People demonstrate outside the main campus of the Centers For Disease Control and Prevention on April 1, 2025 in Atlanta, Georgia. Health and Human Services Secretary Robert F. Kennedy Jr. laid off thousands of employees across multiple agencies on April 1, as part of an overhaul announced in March. (Photo by Elijah Nouvelage/Getty Images)

A coalition of Democratic state officials sued the Trump administration Tuesday over plans to cut more than $11 billion in grants by the Department of Health and Human Services, on the same day thousands of HHS workers reportedly found they’d been swept up in a mass layoff.

In Washington, the Republican chairman and top Democrat on the Senate Health, Education, Labor and Pensions Committee wrote HHS Secretary Robert F. Kennedy Jr. asking him to appear before the panel and discuss his plans for the massive agency.

The federal suit, signed by 22 attorneys general and two Democratic governors, alleges Kennedy revoked, without warning, billions in grant funding appropriated by Congress during the COVID-19 pandemic, starting last week. That led to states scrambling to adjust plans for vaccination efforts, infectious disease prevention, mental health programs and more.

The sudden and chaotic rollout of the grant cuts foreshadowed a scene at HHS offices, including at big campuses in Maryland, on Tuesday morning. Termination notices to laid-off workers were reportedly emailed early Tuesday, but many workers did not see them before arriving at the office and finding out they’d lost their jobs when their key cards did not work.

Few specifics

Both the mass layoffs and the grant funding cuts challenged in the lawsuit stem from Kennedy’s March 27 announcement that the department would be “realigning,” by shuttering several offices and cutting 10,000 workers.

It was unclear Tuesday exactly what offices or employees were affected.

An HHS spokesperson responded to a request for comment by referring States Newsroom to Kennedy’s announcement, a press release and an accompanying fact sheet from March 27.

None provided a detailed breakdown but laid out plans to eliminate 3,500 full-time positions at the Food and Drug Administration, 2,400 employees at the Centers for Disease Control and Prevention, 1,200 staff at the National Institutes of Health and 300 workers at the Centers for Medicare and Medicaid Services.

The spokesperson did not respond to a follow-up inquiry requesting more details of the positions eliminated and other clarifications.

Efficiency doubted

In a written statement, Andrés Arguello, a policy fellow at Groundwork Collective, a think tank focused on economic equity, said the cuts would have “the exact opposite” effect of the administration’s stated goal of government efficiency.

“Gutting 10,000 public servants means higher costs, longer wait times, and fewer services for families already struggling with the rising cost of living,” Arguello, an HHS deputy secretary under former President Joe Biden, wrote. “Entire offices that support child care, energy assistance, and mental health treatment are being dismantled, leaving working families with fewer options and bigger bills. This isn’t streamlining—it’s abandonment, and the price will be paid by the sick, the vulnerable, and the poor.”

The lack of communication led to confusion among advocates and state and local health workers about the impacts of the staff cuts and cast doubt about the administration’s goals, speakers on a Tuesday press call said.

“There are so many more questions than answers right now,” Sharon Gilmartin, the executive director of Safe States Alliance, an anti-violence advocacy group, said. “They clearly are eliminating whole divisions and branches, which doesn’t speak to bureaucratic streamlining. It speaks to moving forward an agenda, which has not been elucidated for the public health community, it’s not been elucidated for the public.”

While specific consequences of the cuts were not yet known, Gilmartin and others said they would be felt at the state and local level.

“I think what we do know is that … when we’re cutting these positions at the federal level, we are cutting work in states and communities,” Gilmartin said.

Pain in the states

The lawsuit from Democratic officials is full of details about the impacts of the loss of federal funding on state programs.

The suit was brought in Rhode Island federal court by the attorneys general of Colorado, Rhode Island, California, Minnesota, Washington, Arizona, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon and Wisconsin and Govs. Andy Beshear of Kentucky and Josh Shapiro of Pennsylvania.

HHS revoked “more than half a billion dollars” of grants from Pennsylvania, the Democratic officials said, affecting more than 150 state employees and contracted staff. The grants funded work “to respond to and mitigate the spread of infectious disease across the Commonwealth” and mental health and substance abuse programs.

In Nevada, “HHS abruptly terminated at least six grants” that had funded epidemiology and lab capacity, immunization access and mental health services, according to the suit.

“These terminations led Nevada to immediately terminate 48 state employees and to order contractors working under these awards to immediately cease all activity,” the complaint reads. “The loss of funding will have substantial impacts on public health in Nevada.”

The cutoff of $13 million in unobligated grants for local communities in Minnesota will mean the shuttering of clinics to provide vaccines for COVID-19, measles, mumps, rubella, influenza and other diseases, the suit said.

“One local public health agency reported that it held 21 childhood vaccination clinics and provided approximately 1,400 vaccinations to children in 2024,” a paragraph in the complaint about Minnesota local vaccine clinics said. “It also held 87 general vaccination clinics in 2024. As a result of the termination of the … funds, it has immediately ceased all vaccination clinics for 2025.”

The grant terminations also affected state plans already in the works.

Rhode Island had received an extension from HHS for a grant with $13 million unspent, but that money was revoked last week.

“Accordingly, the state public health department developed a workplan for its immunization program that included an April 2025 vaccination clinic for seniors, provided salaries for highly trained technicians to ensure that vaccine doses are stored and refrigerated correctly to prevent waste of vaccines purchased with other tax-payer dollars, planned computer system upgrades, and covered printing costs for communications about vaccine campaigns,” the suit said.

Senators want RFK Jr. on the Hill

Democrats on Capitol Hill issued a slew of statements opposing the cuts and warning of their effects.

Republicans were more deferential to the administration, asking for patience as details of the cuts are revealed.

But the letter from the top members of the Health, Education, Labor and Pensions Committee also brought both sides together to write Kennedy asking him to testify before the committee to make those explanations plain.

“The hearing will discuss your proposed reorganization of the Department of Health and Human Services,” the letter from Louisiana Republican Bill Cassidy and Vermont independent Bernie Sanders said.

In a written statement, Cassidy said the hearing would be an opportunity for Kennedy to inform the public about the reorganization.

“The news coverage on the HHS reorg is being set by anonymous sources and opponents are setting the perceptions,” Cassidy said in a written statement. “In the confirmation process, RFK committed to coming before the committee on a quarterly basis. This will be a good opportunity for him to set the record straight and speak to the goals, structure and benefits of the proposed reorganization.”

A nurse administers a measles, mumps and rubella vaccine to a patient in Utah. More states are loosening vaccine mandates, scaling back vaccine promotion efforts and taking other steps that likely will lower vaccination rates. (Photo by George Frey/Getty Images)

More states are loosening vaccine mandates, scaling back vaccine promotion efforts and taking other steps likely to lower vaccination rates — even as a major measles outbreak spreads in Texas.

Meanwhile, public health experts worry that the confirmation of vaccine skeptic Robert F. Kennedy Jr. as secretary of the U.S. Department of Health and Human Services could add fuel to such efforts, leading to the resurgence of long-tamed infectious diseases. Kennedy has made numerous baseless or false claims about vaccines, including linking them to autism and cancer and saying there is “poison” in the coronavirus vaccine.

This week, the U.S. Food and Drug Administration, which Kennedy now oversees, canceled the upcoming meeting of a scientific panel that was slated to discuss next year’s flu vaccines. Also this week, an unvaccinated child died of measles in Texas — the country’s first measles death in a decade. The outbreak, which has spilled into neighboring New Mexico, has now grown to more than 130 cases.

Already, vaccination rates are lower than they were before the pandemic. The COVID-19 vaccines saved millions of lives, but many Americans bristled at vaccine mandates, and disinformation and rapidly evolving public health advice undermined many people’s trust in scientific authorities.

Changing attitudes have had an impact: Vaccination rates among children born in 2020 and 2021 declined by between 1.3 and 7.8 percentage points for recommended shots, compared with children born in 2018 and 2019, according to a September report by the federal Centers for Disease Control and Prevention.

The anti-vaccination trend is “the antithesis of public health,” Dr. Scott Rivkees, a pediatric endocrinologist who served as Florida’s surgeon general and health secretary from 2019 to 2021, told Stateline.

“The role of people in departments of health and the role of people in health care and medicine is to promote health and make sure the public is safe,” Rivkees told Stateline. “There’s such a rich history of legal precedent, such a rich history of public health precedent, saying that society benefits by having individuals vaccinated.”

In all 50 states plus the District of Columbia, children must receive certain vaccines to attend school. Every state offers an exemption for children who cannot be vaccinated for medical reasons. Thirty states plus the district allow families to skip the vaccinations for religious reasons, 13 states grant exemptions for religious or personal reasons, and two states — Louisiana and Minnesota — don’t require people to specify whether their objection is religious or personal.

Five states — California, Connecticut, Maine, New York and West Virginia — don’t allow nonmedical exemptions.

Republican officials in more than a dozen states have introduced legislation to loosen vaccine rules or otherwise reduce their use.

Legislation in Arizona would make it easier to claim a school exemption, while GOP-sponsored bills in Connecticut, Minnesota, New York and Oregon would limit or prohibit vaccine mandates for adults.

As childhood immunization rates fall, Wisconsin urges families to get kids vaccinated

In Idaho, a Senate panel last week debated a bill that would ban mRNA vaccines, including COVID-19 vaccines, for a decade. Montana and Mississippi lawmakers considered but defeated similar proposals. And in West Virginia — one of the five states that currently does not allow nonmedical exemptions to school vaccine requirements — lawmakers are advancing a bill that would allow religious and philosophical objections.

“Public health will always, to some extent, involve politics, because it requires resources,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. Offit serves on the FDA panel that was supposed to discuss next year’s flu vaccines.

“But it doesn’t have to be partisan, which is what has happened.”

A shift in Louisiana

Earlier this month, Dr. Ralph Abraham, Louisiana’s first-ever surgeon general, sent a memo to staff at the Louisiana Department of Health saying they should no longer recommend that Louisianans get “any and all vaccines.” The memo also said the agency will “no longer promote mass vaccination.” Instead, Abraham said, health workers should encourage residents to discuss the risks and benefits of vaccines with their doctors.

The memo puts an end to the Louisiana health department’s robust history of promoting vaccinations through local public health departments, community health fairs and media campaigns.

“Vaccines should be treated with nuance, recognizing differences between seasonal vaccines and childhood immunizations, which are an important part of providing immunity to our children. … Getting vaccinated, like any other health procedure, is an individual’s personal choice,” the memo states.

The agency did not respond to multiple requests for comment via email and phone call. But in a letter posted to the department’s website earlier this month, Abraham wrote that the state had made several missteps during the pandemic, including: promoting “inaccurate and inconsistent guidance on masking, poor decisions to close schools, unjustifiable mandates on civil liberties, and false claims regarding natural immunity.”

Abraham wrote that vaccinations can be good for some, but can be harmful for others, and that for decades public health has been driven by an ideology that “the sacrifice of a few is acceptable and necessary for the ‘greater good.’”

“We should reject this utilitarian approach and restore medical decision-making to its proper place: between doctors and patients,” he wrote.

Louisiana Republican lawmakers have embraced this sentiment, saying that after the COVID-19 pandemic, they want to see less government involvement in vaccinations.

“I’m pleased that Dr. Abraham has taken this approach,” said Republican state Rep. Kathy Edmonston, who last year authored laws prohibiting Louisiana schools from requiring COVID-19 vaccinations and mandating that they provide exemption information to parents. “I’m not against vaccinations. He’s not against vaccinations. I’m for people being able to make up their own mind.”

Jill Hines, co-director of Health Freedom Louisiana, a group that opposes vaccine mandates, dismissed the significance of ending mass vaccination campaigns, because “everybody should have a primary care physician if they want one, and nobody is really denied access to a vaccine.”

But Kimberly Hood, former assistant secretary of the Louisiana Office of Public Health, noted that the state is largely rural, and many residents don’t have easy access to a health care provider.

“Failing to promote vaccination may not sound like a huge deal, but it actually invalidates what we in public health have seen and learned for many, many years, which is that you have to make it easy, affordable, accessible,” Hood told Stateline.

“It’s not just stepping away from vaccination; we’re stepping away from our kind of obligation together, what it means to live together in a society.”

Staying the course in Mississippi

But in neighboring Mississippi, which is also Republican-dominated, GOP leaders are staying the course — at least so far. More than two dozen anti-vaccine bills have died in the Mississippi legislature in the past two years, including this year’s proposed ban on mRNA vaccines.

The state struggled with COVID-19 vaccine hesitancy during the pandemic, and in 2022 Republican Gov. Tate Reeves signed into law a measure banning COVID-19 vaccine mandates.

But for years, Mississippi maintained one of the highest childhood vaccination rates in the nation. The state slipped from first to third between 2023 and 2024, after a federal judge ruled that the state must allow religious exemptions. Its current childhood vaccination rate is 97.5%, well above the 91% national average but lower than the 99.3% rate it had in 2019.

“Our law is still in effect, and if you don’t have a medical or religious exemption, then you must be fully vaccinated to attend school or go to day care in Mississippi,” said Dr. Daniel Edney, Mississippi’s state health officer. “The science is clear and in Mississippi we stand on the science.”

Edney said he hasn’t faced any political pressure to reverse course. Unlike in Louisiana, where Republican Gov. Jeff Landry tapped Abraham — a former three-term Republican congressman who co-chaired his transition committee — as surgeon general, Edney was selected by the 11-member Mississippi State Board of Health. The governor chooses the members of that panel, but they serve staggered four-year terms.

“I have zero pressure from the governor or legislative leadership regarding our approach to vaccines,” Edney told Stateline. “We’re not focused on politics. We don’t blow in the wind based on what administration is in power.”

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

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