human services

WASHINGTON — The Trump administration is facing a new legal complaint from a group of government employees affected by a policy that went into effect Thursday that eliminates coverage for gender-affirming care in federal health insurance programs.

The complaint, filed Thursday on the employees’ behalf by the Human Rights Campaign, is in response to an August announcement from the Office of Personnel Management that it would no longer cover “chemical and surgical modification of an individual’s sex traits through medical interventions” in health insurance programs for federal employees and U.S. Postal Service workers.

The complaint argues that denying coverage of gender-affirming care is sex-based discrimination and asks the personnel office to rescind the policy.

“This policy is not about cost or care — it is about driving transgender people and people with transgender spouses, children, and dependents out of the federal workforce,” Human Rights Campaign Foundation President Kelley Robinson said in a statement.

The complaint, filed with the Equal Employment Opportunity Commission, includes testimonies from four current federal workers at the State Department, Health and Human Services and the Postal Service who would be directly affected by the elimination of coverage.

For instance, the Postal Service employee has a daughter whose doctors recommended that she get puberty blockers and potentially hormone replacement therapy for her diagnosed gender dysphoria, which would not be covered under the new policy, according to the complaint.

The complaint notes that the workers are making the claim on behalf of themselves and a “class of similarly situated federal employees.”

The Trump administration has taken other steps to restrict care for transgender Americans, particularly minors. In December, the U.S. Department of Health and Human Services released proposals that would block gender-affirming care to minors, including a policy that would bar Medicare and Medicaid dollars to hospitals that provide such care to children.

Senior Trump officials, such as Health and Human Services Secretary Robert F. Kennedy Jr., call gender-affirming care “malpractice” for minors. But such restrictions go against recommendations from major medical groups such as the American Medical Assn. and the American Academy of Pediatrics.

WASHINGTON — In the whirlwind first year of President Trump’s second term, some of the most polarizing changes have taken place within the Department of Health and Human Services, where Robert F. Kennedy Jr. has openly rebuffed the medical establishment as he converts the ideas of his Make America Healthy Again movement into public policy.

Since entering office in February, the Health secretary has overseen a dramatic reshaping of the agencies he oversees, including eliminating thousands of jobs and freezing or canceling billions of dollars for scientific research. As part of his campaign against chronic disease, he has redrawn the government’s position on topics such as seed oils, fluoride and Tylenol. He also has repeatedly used his authority to promote discredited ideas about vaccines.

The department’s rapid transformation has garnered praise from MAHA supporters who say they long viewed Health and Human Services as corrupt and untrustworthy and have been waiting for such a disruption. And both Democrats and Republicans have applauded some of the agency’s actions, including efforts to encourage healthy eating and exercise, and deals to lower the prices of costly drugs.

But many of the drastic changes Kennedy has led at the department are raising grave concerns among doctors and public health experts.

“At least in the immediate or intermediate future, the United States is going to be hobbled and hollowed out in its scientific leadership,” said Lawrence Gostin, a Georgetown University public health law professor who was removed from a National Institutes of Health advisory board this year with a letter that said he was no longer needed. “I think it will be extraordinarily difficult to reverse all the damage.”

Department spokesperson Andrew Nixon denied any threat to scientific expertise at the agency and lauded its work.

“In 2025, the Department confronted long-standing public health challenges with transparency, courage, and gold-standard science,” Nixon said in a statement. “HHS will carry this momentum into 2026 to strengthen accountability, put patients first, and protect public health.”

The overhaul comes alongside broader uncertainties in the nation’s health system, including Medicaid cuts passed by Congress this year and expiring Affordable Care Act subsidies that are putting millions of Americans’ insurance coverage in jeopardy.

Here’s a closer look at Kennedy’s first year leading the nation’s health agency:

Kennedy’s vaccine views ripple across the department

After many years spent publicly assailing vaccines, Kennedy sought during his confirmation process to reassure senators he wouldn’t take a wrecking ball to vaccine science. But less than a year later, his Health Department has repeatedly pushed the limits of those commitments.

In May, Kennedy announced the Centers for Disease Control and Prevention would no longer recommend COVID-19 vaccines for healthy children and pregnant women — a move immediately questioned by public health experts who saw no new data to justify the change.

In June, Kennedy fired an entire 17-member CDC vaccine advisory committee — later installing several of his own replacements, including multiple vaccine skeptics.

That group has made decisions that have shocked medical professionals, including declining to recommend COVID-19 shots for anyone, adding new restrictions on a combination shot against chickenpox, measles, mumps and rubella and reversing the long-standing recommendation that all babies receive a hepatitis B shot at birth.

Kennedy in November also personally directed the CDC to abandon its position that vaccines do not cause autism, without supplying any new evidence to support the change. Although he left the old language on the agency website to keep a promise he made to Republican Sen. Bill Cassidy, he added a disclaimer saying it remained because of the agreement.

Public health researchers and advocates strongly refute the updated website and note that scientists have thoroughly explored the issue in rigorous research spanning decades, all pointing to the same conclusion that vaccines don’t cause autism.

Kennedy has promised a wide-ranging effort to study environmental factors that potentially contribute to autism and in an Oval Office event with Trump in September promoted unproven — and in some cases discredited — ties among Tylenol, vaccines and the complex brain disorder.

Kennedy reconfigures department with massive staffing and research cuts

Within two months of taking office, Kennedy announced a sweeping restructuring of Health and Human Services that would shut down entire agencies, consolidate others into a new one focused on chronic disease and lay off about 10,000 employees on top of 10,000 others who had already taken buyouts.

Although parts of the effort are still tied up in court, thousands of the mass layoffs were allowed to stand. Those and voluntary departures significantly thinned out the sprawling $1.7-trillion department, which oversees food and hospital inspections, health insurance for roughly half of the country and vaccine recommendations.

Kennedy also has fired or forced out several leaders at the department, among them four directors at the National Institutes of Health, the Food and Drug Administration’s former vaccine chief and a director of the CDC whom he had hired less than a month earlier.

On top of staffing reductions, he has overseen significant cuts to scientific research. That includes the NIH slashing billions of dollars in research projects and the termination of $500 million in contracts to develop vaccines using mRNA technology.

Amid the cuts, Kennedy has proposed or funded some new research on topics related to his MAHA goals, including autism, Lyme disease and food additives.

MAHA gains momentum despite some stumbles

Kennedy started using the phrase “MAHA” on the campaign trail last year to describe his crusade against toxic exposures and childhood chronic disease, but 2025 was the year it became ingrained in the national lexicon.

In his tenure so far, the Health secretary has made it the centerpiece of his work, using the MAHA branding to wage war on ultra-processed foods, pressure companies to phase out artificial food dyes, criticize fluoride in drinking water and push to ban junk food from the program that subsidizes grocery store runs for low-income Americans.

The idea has even spread beyond Kennedy’s agency across the federal government.

Defense Secretary Pete Hegseth has appeared with Kennedy to promote fitness with pull-up displays. Transportation Secretary Sean Duffy teamed up with Kennedy in early December to announce $1 billion in funding for airports to install resources including playgrounds and nursing pods for mothers and babies. And Environmental Protection Agency administrator Lee Zeldin recently announced he is working toward unveiling a MAHA agenda with health-related goals for his own department.

MAHA has earned widespread popularity among the American public — even as it has endured some administration foibles. In May, for example, Health and Human Services faced scrutiny for releasing a MAHA report that contained several citations to studies that didn’t exist.

But to the extent that the initiative has included calls to action that aren’t based on science — such as urging distrust in vaccines or promoting raw milk, which is far more likely than pasteurized milk to lead to illness — critics say it can be dangerous.

Swenson writes for the Associated Press.

The American Academy of Pediatrics sued the U.S. Department of Health and Human Services on Wednesday, seeking to block nearly $12 million in cuts to the group.

Earlier this month, the federal government “abruptly terminated” grants to the group, the lawsuit says.

The funding supported numerous public health programs, including efforts to prevent sudden unexpected infant death, strengthen pediatric care in rural communities and support teens facing substance use and mental health challenges.

“AAP does not have other sources of grant funding to replace the federal awards, and without the necessary funds it must immediately terminate its work on its dozens of programs that save children’s lives every day,” says the lawsuit, filed in the U.S. District Court for the District of Columbia. “Within a few weeks, AAP will have to begin laying off employees dedicated to this critically important work.”

The suit alleges Health and Human Services made the cuts in retaliation for the doctors’ group speaking out against the Trump administration’s positions and actions.

The doctors’ group has been vocal about its support for pediatric vaccines and has publicly opposed the agency’s positions. Health Secretary Robert F. Kennedy Jr. — who helped lead the anti-vaccine movement for years — is seeking to broadly remake federal policies on vaccines. Earlier this year, the pediatrics group released its own recommendations on COVID-19 vaccines, which substantially diverged from the government’s recommendations.

The group also supports access to gender-affirming care and has publicly criticized Health and Human Services positions on the topic, saying it opposes what it calls the government’s infringements on the doctor-patient relationship.

“The Department of Health and Human Services is using federal funding as a political weapon to punish protected speech, trying to silence one of the nation’s most trusted voices for children’s well-being by cutting off critical public health funding in retaliation for speaking the truth,” Skye Perryman, president and chief executive officer of Democracy Forward, said in a statement. Perryman’s organization is representing the doctors’ group in the case.

A spokesman for Health and Human Services could not immediately be reached for comment.

Mark Del Monte, CEO and executive vice president of the 67,000-member doctors’ group, said the organization depends on its relationship with the federal government.

“We need this partnership to advance policies that prioritize children’s health. These vital child health programs fund services like hearing screenings for newborns and safe sleep campaigns to prevent sudden unexpected infant death,” he said in a statement. “We are forced to take legal action today so that these programs can continue to make communities safer and healthier.” 

Ungar writes for the Associated Press.

Former Nebraska U.S. Sen. Ben Sasse, a conservative who rebuked political tribalism and stood out as a longtime critic of President Trump, announced Tuesday he was diagnosed with advanced pancreatic cancer.

Sasse, 53, made the announcement on social media, saying he learned of the disease last week and is “now marching to the beat of a faster drummer.”

“This is a tough note to write, but since a bunch of you have started to suspect something, I’ll cut to the chase,” Sasse wrote. “Last week I was diagnosed with metastasized, stage-four pancreatic cancer, and am gonna die.”

Sasse was first elected to the Senate in 2014. He comfortably won reelection in 2020 after fending off a pro-Trump primary challenger. Sasse drew the ire of GOP activists for his vocal criticism of Trump’s character and policies, including questioning his moral values and saying he cozied up to adversarial foreign leaders.

Sasse was one of seven Republican senators to vote to convict the former president of “ incitement of insurrection ” after the Jan. 6, 2021, attack on the U.S. Capitol. After threats of a public censure back home, he extended his critique to party loyalists who blindly worship one man and rejected him for his refusal to bend the knee.

He resigned from the Senate in 2023 to serve as the 13th president of the University of Florida after a contentious approval process. He left that post the following year after his wife was diagnosed with epilepsy.

Sasse, who has degrees from Harvard, St. John’s College and Yale, worked as an assistant secretary of Health and Human Services under President George W. Bush. He served as president of Midland University, a small Christian university in eastern Nebraska, before he ran for the Senate.

Sasse and his wife have three children.

“I’m not going down without a fight. One sub-part of God’s grace is found in the jawdropping advances science has made the past few years in immunotherapy and more,” Sasse wrote. “Death and dying aren’t the same — the process of dying is still something to be lived.”