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 seeks 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, 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.