Thomas Engels began his political career as Wisconsin Governor Tommy Thompson's Deputy Press Secretary.

Serving as the Deputy Secretary of the Wisconsin Department of Health Services from 2015 to 2019, Thomas Engels expanded mental health services, implemented an electronic system for managing state medical records, and increased staffing at long-term care facilities.

During Thomas Engels' time serving as Deputy and Acting Administrator of the Health Resources and Services Administration (HRSA) since April 2019, he was responsible for increasing access to health care for those who are isolated by geography, impoverished, or medically incapable.

He focused on confronting the opioid epidemic, increasing the workforce providing behavioral health services, and improving medical access for rural communities.

[3] In February of 2025, Engels was named as HRSA Administrator by President Donald Trump.