ACP policy update 2025: How cuts to HHS could impact physicians and patients

Brian Outland, PhD, director of regulatory affairs at the American College of Physicians, breaks down the practical consequences of a massive reorganization underway at the Department of Health and Human Services (HHS) — including a 20,000-person workforce reduction and agency consolidations.

“For a primary care physician, it can mean access to patient care for them,” Outland said. “With some of the changes that are happening, especially thinking about Medicaid … millions of American patients will perhaps lose their health care coverage.”

He explained that combining federal departments while cutting staff may lead to slower appeals processing and delayed data for value-based care programs — directly affecting private and independent practices. “If they are in a value-based payment program, getting their reports and … information back to be able to see where they are … [may slow down],” Outland said. “If they are perhaps in a fee-for-service … the appeals [may be] slowed down, which then causes a backup and [delays in] reimbursement.”

Outland also noted the emotional toll of disrupted access to care. “Physicians love their patients … just not being able to see them because they don’t have insurance is quite heartbreaking.”

The restructuring of HHS — including the creation of a new "Healthy America" administration and elimination of programs like the Administration for Community Living — could intensify operational strain across the health care system.