Trump Administration and DOGE Eliminate Staff Who Help Older Adults and People With Disabilities

As we highlighted last week, Elon Musk’s Department of Government Efficiency (DOGE) and Robert F. Kennedy, Jr.—the newly installed head of the U.S. Department of Health and Human Services (HHS)—have fired thousands of people across many agencies and announced plans for sweeping organizational changes. This week, the terminations continue, targeting agencies and programs that support older adults and people with disabilities, especially those with limited resources.

Here’s a summary of the impacted programs serving older adults and people with disabilities.

Medicare-Medicaid Coordination Office: Supports Dually Eligible Beneficiaries

Some of the latest firings target the Medicare-Medicaid Coordination Office (MMCO) within the Centers for Medicare & Medicaid Services (CMS), which works to help these two complex programs coordinate and function more seamlessly for enrollees by identifying opportunities for improved care and savings. This work is vital because of the challenges dually eligible people face when they try to navigate both sets of coverage, including delays or denials of care, convoluted appeals processes, duplicated and wasteful services, and administrative burdens.

At least one-third of the MMCO staff have been fired…

At least one-third of the MMCO staff have been fired, leaving the agency—and people who are dually eligible for Medicare and Medicaid—in an untenable position.

Low-Income Home Energy Assistance Program: Helps Families Afford Home Energy Bills

The massive layoffs have also targeted the Low-Income Home Energy Assistance Program (LIHEAP). Each year, LIHEAP helps 6 million families with young children, older adults, and people with disabilities pay their heating and cooling bills. This assistance makes it possible for them to avoid dangerous temperatures and exorbitant utility costs and live safely in their homes. All staff who run the program have been fired.

All staff who run the program have been fired.

Offices that Prioritize Minority Health and Combatting Infectious Diseases

HHS’s Office of Minority Health (OMH) has also been slashed. As its name suggests, this office is dedicated to improving the health of racial and ethnic minority populations who have been historically underserved and overlooked, and who bear a disproportionate burden of disease due to worse health outcomes over time resulting directly and indirectly from racism.

Similarly, the Office of Infectious Diseases and HIV/AIDS Policy is being dismantled. Like OMH, this office’s name contains its focus; in its own words: “Our vision is a world free of infectious diseases. Our mission is to provide strategic leadership and management, while encouraging collaboration, coordination, and innovation among federal agencies and stakeholders to reduce the burden of infectious diseases.” Despite breakthroughs in treating and managing HIV/AIDS, the disease remains a serious condition for over 1 million people in the United States, including many older adults.

Administration for Community Living: Helps People Stay in Their Homes and Communities

Additional details have come out about firings at and the dismantling of the Administration for Community Living (ACL). This includes the termination of the entire Center for Policy and Evaluation, which analyzes services and programs dedicated to supporting long-term services and supports, employment for people with disabilities, family caregiver supports, and consumer rights and protections. The reassignment of ACL’s programs is likely to cause significant disruption and raises major questions about the impacts on access to care and community-based providers.

Latest Cuts Build on Previous DOGE Harms

All of these layoffs come on top of previous assaults on the Social Security Administration—some fueled only by personal animus without regard to impact or outcome— that have increased wait times, decreased data security, and stretched the capacity of the already understaffed agency.

These cuts do not reflect a thoughtful strategy to improve program performance, or to eliminate fraud, waste and abuse.

Together, these cuts do not reflect a thoughtful strategy to improve program performance or eliminate fraud, waste, and abuse. Indeed, some of the very people and groups targeted for elimination empower, train, and support volunteer watchdogs against fraud, while other changes are likely to worsen efficiency, the customer experience, and taxpayer costs.

Medicare Rights has worked closely with these agencies and others to help people gain access to the services they need and bridge gaps in the Medicare and Medicaid programs. These firings have been done in a rushed, reckless way that does not take into account the vital work done by the experts and professionals within these agencies nor the impact the cuts will have on the people they serve. And the changes are not just in staffing, as those in power have cut accommodations that make the federal government accessible and accountable for people with disabilities—like American Sign Language interpreters to help those who are Deaf or hard-of-hearing access information—and eliminated research into helping people with disabilities get jobs. We strongly oppose the undermining of HHS, SSA, and other federal agencies that provide necessary services to build health and economic security.

Further Reading

Read more about firings at HHS.

Read more about threats to SSA data privacy.