A few days ago, Robert F. Kennedy Jr., the health secretary, embarked on a media tour to defend his decision to lay off thousands of his department’s workers.
He announced a plan last week to cut 10,000 jobs, in addition to the estimated 10,000 jobs cut through retirements and buyouts in the early weeks of the Trump administration.
Mr. Kennedy had called the Health and Human Services Department “the biggest agency in government, twice the size of the Pentagon, $1.9 trillion dollars,” during an interview with NewsNation. He went on to suggest that the department was doing little to improve the health of Americans, “with all the money that was being thrown at it, with all the personnel that were being brought in.”
H.H.S. does spend more than the Department of Defense, which has a discretionary budget of about $850 billion. But according to several budget experts, the overwhelming majority of the H.H.S. department’s $1.8 trillion budget is not spent on its staff.
Spending on personnel at the federal health agencies accounts for a small fraction of its budget — less than 1 percent, according to three budget experts. That includes the staff of the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health and others.
The overwhelming majority of the money is spent through Medicare, for the health care of people older than 65, or through Medicaid, for people with low incomes. Those funds filter out to hospitals, clinics, nursing homes, dialysis centers, pharmaceutical companies, medical device makers and Medicare Advantage private insurance plans.