punishing for illnesses. The Centers for Disease Control and Prevention were hit with a first round of layoffs this week, which could affect outbreak response and reporting. The Epidemic Intelligence Service, a disease-detective training program, could be on the chopping block.Oh, and you’re working on your taxes – while thousands of Internal Revenue Service probationary employees are expected to be laid off during tax season.The government certainly has room for improvement – backlogs that should be cleared, investigations that should be more thorough, communication that should be sharper, actions that should be more transparent. But all of this work is done by the federal government and its millions of workers and contractors, whose daily jobs touch the lives of all Americans and many around the globe.In the first weeks of the Trump administration, the president and the billionaire Elon Musk, tasked with cutting government through the so-called “department of government efficiency” (Doge), have waged war against federal workers. Musk and his team have moved from agency to agency, indiscriminately firing probationary employees and those whose work they say doesn’t align with the administration’s priorities, including many who work on diversity initiatives or in international development.The result is a hobbled and terrified federal workforce that is just at the beginning of the expected cuts – and an American public that is starting to experience the repercussions.“We’re playing Russian roulette, and basically you’re putting a whole bunch of more bullets in the chambers,” said Max Stier, the CEO of the Partnership for Public Service, a non-profit that advocates for a strong civil service. “You can’t prevent all bad things from happening, but our federal government is, in a lot of ways, a manager of risk, and it does a pretty darn good job of managing that risk, even though it can be improved.”An email went out in January to millions of federal employees offering a deferred resignation, which the White House says about 75,000 people have accepted, although it’s unclear how many of the people who accepted are actually eligible.Joel Smith works at the Social Security Administration and is the president of the American Federation of Government Employees Local 3184, which covers more than 90 agency offices in parts of Arizona, New Mexico, Texas and Louisiana. He said the office of management and budget, which has coordinated the buyout program it’s calling a “fork in the road”, hasn’t communicated with the agencies about which employees accepted the buyout. Some employees didn’t show up the first day the program’s leave was supposed to begin, and the agency had to call them to figure out where they were, he said.“It’s just chaos on top of chaos, on top of terror, on top of employees that want to leave are being told they can’t leave. I’m trying to think of a good word for it. I don’t know if there is one, other than clusterfuck,” Smith said.Those that remain in their jobs worry about whether they’re next as they add to their workloads to cover for those who lost their jobs or quit. People eyeing next career moves will avoid civil service, previously seen as a stable career, to stay out of the current chaos.Many people take core functions of the federal government for granted, as it protects them from disasters or national security concerns, but might not otherwise affect them. But that could change after widespread firings. For example, layoffs in the Environmental Protection Agency mean that those remaining in their positions have less capacity to do their jobs.“That could come in the guise of someone not being able to respond to an environmental disaster,” said Nicole Cantello, president of the American Federation of Government Employees Local 704. “Or what about if there’s a facility illegally flaring air pollutants? We might not be as able to respond to something like that which could have health effects. There could be devastating effects to the American people.”If you or your loved ones use any direct services such as benefits programs, you could see the effects of a beleaguered federal workforce up close.Let’s say you’re helping your parents sign up for social security. The Social Security Administration is already understaffed, so losing any positions will make wait times longer for people who need to access benefits, Smith said.Smith’s father filed for retirement benefits in November to begin in February, but by February, his case hadn’t been processed – it was stuck in somebody’s backlog. A member of Congress had to intervene to bring attention to the delay, a frequent tactic to overcome stalled claims.“What people think they’re witnessing now and they’re complaining about now, in terms of delays, is going to be considered the good old days here in a year or two if this continues,” he said. “We already don’t have the people to do the work.”For federal workers and their families, the impact is heavy and immediate if they lose their livelihoods.“The way it’s working now is that the career civil servants are viewed as the villains,” said Rob Shriver, former acting director of the US office of personnel management who now works at Democracy Forward. “They’re viewed as people who are to be worked around and not worked with. They’re being deprived of the thing that’s most important to them, which is to contribute to the agency’s mission and bring their skills and expertise to the table to help inform decision makers.”Though many have focused on the disruption caused in Washington, federal workers live throughout the US and, in some cases, other parts of the world.“There’s a human aspect of it, which is these people are not just being fired, but they’re being fired in the worst way. No notice, no nothing. This is true across the board. There is zero humanity being demonstrated,” said Stier, of the Partnership for Public Service. “It is unbelievably costly to the individuals involved, and it’s costly to the system and to the American taxpayers. It’s going to cost the American taxpayer a ton of money. It is not going to save any money.”Send us a tipIf you have information you’d like to share securely with the Guardian about the impact of cuts to federal programs or the federal workforce, please use a non-work device to contact us via the Signal messaging app at (646) 886-8761. More

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      Robert F Kennedy Jr sworn in as health secretary after Senate confirmation

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      Robert F Kennedy Jr has taken control of America’s vast healthcare apparatus, after the Senate voted on Thursday to confirm the controversial anti-vaccine campaigner’s nomination as health secretary.The Senate voted 52 to 48, with all Republicans other than the veteran Kentucky senator and former majority leader, Mitch McConnell, backing the former environmental lawyer.Kennedy was sworn in later on Thursday by US supreme court justice Neil Gorsuch.Kennedy abandoned his independent presidential bid last year after a weak campaign and endorsed Donald Trump.The vote installs one of America’s most prominent vaccine skeptics to run its federal health infrastructure, granting oversight of the very agencies – including the Centers for Disease Control and Prevention and the Food and Drug Administration – that he has spent years battling through lawsuits and public campaigns. Kennedy will wield sweeping authority over the nation’s $2tn health system, including drug approvals for Medicare, the government health insurance scheme for older Americans.His path to the top crystallized after securing backing from the Republican senator Bill Cassidy, a physician who extracted what he called “unprecedented” commitments for collaboration from both Kennedy and the Trump campaign. The key moderate Senate Republicans Susan Collins and Lisa Murkowski also fell in line this week, having previously expressed doubts over Trump’s nomination.McConnell, the lone Republican defection, cited his own experience battling childhood polio as a primary reason for his vote against Kennedy.“I’m a survivor of childhood polio,” McConnell said. “In my lifetime, I’ve watched vaccines save millions of lives from devastating diseases across America and around the world. I will not condone the re-litigation of proven cures.”At his confirmation hearing, Kennedy equivocated and said he just wanted to ensure vaccine safety and would not stop vaccines from being available. But he has long peddled conspiracy theories and debunked claims, including that vaccinating babies against measles, mumps and rubella is linked to autism, and had previously said that “no vaccine is safe and effective”.He also tried to persuade the US government to rescind authorization for the newly developed coronavirus vaccine in 2021, despite the world having desperately waited for the shots to be developed while millions died during the pandemic. At the hearing he said “I don’t think anybody can say that” the Covid-19 vaccines saved millions of lives.McConnell said: “Individuals, parents, and families have a right to push for a healthier nation and demand the best possible scientific guidance on preventing and treating illness. But a record of trafficking in dangerous conspiracy theories and eroding trust in public health institutions does not entitle Mr Kennedy to lead these important efforts.”This was the second time in as many days that McConnell has opposed one of Trump’s nominees. On Wednesday, he voted against confirming Tulsi Gabbard as director of national intelligence, again the sole Republican to do so.Democrats – the party historically aligned with the Kennedy family legacy – have, on the other hand, totally disavowed RFK Jr as a nominee, chiefly based on his lack of subject area expertise.“Robert F Kennedy Jr is not remotely qualified to become the next secretary of health and human services,” the Senate minority leader, Chuck Schumer, said on the floor on Wednesday. “In fact, I might go further. Robert F Kennedy Jr might be one of the least qualified people the president could have chosen for the job.”skip past newsletter promotionafter newsletter promotionMost of the wider Kennedy political clan disowned RFK Jr, the son of the former US attorney general Robert F Kennedy and the nephew of US president John F Kennedy, during his presidential campaign last year.JFK’s daughter Caroline Kennedy, the former US ambassador to Australia, wrote to lawmakers ahead of the confirmation process and called her cousin a predator, saying he had enriched himself through his anti-vaccine “crusade”, while making victims of sick children and their families. She also noted that he had vaccinated his own children, something Kennedy says he now regrets having done.Kennedy has been at the center of numerous other controversies, including being accused of sexual misconduct, staging pranks with roadkill, including a dead bear cub, and claiming a previous illness was caused by having a worm in his brain, which prompted some opponents to call him a laughing stock. Kennedy has talked about his own recovery from heroin addiction. Through it all, Trump stuck with his nomination and on Thursday the Republican-controlled Senate acquiesced.Kennedy has in the past, however, been admired by Democratic leaders for his environmental advocacy. He has pledged to take on the big food manufacturers to try to loosen their grip on America’s over-processed diet and has become the face of the Trump administration’s offshoot motto “Maha”, or Make American Healthy Again.During the Senate finance committee hearing, Elizabeth Warren had raised alarm over Kennedy’s financial ties to anti-vaccine litigation, including a fee-sharing arrangement with the law firm Wisner Baum that earned him $2.5m over three years – an arrangement he initially planned to maintain while serving as secretary before amending his ethics agreement under pressure.Post-confirmation, the Democratic senator from Massachusetts, who had her own run for president in 2020, reiterated her dismay, calling the vote in favor of the incoming secretary of health and human services “a huge mistake”.“When dangerous diseases resurface and people can’t access lifesaving vaccines, all Americans will suffer,” Warren said in a statement. “And thanks to his serious, unresolved conflicts of interest, RFK Jr’s family could continue getting richer from his anti-vaccine crusade while he’s in office.”The Republican senator Lindsey Graham of South Carolina, defended his vote for Kennedy. “Every president deserves their team,” Graham said, adding: “I look forward to working with RFK Jr to improve our quality of life and health in America.” More