On 9/11, first responders rushed to help. Unfortunately, their own lives were being put in jeopardy as they breathed in asbestos, benzene and other toxic dust at Ground Zero, increasing their cancer risk.
Years later, the Zadroga Act was passed to care for these first responders. It created the federally funded World Trade Center Health Program under the umbrella of the National Institute of Occupational Safety and Health (NIOSH). The program provides lifetime monitoring and treatment to responders, 150,000 of whom were enrolled as of 2025, reports ABC News, (up from 76,000 in 2015).
The program has been a great success, with New York City Fire Department (FDNY) data revealing 86% of participants are still alive five years after a cancer diagnosis compared with 66% of patients diagnosed but not part of it. A bill had even been introduced to provide additional funding.
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Unfortunately, the program is no longer working as intended, due to uncertainty created by the Trump administration — and this will have consequences.
"This is a program with zero fraud that only does one thing: It saves lives," Michael Barasch, partner at Barasch & McGarry, a law firm representing thousands of first responders and 9/11 survivors, told ABC News.
"Mark my words: People will die without it."
Confusion about staffing causes chaos
The normal operation of the World Trade Center Health Program has been interrupted as the Trump administration continues to alter staffing levels.
Early in 2025, there was a 20% staffing cut, with 16 doctors and nurses losing their jobs, ABC News reported. NIOSH director, Dr. John Howard was also taken out of his position as administrator. Then, many of the terminated workers saw their jobs reinstated in February, although it wasn’t clear if Howard’s position had been restored or not, despite the doctor requesting an official decision.
In April, another round of layoffs hit 15 employees. However, this has also now been reversed, with the administration going a step beyond previous reinstatements because the new letter sent to workers made clear the termination was canceled entirely. In the past, many workers were only brought back temporarily to train replacements.
While the reinstatements are good news, they don’t undo the damage done or the future uncertainty.
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9/11 first responders pay the price
Workers may be back on the job soon, but disastrous things happened while they were off.
"We postponed chemotherapy for a firefighter this week, hoping this could be fixed," Dr. David Prezant, chief medical officer of the FDNY and director of its World Trade Center Health Program told ABC News.
"He’s too young for Medicare, and this delay may cost him his life."
This firefighter was one of three who had treatment interrupted, putting them all at risk since every moment can count when it comes to fighting cancer.
Unfortunately, many people have also been denied the opportunity to start treatment, as they aren’t eligible to begin until their illness is certified as being caused by exposure on 9/11. The certification must be signed by Howard, and an internal Department of Health and Human Services newsletter shared with ABC explained that the program had "been directed not to process any new certifications."
Prezant told ABC that this a clear sign Howard hadn’t actually been reinstated, and explained that while clinics found a workaround and started treating some patients under initial approvals while awaiting certification, this loophole was recently shut down.
This pause on enrollment will affect 9/11 first responders throughout the country, and Barasch thinks lawmakers are simply unaware of how big the scope is.
"People in all 50 states are enrolled in the program. Thousands of them no longer live near the original attack sites. They need care where they are," he explained.
If the latest staff reinstatements last, this could provide opportunities for responders nationwide to get the help they need. Further, despite the chaos, there is reason for optimism in the long term as the Trump administration insists it doesn’t want to end the World Trade Center Health Program, nor does it intend to end other critical functions NIOSH performs.
"Those programs were not terminated, as the media has reported. But they’ve simply been consolidated into a place that makes more sense," Health Secretary Robert F. Kennedy Jr. said in a recent interview, explaining they would be merged into a newly-created agency dubbed the Administration for a Healthy America.
Other programs that were on the chopping block have also been granted at least a temporary reprieve, with some food safety workers at various FDA labs also receiving notification that recent layoffs had been reversed.
Still, since the Trump administration has already gone through multiple hiring and firing cycles, it remains unclear how safe any of these NIOSH operations have a stable future.
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This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
