What is the Administration for a Healthy America?

In March, HHS announced major restructuring plans, which included cutting around 10,000 jobs and creating the Administration for a Healthy America.

According to HHS, it planned to combine multiple health agencies into the Administration for a Healthy America, which would "centralize core functions such as human resources, information technology, procurement, external affairs, and policy."

Specifically, the Administration for a Healthy America would combine the following agencies into one entity:

• The  Office of the Assistant Secretary for Health
• The  Health Resources and Services Administration (HRSA)
• The  Substance Abuse and Mental Health Services Administration (SAMHSA)
• The  Agency for Toxic Substances and Disease Registry
• The  National Institute for Occupational Safety and Health

The new agency's work will focus on "areas including primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development" for low-income Americans, HHS said.

In its proposed budget, HHS requested $20 billion to create the Administration for a Healthy America. Specifically, HHS requested $7.1 billion in discretionary funding for primary care initiatives, $1.1 billion for maternal and child health programs, $5.8 billion for mental and behavioral health programs, and various other funding for research and workforce programs.

The Administration for a Healthy America would also have $500 million in policy, research, and evaluation funding allocated to support any "Make America Healthy Again" initiatives, including a focus on chronic childhood diseases. However, many specific programs, like those focused on preventing childhood lead poisoning, bolstering the healthcare workforce, and advancing rural health initiatives, would be eliminated.

In its budget, HHS also proposed eliminating dozens of other programs like rural hospital flexibility grants, state rural health offices, screening programs for newborn heritable disorders, a firearms injury and mortality prevention research program, a traumatic brain injury prevention program, and a variety of workforce programs.

The unanswered questions

So far, there are few details about what the Administration for a Healthy America would do or how it would function. However, Jeff Davis, health policy director at McDermott+ Consulting, said the new agency will likely continue to provide services like technical assistance and grant distribution.

It is also unknown who Kennedy and President Donald Trump choose to run the Administration for a Healthy America and manage it programs, how its branches will be organized and financed, and how it will be staffed, Davis added.

Congress also has a role to play, Davis noted. HHS may lack the statutory authority for some aspects of the reorganization, and new legislation might be necessary to codify the Administration for a Healthy America and shut down HRSA, SAMHSA, and various other programs, he said.

Ann Greiner, president and CEO of the advocacy group Primary Care Collaborative, said the healthcare industry is watching to see whether the Administration for a Healthy America will maintain critical functions from agencies like HRSA and SAMHSA.

The Trump administration has espoused preventive care and reducing chronic illnesses, and since these are rooted in primary care, providers are concerned whether the new approach will disrupt the system, Greiner said.

"You can draw a bright line between lack of access to primary care and poor health," she said.