How Bloated Is HHS And Will Bobby Streamline? Musk Will Probably DOGE Indian Health…

Written by Closed VAERS on March 7, 2025. Posted in Current News

In my last article HERE we got all the agencies under HHS onto the table. Sure we all hear about FDA, CDC, NIH, CMS and maybe HRSA but who knew there were so many agencies?

The yearly operating cost of the United States Department of Health and Human Services (HHS) can be understood through its annual budget, which reflects the total funding allocated for its operations, programs, and services. For Fiscal Year (FY) 2025, the proposed budget for HHS includes $130.7 billion in discretionary budget authority and $1.7 trillion in mandatory budget authority, totaling approximately $1.83 trillion.

This figure aligns with recent trends, as the FY 2024 budget was estimated at $1.7 trillion, and the FY 2020 budget was reported at $1.293 trillion, showing a general increase over time.

The budget encompasses both discretionary spending, which covers operational costs like staff salaries, administrative expenses, and discretionary grants, and mandatory spending, which funds programs like Medicare and Medicaid that are required by law.

With over 80,000 employees and 115 programs across 11 operating divisions—such as the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the Centers for Medicare & Medicaid Services (CMS)—this budget supports a wide range of activities, from public health initiatives to social services.

However, “operating cost” can sometimes imply the cost of running the department itself (e.g., salaries, facilities, and administrative overhead) rather than the total budget, which includes massive program expenditures.

While exact figures for administrative overhead alone are not isolated in the provided data, posts on X and web sources consistently cite the total budget—ranging from $1.6 trillion to $1.83 trillion in recent years—as the key figure associated with HHS’s annual operations. For instance, the discretionary portion ($130 billion in FY 2025) gives a sense of the scale of non-mandatory operational funding, but the full $1.83 trillion reflects the department’s total yearly cost to function and deliver its mission.

Thus, based on the most current proposal for FY 2025, the yearly operating cost of HHS, in terms of its total budget, is approximately $1.83 trillion. This number encapsulates both its direct operational expenses and the extensive programmatic spending that defines its role in the federal government.

I created this simple interactive dashboard this HERE so we can take a look at the employees and average salaries to see if we can spot some bloat which is why I singled out Indian Health Services. Yikes!

Please see the “How To” video below for the explanation, but just know when in the dashboard using your laptop or mobile phone you can click the “Substack” or vaersaware.com logo to launch back to my website or this article. I compiled all this information from Grok and it goes as follows:

1. National Institutes of Health (NIH):
   • Workforce: ~18,000 employees.
   • Average Salary: ~$100,000 (based on federal GS scale trends and role complexity).
   • Total: 18,000 × $100,000 = $1.8 billion annually.
2. Centers for Disease Control and Prevention (CDC):
   • Workforce: 10,000-12,000 employees (using 11,000 as midpoint).
   • Average Salary: ~$100,000 (2018 data adjusted for inflation from $1.1 billion payroll for 10,639 staff).
   • Total: 11,000 × $100,000 = $1.1 billion annually.
3. Food and Drug Administration (FDA):
   • Workforce: ~18,000 employees.
   • Average Salary: ~$100,000 (aligned with Glassdoor/PayScale 2025 estimates).
   • Total: 18,000 × $100,000 = $1.8 billion annually.
4. Centers for Medicare & Medicaid Services (CMS):
   • Workforce: ~6,500 employees.
   • Average Salary: ~$110,000 (reflecting higher GS levels for administrative roles).
   • Total: 6,500 × $110,000 = $715 million annually.

Additional Key HHS Agencies

5. Health Resources and Services Administration (HRSA):
   • Workforce: ~2,500 employees (per 2023 estimates, stable into 2025).
   • Average Salary: ~$95,000 (federal average adjusted for public health roles).
   • Total: 2,500 × $95,000 = $237.5 million annually.
   • Note: HRSA oversees grants and health center programs, with a modest direct staff.
6. Agency for Healthcare Research and Quality (AHRQ):
   • Workforce: ~300-500 employees (small agency, estimated at 400).
   • Average Salary: ~$110,000 (research-focused, higher-end GS scale).
   • Total: 400 × $110,000 = $44 million annually.
   • Note: AHRQ’s budget is $477 million (FY 2025 request), with payroll a small fraction.
7. Administration for Children and Families (ACF):
   • Workforce: ~1,200-1,500 employees (estimated 1,350 from 2020 data).
   • Average Salary: ~$90,000 (social service administration roles).
   • Total: 1,350 × $90,000 = $121.5 million annually.
   • Note: ACF’s $73 billion budget is mostly grants, not staff costs.
8. Indian Health Service (IHS):
   • Workforce: ~15,000 employees (including tribal hires, per 2023 reports).
   • Average Salary: ~$85,000 (mix of clinicians and support, lower than NIH/FDA).
   • Total: 15,000 × $85,000 = $1.275 billion annually.
   • Note: IHS’s $9.1 billion FY 2025 request includes significant direct care.
9. Substance Abuse and Mental Health Services Administration (SAMHSA):
   • Workforce: ~600-700 employees (estimated 650).
   • Average Salary: ~$100,000 (specialized mental health roles).
   • Total: 650 × $100,000 = $65 million annually.
   • Note: SAMHSA’s $7.5 billion budget is grant-heavy.

Broader HHS Context

• Total HHS Workforce: Over 80,000 employees (FY 2025 contingency plan cites 90,512 total, with 49,625 retained during lapses).
• Office of the Secretary and Other Staff Divisions: ~15,000-20,000 employees (e.g., 15,447 in 2020 per OpenPayrolls). At $90,000 average (mixed roles), this adds ~$1.35-$1.8 billion.
• HHS-Wide Salary Estimate: If 90,000 employees average $100,000 (a reasonable federal benchmark), total payroll could reach $9 billion. However, agency-specific totals above sum to ~$8.16 billion (excluding minor offices), suggesting unaccounted staff or lower averages in some areas.

Assumptions and Gaps

• Salaries reflect GS scale norms ($63,000-$160,000 for GS-9 to GS-15), adjusted for locality (e.g., D.C. area) and inflation to 2025.
• Exact payrolls aren’t public; estimates use workforce size × average salary, cross-checked with budget proportions (10-30% for personnel).
• Smaller offices (e.g., ASPR, AHRQ) and the Public Health Service Commissioned Corps (~6,000 officers) add minor costs, likely under $1 billion combined.

Total Cumulative Estimate

Summing major agencies: NIH ($1.8B) + CDC ($1.1B) + FDA ($1.8B) + CMS ($715M) + HRSA ($237.5M) + AHRQ ($44M) + ACF ($121.5M) + IHS ($1.275B) + SAMHSA ($65M) = ~$7.158 billion. Adding ~$1.5 billion for the Office of the Secretary and others brings the total to approximately $8.6-$9 billion for HHS agency salaries in 2025. This aligns with the $130.7 billion discretionary budget’s personnel share and the $1.83 trillion total budget’s administrative slice.

So, the total cumulative HHS agency staff salary is roughly $8.6 to $9 billion annually, based on current estimates.

Admin. For Strategic Preparedness and Response (ASPR):

ASPR’s workforce has grown significantly in recent years. A January 2025 GAO report notes that ASPR’s staff doubled from about 1,000 in FY 2019 to nearly 2,000 by FY 2022, largely due to contract staff during the COVID-19 response, though it suggests a reduction as that winds down.

The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) lists 1,089 total staff, with 784 (72%) retained during a funding lapse—669 exempt (61%, funded by carryover) and 115 excepted (11%). This 1,089 figure likely reflects a core staff count, excluding some contractors or temporary hires. Posts on X from mid-February 2025 report layoffs of “nearly all probationary staff” (estimated 10-20% of total), suggesting a pre-layoff headcount of 1,200-1,500. For 2025, I’ll estimate ~1,200 employees post-layoffs, balancing the 1,089 baseline with growth trends and partial contractor retention.

Average Salary

ASPR staff include emergency managers, scientists, and administrators, often at higher GS levels (GS-12 to GS-15). The federal GS scale for 2025 (D.C. locality) ranges from ~$90,000 (GS-12) to $160,000+ (GS-15). Glassdoor (2023-2025) estimates an HHS-wide average of $92,973, trending toward $100,000-$110,000 with inflation.

ASPR’s specialized roles (e.g., BARDA, National Disaster Medical System) likely push this higher. FederalPay.org’s 2015 CMS average of $124,991 suggests $130,000-$140,000 by 2025 with raises. I’ll use $120,000 as an average, reflecting a mix of senior technical staff and support roles, slightly above NIH/FDA ($100,000) but below ARPA-H ($130,000).

Cumulative Salary Calculation

• Workforce: 1,200 employees.
• Average Salary: $120,000 per year.
• Total: 1,200 × $120,000 = $144,000,000, or $144 million annually.

Budget Context

ASPR’s FY 2025 budget isn’t isolated in the $1.83 trillion HHS request, but its $2.2 billion FY 2023 appropriation (web data) and reliance on carryover funds (e.g., $1.5 billion multi-year) suggest a lean operation. Payroll at $144 million is 6.5% of $2.2 billion, reasonable for a response-focused agency with significant contract and grant spending. If staff were 1,500 pre-layoffs, the total could have been $180 million (1,500 × $120,000), dropping to $144 million after a 20% cut (300 staff).

Final Estimate

The total cumulative ASPR staff salary for 2025 is approximately $144 million, based on 1,200 employees at $120,000 each. This could range from $130 million (1,089 staff) to $160 million (higher headcount or salaries), but $144 million fits current data and post-layoff adjustments noted on X. Exact figures aren’t public, so this is an informed estimate.

Office of Inspector General (OIG):

The HHS OIG oversees fraud, waste, and abuse in HHS programs, with a workforce of auditors, investigators, attorneys, and support staff. The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) lists OIG with 1,592 total staff, with 1,167 (73%) retained during a funding lapse—1,057 (66%) exempt (funded by carryover or HCFAC funds) and 110 (7%) excepted (e.g., for critical duties).

This is slightly down from FY 2023’s 1,604 staff (1,177 retained), reflecting minor adjustments. Web sources (oig.hhs.gov, February 2025) and posts on X consistently cite ~1,600 employees, a stable figure over recent years. I’ll use 1,592 as the 2025 count, with a range to 1,600 for consistency with public statements.

Average Salary

OIG staff include specialized roles—auditors, criminal investigators, attorneys—typically at GS-11 to GS-15 levels, with some SES appointees. For 2025, D.C.-area GS salaries range from ~$75,000 (GS-11) to $160,000+ (GS-15) with locality pay, while SES caps at $221,900 (Level IV). Glassdoor (2023-2025) estimates an OIG average of ~$100,000-$110,000 across 60 salaries, trending higher with inflation. FederalPay.org (2020) reported an average of $102,502, adjusting to ~$120,000 by 2025.

The Inspector General earns $243,700 (Level I), but this is an outlier. Given OIG’s skilled workforce and top workplace ranking (Partnership for Public Service, 2025), I’ll use $130,000 as an average, matching OCR and ASFR, above NIH’s $100,000, reflecting its expertise.

Cumulative Salary Calculation

• Workforce: 1,592 employees.
• Average Salary: $130,000 per year.
• Total: 1,592 × $130,000 = $206,960,000, or $206.96 million annually.

Budget Context

OIG’s FY 2025 budget request is $499.7 million (oig.hhs.gov, March 2024), with personnel typically 30-50% of such budgets. At $206.96 million, payroll is ~41%, plausible for a staff-heavy oversight agency. Comparatively, NIH’s $1.8 billion payroll is ~3.9% of its $46.4 billion budget, but OIG’s smaller scope and enforcement focus justify a higher percentage. If staff were 1,600 at $140,000, the total would be $224 million, still fitting. OS Staff Divisions’ $850 million (7,087 staff) excludes OIG, which has its own line item.

Final Estimate

The total cumulative OIG staff salary for 2025 is approximately $207 million, based on 1,592 employees at $130,000 each. This could range to $192 million (1,600 staff at $120,000) or $224 million (1,600 staff at $140,000), but $207 million aligns with the latest staffing data and budget context. Exact payroll isn’t public, so this is an informed estimate.

Assistant Secretary for Health (ASH):

The Office of the Assistant Secretary for Health (OASH) oversees public health policy, the U.S. Public Health Service Commissioned Corps (PHSCC), and 10 regional health offices, but its direct staff is distinct from the broader PHSCC (~6,500 uniformed officers). The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) lists ASH with 1,119 total staff, with 404 (36%) retained during a funding lapse—328 (29%) exempt (funded by carryover or other sources) and 76 (7%) excepted (e.g., for critical duties).

This 1,119 figure is up from 1,089 in FY 2023 (404 retained), reflecting slight growth. Earlier estimates (e.g., FY 2020: 1,013 staff) and posts on X (early 2025) suggest stability around 1,100-1,200, excluding PHSCC officers not directly under ASH’s payroll. I’ll use 1,119 as the precise 2025 count, with a possible range to 1,200 for minor hiring adjustments.

Average Salary

ASH staff include public health experts, policy advisors, and administrators, often at GS-12 to GS-15 levels, with the Assistant Secretary potentially a four-star admiral (PHSCC) or civilian at $203,700 (Level III Executive Schedule, 2025). For 2025, D.C.-area GS salaries range from ~$90,000 (GS-12) to $160,000+ (GS-15) with locality pay. Glassdoor (2023-2025) estimates an HHS average of $92,973, trending to $100,000-$110,000.

OpenPayrolls’ 2020 OS average of $78,731 adjusts to ~$90,000-$100,000, but ASH’s specialized roles (e.g., disease prevention, science policy) push it higher. I’ll use $120,000 as an average, matching ASA and ASPR, reflecting its skilled workforce and D.C. base, though below ASFR’s $130,000 due to less financial focus.

Cumulative Salary Calculation

• Workforce: 1,119 employees.
• Average Salary: $120,000 per year.
• Total: 1,119 × $120,000 = $134,280,000, or $134.28 million annually.

Budget Context

ASH’s costs are part of the Office of the Secretary’s budget within HHS’s $130.7 billion FY 2025 discretionary request (of $1.83 trillion total). OS Staff Divisions’ 7,087 staff at $120,000 average would total ~$850 million; ASH’s $134.28 million is ~16% of this, reasonable for a prominent public health arm. If staff reached 1,200 at $130,000, the total would be $156 million, still fitting OS’s scope. Comparatively, ASA’s $36 million (300 staff) and ASFR’s $65 million (500 staff) suggest ASH’s larger size aligns with its broader mandate.

Final Estimate

The total cumulative ASH (OASH) staff salary for 2025 is approximately $134.3 million, based on 1,119 employees at $120,000 each. This could range to $120 million (1,000 staff) or $156 million (1,200 staff at $130,000), but $134.3 million matches the latest staffing data and context. Exact payroll isn’t public, so this is an informed estimate. If you meant a different “ASH,” please clarify, but I’ve assumed OASH fits your pattern.

Office of Medicare Hearings and Appeals (OMHA):

OMHA administers the nationwide Administrative Law Judge (ALJ) hearing program for Medicare appeals (Level 3), with headquarters in Arlington, VA, and 10 field offices (e.g., Miami, Cleveland, Irvine).

The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) lists OMHA with 672 total staff, with 335 (50%) retained during a funding lapse—259 (39%) exempt (funded by carryover or other sources) and 76 (11%) excepted (e.g., for critical duties). This is up from FY 2023’s 652 staff (328 retained), reflecting modest growth.

OMHA’s staff includes ALJs (50-70, per hhs.gov bios and field office estimates), attorney adjudicators, and support personnel (e.g., legal assistants, IT). HHS.gov (January 2025) notes 10 field offices averaging 50-60 staff each, plus a centralized docketing division (50-100). Posts on X (February 2025) suggest ~700 staff, aligning with hiring trends (USAJobs listings, 2025). I’ll use 672 as the 2025 count, with a range to 700 for potential expansion.

Average Salary

OMHA staff span GS-11 to GS-15 levels, with ALJs on a separate pay scale ($191,900-$210,700, 2025 ALJ rates). GS salaries in D.C./Arlington range from $75,000 (GS-11) to $160,000+ (GS-15) with locality pay. Glassdoor (2023-2025) estimates an HHS average of $92,973, trending to $110,000, but OMHA’s legal focus pushes it higher. The Chief ALJ may earn $221,900 (SES Level IV), per 2025 pay tables. I’ll use $140,000 as an average, matching OGA and DAB, reflecting ALJs ($200,000) balanced with lower GS support staff (~$90,000-$120,000), above IEA’s $130,000 due to judicial roles.

Cumulative Salary Calculation

• Workforce: 672 employees.
• Average Salary: $140,000 per year.
• Total: 672 × $140,000 = $94,080,000, or $94.08 million annually.

Budget Context

OMHA’s FY 2016 budget was $140 million (hhs.gov, 2015), with projections of growth to handle a backlog (1.2 million claims, FY 2015). The FY 2025 HHS budget doesn’t isolate OMHA, but its $94.08 million payroll fits within the $130.7 billion discretionary request (of $1.83 trillion total). At ~67% of the 2016 budget, this suggests personnel dominate costs, plausible for an adjudication-focused office. If staff were 700 at $150,000, the total would be $105 million, still reasonable. Comparatively, OIG’s $207 million (1,592 staff) reflects a larger scope.

Final Estimate

The total cumulative OMHA staff salary for 2025 is approximately $94.1 million, based on 672 employees at $140,000 each. This could range to $89.6 million (640 staff at $140,000) or $105 million (700 staff at $150,000), but $94.1 million aligns with the latest staffing data and context. Exact payroll isn’t public, so this is an informed estimate.

Office of the General Counsel (OGC):

The OGC provides legal services across HHS, with headquarters in Washington, D.C., and 10 regional offices. The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) lists OGC with 672 total staff, with 364 (54%) retained during a funding lapse—306 (46%) exempt (funded by carryover or other sources) and 58 (9%) excepted (e.g., for critical duties). This matches FY 2023’s 672 staff (364 retained), showing stability.

OGC’s structure includes divisions like the General Law Division, Legislative Division, and CMS Division, plus regional counsel (e.g., Region IX, San Francisco). HHS.gov (January 2025) lists leadership (e.g., General Counsel Sam Bagenstos) and 10-15 named attorneys per region, suggesting ~100-150 regional staff, with the rest at HQ (500-550). Posts on X (February 2025) and web estimates (e.g., 600-700 staff) align with this. I’ll use 672 as the 2025 count, with a range to 700 for slight growth or contractor inclusion.

Average Salary

OGC staff are primarily attorneys, legal analysts, and support personnel, spanning GS-11 to GS-15 levels, with some SES appointees. For 2025, D.C.-area GS salaries range from ~$75,000 (GS-11) to $160,000+ (GS-15) with locality pay, while SES caps at $221,900 (Level IV). Glassdoor (2023-2025) estimates an HHS attorney average of ~$120,000-$140,000, trending higher by 2025. OpenPayrolls’ 2020 OS average of $78,731 adjusts to ~$90,000-$100,000, but OGC’s legal expertise pushes it up. The General Counsel earns $221,900 (SES), per 2025 pay tables. I’ll use $150,000 as an average, above OMHA’s $140,000, reflecting a higher concentration of senior attorneys vs. ALJs and support staff.

Cumulative Salary Calculation

• Workforce: 672 employees.
• Average Salary: $150,000 per year.
• Total: 672 × $150,000 = $100,800,000, or $100.8 million annually.

Budget Context

OGC’s costs are within the Office of the Secretary’s budget, part of HHS’s $130.7 billion FY 2025 discretionary request (of $1.83 trillion total). OS Staff Divisions’ 7,087 staff at $120,000 average totals ~$850 million; OGC’s $100.8 million is ~11.9%, fitting its legal scope. Comparatively, OMHA’s $94.1 million (672 staff) and OIG’s $207 million (1,592 staff) bracket OGC’s mid-to-high range. If staff were 700 at $160,000, the total would be $112 million, still plausible.

Final Estimate

The total cumulative OGC staff salary for 2025 is approximately $100.8 million, based on 672 employees at $150,000 each. This could range to $94.1 million (672 staff at $140,000) or $112 million (700 staff at $160,000), but $100.8 million aligns with the latest staffing data and context. Exact payroll isn’t public, so this is an informed estimate.

Office for Civil Rights (OCR):

The OCR enforces federal civil rights, conscience, and health privacy laws (e.g., HIPAA), operating with headquarters in Washington, D.C., and 10 regional offices. The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) lists OCR with 532 total staff, with 245 (46%) retained during a funding lapse—177 (33%) exempt (funded by carryover or other sources) and 68 (13%) excepted (e.g., for critical duties). This is down slightly from FY 2023’s 546 staff (247 retained), reflecting minor adjustments.

OCR’s structure includes an Enforcement Division, Policy Division, and Strategic Planning Division (reorganized in 2023), per HHS announcements. Historical data notes a 45% staff drop since FY 2016 (civilrights.org, 2024), implying a peak of ~965 staff then (532 ÷ 0.55), though current levels stabilized around 500-550. Posts on X (February 2025) and HHS.gov (January 2025) don’t indicate major shifts. I’ll use 532 as the 2025 count, with a range to 550 for potential hires.

Average Salary

OCR staff include attorneys, investigators, policy analysts, and administrators, typically at GS-11 to GS-15 levels. For 2025, D.C.-area GS salaries range from ~$75,000 (GS-11) to $160,000+ (GS-15) with locality pay. Glassdoor (2023-2025) estimates an HHS average of $92,973, trending to $110,000. OpenPayrolls’ 2020 OS average of $78,731 adjusts to ~$90,000-$100,000, but OCR’s legal and enforcement roles suggest higher pay. The Director’s salary could reach $221,900 (SES Level IV), per 2025 pay tables. I’ll use $130,000 as an average, matching ASFR and ASPE, above ASPA’s $120,000, reflecting OCR’s skilled, specialized workforce.

Cumulative Salary Calculation

• Workforce: 532 employees.
• Average Salary: $130,000 per year.
• Total: 532 × $130,000 = $69,160,000, or $69.16 million annually.

Budget Context

OCR’s FY 2025 budget request isn’t isolated in the $1.83 trillion HHS total, but advocacy groups (civilrights.org, 2024) push for $80 million, double FY 2024’s $40 million enacted, to address staffing strain. At $130,000 per staff, $40 million supports ~308 employees, suggesting 532 includes carryover-funded or reallocated staff. OS Staff Divisions’ 7,087 staff at $120,000 total ~$850 million; OCR’s $69.16 million is ~8%, fitting its enforcement role. If staff were 550 at $140,000, the total would be $77 million, aligning with funding pleas.

Final Estimate

The total cumulative OCR staff salary for 2025 is approximately $69.2 million, based on 532 employees at $130,000 each. This could range to $65 million (500 staff at $130,000) or $77 million (550 staff at $140,000), but $69.2 million matches the latest staffing data and context. Exact payroll isn’t public, so this is an informed estimate.

Assistant Secretary for Financial Resources (ASFR):

ASFR serves as HHS’s financial and budget oversight arm, encompassing the Immediate Office, Office of Budget, Office of Finance, Office of Grants, and Office of Acquisitions. The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) doesn’t break out ASFR’s staff separately but includes it within the Office of the Secretary (OS) Staff Divisions, totaling 7,087 employees, with 2,111 (30%) retained during a lapse—1,592 (22%) exempt and 519 (7%) excepted. ASFR is one of several OS staff divisions (e.g., ASA, ASL, ASPA), alongside the Immediate Office (~100 staff).

Exact ASFR staffing isn’t public, but its scope—overseeing budget, finance, grants, and acquisitions—suggests a larger workforce than ASA’s administrative focus. Historical data (e.g., Federal Register updates) and web sources (HHS.gov, 2025) list ASFR sub-offices with roles like Deputy Assistant Secretaries and division directors, implying a robust team. I’ll estimate ~500 employees for ASFR, a reasonable share of OS’s 7,087, reflecting its critical functions (larger than ASA’s ~300 but smaller than operating divisions like NIH’s 18,000). This aligns with posts on X speculating 400-600 staff, considering its enterprise-wide reach.

Average Salary

ASFR staff include financial analysts, budget experts, grants specialists, and senior leaders, typically at GS-12 to GS-15 levels. For 2025, D.C.-area GS salaries range from ~$90,000 (GS-12) to $160,000+ (GS-15) with locality pay. Glassdoor (2023-2025) estimates an HHS average of $92,973, trending to $100,000-$110,000. OpenPayrolls’ 2020 OS average of $78,731 adjusts to ~$90,000-$100,000 by 2025, but ASFR’s senior roles (e.g., Chief Financial Officer duties, per Federal Register, 2023) push it higher. The Assistant Secretary’s salary is $203,700 (Level III Executive Schedule, 2025), skewing the average. I’ll use $130,000, above ASA’s $120,000, reflecting ASFR’s technical and leadership intensity.

Cumulative Salary Calculation

• Workforce: 500 employees.
• Average Salary: $130,000 per year.
• Total: 500 × $130,000 = $65,000,000, or $65 million annually.

Budget Context

ASFR’s costs fall under the OS budget within HHS’s $130.7 billion FY 2025 discretionary request (part of $1.83 trillion total). If OS’s 7,087 staff averaged $120,000, that’s ~$850 million; ASFR’s $65 million is ~7.6% of this, plausible for a key financial hub. Comparatively, ASA’s $36 million for 300 staff is ~4%, supporting ASFR’s larger estimate. If staff were 400 or 600, the total would range from $52 million to $78 million, still fitting OS’s scope.

Final Estimate

The total cumulative ASFR staff salary for 2025 is approximately $65 million, based on 500 employees at $130,000 each. This could range from $52 million (400 staff) to $78 million (600 staff), but $65 million balances its role and staffing trends. Exact figures aren’t public, so this is an informed estimate.

Agency for Toxic Substances and Disease Registry (ATSDR):

ATSDR’s exact staff count for 2025 isn’t fully detailed in public sources, but historical and recent data provide a basis. The FY 2010 budget reported “roughly 300 full-time employees” (not including contractors), per Wikipedia, while a 2009 congressional hearing noted a decline from 500 to about 300 staff.

The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) doesn’t isolate ATSDR’s total but indicates it operates under CDC oversight, with a joint Office of the Director with the National Center for Environmental Health (NCEH). A 2024 Global Biodefense profile estimates “approximately 400” multidisciplinary staff (epidemiologists, toxicologists, etc.), including 10 regional offices. Posts on X in early 2025 suggest a range of 300-500, reflecting possible contractor inclusion. Given growth trends and a stable mission, I’ll estimate ~400 employees for 2025, balancing the 300 (2010) and 400 (2024) figures, assuming modest expansion but no major layoffs like ASPR’s.

Average Salary

ATSDR staff—scientists, public health experts, and administrators—typically fall under the General Schedule (GS) pay scale. For 2025, GS salaries in Atlanta (ATSDR’s headquarters) range from ~$85,000 (GS-12) to $150,000+ (GS-15) with locality adjustments. Glassdoor (2023-2025) estimates an HHS-wide average of $92,973, trending to $100,000-$110,000 with inflation. FederalPay.org’s 2015 CMS average of $124,991 suggests $130,000-$140,000 by 2025. ATSDR’s specialized roles (e.g., toxicologists) likely exceed the CDC’s $100,000 average (from my CDC estimate). I’ll use $115,000 as an average, slightly above NIH/FDA ($100,000) but below ARPA-H ($130,000), reflecting its technical focus and Atlanta’s cost of living.

Cumulative Salary Calculation

• Workforce: 400 employees.
• Average Salary: $115,000 per year.
• Total: 400 × $115,000 = $46,000,000, or $46 million annually.

Budget Context

ATSDR’s FY 2010 operating budget was $76.8 million, with payroll (~$34.5 million at 300 × $115,000) at ~45%, high due to its small size and staff intensity. The FY 2025 CDC budget request includes $9.683 billion in discretionary funds, but ATSDR’s share isn’t broken out; its $46 million payroll would be a tiny fraction of CDC’s total, plausible for a sub-agency. If staff were 500, the total would be $57.5 million (500 × $115,000), still reasonable within historical budgets (e.g., $74.7 million in FY 2008).

Final Estimate

The total cumulative ATSDR staff salary for 2025 is approximately $46 million, based on 400 employees at $115,000 each. This could range to $34.5 million (300 staff) or $57.5 million (500 staff), but $46 million fits current estimates and context. Exact payroll isn’t public, so this is an informed approximation.

Assistant Secretary for Administration (ASA):

ASA oversees HHS-wide administration—human resources, IT, operations, and facilities—but its direct staff is relatively small, as it’s a coordinating office, not a large agency. The FY 2025 HHS Contingency Staffing Plan (December 16, 2024) doesn’t isolate ASA’s staff but provides a total for the Office of the Secretary (OS) Immediate Office and Staff Divisions: 7,087 employees, with 2,111 (30%) retained during a lapse—1,592 (22%) exempt and 519 (7%) excepted. ASA is one of several OS staff divisions (e.g., ASA, ASL, ASPA), alongside the Immediate Office (~100 staff).

Historical data helps narrow it down. OpenPayrolls.com (2020) lists 15,447 employees under “Office of the Secretary of HHS,” with an average salary of $78,731, but this likely includes overlap with operating divisions. More focused estimates suggest OS staff divisions total ~15,000-20,000 (per earlier HHS-wide breakdowns), with ASA as a subset.

Web sources (HHS.gov, 2025) describe ASA managing offices like the Office of Human Resources (OHR) and Office of the Chief Information Officer (OCIO), but don’t specify headcounts. Given its scope, ASA likely employs 200-500 staff directly, with additional personnel in sub-offices counted under OS totals. I’ll estimate ~300 employees for ASA’s core staff, a reasonable fraction of OS’s 7,087, reflecting its leadership role without inflating beyond typical staff division sizes (e.g., AHRQ’s 294).

Average Salary

ASA staff include senior administrators, HR specialists, IT professionals, and policy experts, typically at GS-12 to GS-15 levels. For 2025, D.C.-area GS salaries range from ~$90,000 (GS-12) to $160,000+ (GS-15) with locality pay. Glassdoor (2023-2025) estimates an HHS average of $92,973, trending to $100,000-$110,000. OpenPayrolls’ 2020 OS average of $78,731 suggests $90,000-$100,000 by 2025 with inflation, but ASA’s leadership focus (e.g., Assistant Secretary salary at $203,700, Level III Executive Schedule, per 2025 pay tables) pushes the average higher. I’ll use $120,000, matching ASPR and AHRQ, as ASA’s staff likely skews toward senior grades.

Cumulative Salary Calculation

• Workforce: 300 employees.
• Average Salary: $120,000 per year.
• Total: 300 × $120,000 = $36,000,000, or $36 million annually.

Budget Context

ASA’s costs are embedded in the HHS Office of the Secretary’s FY 2025 budget, part of the $130.7 billion discretionary request within the $1.83 trillion total HHS budget. OS Staff Divisions don’t have isolated budgets, but if 7,087 OS staff averaged $100,000, that’s $708.7 million total; at $120,000, it’s $850 million. ASA’s $36 million would be ~4-5% of this, plausible for a key administrative arm. If staff were 500, the total would be $60 million, still fitting OS’s scope.

Final Estimate

The total cumulative ASA staff salary for 2025 is approximately $36 million, based on 300 employees at $120,000 each. This could range to $24 million (200 staff) or $60 million (500 staff), but $36 million aligns with its role and OS staffing patterns. Exact payroll isn’t public, so this is an informed estimate.

Office of Intergovernmental and External Affairs (IEA):

The HHS Center for Faith-Based and Neighborhood Partnerships (CFBNP) acts as a liaison to faith-based and community organizations, operating under the Office of Intergovernmental and External Affairs (IEA). Exact staffing numbers aren’t detailed in the FY 2025 HHS Contingency Staffing Plan (December 16, 2024) under a specific CFBNP line item, as it’s not listed among the major staff divisions (e.g., ASA, ASH) or operating divisions.

However, HHS.gov (updated January 2025) and staff bios suggest a small, specialized team. Named staff include Clintandra Thompson (Communications Specialist), Heidi Christensen (Senior Advisor), Katherine (Special Assistant), and Ben O’Dell (Management Analyst), totaling at least 4 known employees. Historical context from the Obama-era White House Office of Faith-Based and Neighborhood Partnerships (13 agency centers) indicates these offices are lean, often with 5-20 staff.

Given its role and visibility (e.g., hosting webinars, per X posts in February 2025), I’ll estimate ~15-20 employees for 2025. The FY 2025 Contingency Plan lists the broader Office of the Secretary (OS) Staff Divisions at 7,087, but CFBNP likely falls under IEA or a separate OS bucket.

A conservative estimate of 20 staff aligns with its modest scope—larger than a minimal office like ASL (94) but far smaller than ASH (1,119). I’ll use 20 as the 2025 count, with a range of 15-25 for flexibility.

Average Salary

CFBNP staff include communications specialists, policy advisors, and analysts, typically at GS-12 to GS-15 levels. For 2025, D.C.-area GS salaries range from ~$90,000 (GS-12) to $160,000+ (GS-15) with locality pay. Glassdoor (2023-2025) estimates an HHS average of $92,973, trending to $100,000-$110,000. OpenPayrolls’ 2020 OS average of $78,731 adjusts to ~$90,000-$100,000, but CFBNP’s expertise (e.g., Ben O’Dell’s 20+ years, per HHS.gov) suggests a higher range.

The Assistant Secretary-level leadership (if applicable) earns $203,700 (Level III Executive Schedule, 2025), but this office may report to a lower tier. I’ll use $120,000 as an average, matching ASA and ASPA, reflecting its skilled, D.C.-based team, though below ASFR’s $130,000 due to less financial focus.

Cumulative Salary Calculation

• Workforce: 20 employees.
• Average Salary: $120,000 per year.
• Total: 20 × $120,000 = $2,400,000, or $2.4 million annually.

Budget Context

CFBNP’s costs are embedded in the Office of the Secretary’s budget or IEA, part of HHS’s $130.7 billion FY 2025 discretionary request (within $1.83 trillion total). OS Staff Divisions’ 7,087 staff at $120,000 average totals ~$850 million; CFBNP’s $2.4 million is ~0.3% of this, fitting its niche role. Comparatively, ASL’s $12.2 million (94 staff) and ASPA’s $14.3 million (119 staff) dwarf CFBNP, supporting its smaller estimate. If staff were 25 at $130,000, the total would be $3.25 million, still reasonable.

Final Estimate

The total cumulative staff salary for the HHS Center for Faith-Based and Neighborhood Partnerships for 2025 is approximately $2.4 million, based on 20 employees at $120,000 each. This could range to $1.8 million (15 staff at $120,000) or $3.25 million (25 staff at $130,000), but $2.4 million aligns with its size and context. Exact payroll isn’t public, so this is an informed estimate based on staffing clues and HHS norms.

So you get the picture and in the interest of time I’ll spare you the details of the last 10 agencies…

Conclusion:

I know it’s hard to see the snake in the grass, but you can definitely see the bloat. So it’s roughly a little over 8 billion a year in salaries, but total operating costs is $130 billion for discretionary administrative costs like facilities and grants. $1.8 trillion in total budget? I guess the next step would be to figure out what the annual budget is for each agency minus the discretionary operating costs and see where that other $1.6 trillion is going?

Paying all the doctors, labs, hospitals, SNF’s, ASC’s for services rendered through Medicare & Medicaid probably isn’t even the lions share either?

I bet you there’s a huge amount of money being syphoned off for all the administration fees for the Medicare Part C, Advantage Plans aka Obama Care aka Affordable Care aka UnitedHealthcare aka Optum! Optum isn’t the only snake just the biggest.

By the way, I think I’m going to be shocked looking at CMS budget over time, their staff should be shrinking as they are hardly any longer processing insurance claims. It’s rare to even find a patient with straight Medicare or Medicaid these days. It’s all HMO managed care. I would usually see newly minted Medicaid or Medicare patients have straight non-managed care only for their first month before they get automatically pushed into a managed care. God Bless.

Bobby better have a pro like me in his corner. I’m sure they are going to try and hide RCM experts like me from Bobby…

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