By REBECCA BOONE and AMANDA SEITZ

Attorneys general in 19 states and Washington, D.C., are challenging cuts to the U.S. Health and Human Services agency, saying the Trump administration’s massive restructuring has destroyed life-saving programs and left states to pick up the bill for mounting health crises.

The lawsuit was filed in federal court in Rhode Island on Monday, New York Attorney General Letitia James said. The attorneys general from Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Michigan, Maryland, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Washington, Wisconsin and the District of Columbia signed onto the complaint.

Health Secretary Robert F. Kennedy Jr. restructured the agency in March, eliminating more than 10,000 employees and collapsing 28 agencies under the sprawling HHS umbrella into 15, the attorneys general said. An additional 10,000 employees had already been let go by President Donald Trump’s administration, according to the lawsuit, and combined the cuts stripped 25% of the HHS workforce.

“In its first three months, Secretary Kennedy and this administration deprived HHS of the resources necessary to do its job,” the attorneys general wrote.

Kennedy has said he is seeking to streamline the nation’s public health agencies and reduce redundancies across them with the layoffs. The cuts were made as part of a directive the administration has dubbed, “ Make America Healthy Again.”

HHS is one of the government’s costliest federal agencies, with an annual budget of about $1.7 trillion that is mostly spent on health care coverage for millions of people enrolled in Medicare and Medicaid.

James, who is leading the lawsuit, called the restructuring a “sweeping and unlawful assault” that would endanger lives.

“This is not government reform. This is not efficiency,” James said during a press conference Monday.

The cuts have resulted in laboratories having limited testing for some infectious diseases, the federal government not tracking cancer risks among U.S. firefighters, early childhood learning programs left unsure of future funds and programs aimed at monitoring cancer and maternal health closing, the attorneys general say. Cuts at the Centers for Disease Control and Prevention also have hampered states’ ability to respond to one of the largest measles outbreaks in recent years, the lawsuit says.

“This chaos and abandonment of the Department’s core functions was not an unintended side effect, but rather the intended result,” of the “MAHA Directive,” they said. They want a judge to vacate the directive because they say the administration can’t unilaterally eliminate programs and funding that have been created by Congress.

The restructuring eliminated the entire team of people who maintain the federal poverty guidelines used by states to determine whether residents are eligible for Medicaid, nutrition assistance and other programs. A tobacco prevention agency was gutted. Staff losses also were significant at the Substance Abuse and Mental Health Services Administration.

The Trump administration is already facing other legal challenges over cuts to public health agencies and research organizations. A coalition of 23 states filed a federal lawsuit in Rhode Island last month over the administration’s decision to cut $11 billion in federal funds for COVID-19 initiatives and various public health projects across the country.

This story has been updated to correct that the lawsuit is filed in federal court in Rhode Island.

Boone reported from Boise, Idaho and Seitz reported from Washington, D.C.