Earlier this month, Vietnam War veteran Paul Cox went to a Department of Veterans Affairs (VA) medical center in St. Louis to visit a sick friend. When he left the hospital, he encountered a woman handing out flyers in its parking lot. “VA workers are being fired,” her leaflet said. “This can hurt your care. This is an assault on the VA. Call or email your Senators and Representatives as soon as you can.”
Cox, a leading Veterans for Peace (VFP) member and supporter of its Save Our VA (SOVA) committee, has distributed similar appeals on many occasions, often to support VA caregivers. So, the longtime VFP activist asked whether she was involved with a labor or veterans’ organization.
It turns out, neither; she was acting on her own, Cox learned. Reading about President Donald Trump’s mass firing of federal employees, she became very worried about the impact on local VA care for her husband. She had typed the flyer herself, taken it to a copy shop, and began hand-billing other patients, staff, and family members.
This grassroots response has become increasingly common since early March when plans for VA job cuts exceeding 80,000 positions made national headlines. Around the country, veterans—along with their caregivers, friends, family, and neighbors—have often reacted with shock and anger.
They have picketed, rallied, called, and emailed Congress, and, where possible, confronted the few Republican representatives still willing to hold town hall meetings despite GOP leadership warnings to lay low. One feisty 80-year-old vet from Virginia even chained himself to a signpost near the White House as a prelude to coordinated March 14 protests. On that date, as Stars and Stripes reported, thousands gathered on the National Mall to defend VA jobs, services, and benefits.
The administration’s opening salvo at the VA involved the blanket dismissal of 2,400 probationary workers, including many former service members. That group and new hires in five other federal departments just got a reprieve in the form of a reinstatement order issued by U.S. District Court Judge William H. Alsup in San Francisco on March 13. The administration is appealing. However, as Alsup warned the union plaintiffs in this case, the VA and other agencies still can downsize based on future Reduction in Force (RIF) plans that are “done right.”
A Headquarters Leak
A March 4 headquarters memo revealed that new Secretary of Veterans Affairs, Doug Collins, plans a RIF from 480,000 employees to 399,957, starting in August. This will return the agency’s headcount to what it was in 2019, and according to that leaked document, “eliminate waste, reduce management and bureaucracy…and increase workforce efficiency.”
In The Hill, Secretary Collins pledged to do this “without making cuts to healthcare or benefits” and warned critics that “we will be making major changes. So get used to it.”
On Capitol Hill, Democrats are warning of the consequences. “The VA,” says Mark Takano, a representative from California, “is on the precipice of destruction” from “a senseless reduction in force.” Takano, the ranking member of the House Veterans Affairs Committee, warns that the VA-run Veterans Health Administration (VHA) will be seriously disrupted—particularly for its hundreds of thousands of new patients with service-related conditions due to past toxic exposure in combat zones or on U.S. military bases.
This enormous influx of disability benefit claimants resulted from the Biden Administration’s passage of the Promise to Address Comprehensive Toxics (PACT) Act in 2022. But, with a VA workforce likely to shrink by 20 percent, veteran advocates fear that will not be met, even with a projected ten-year allocation of $280 billion to fund this expanded coverage.
As a New York Times investigation just confirmed, the VA’s initial job cuts this winter and its Department of Government Efficiency (DOGE)-driven cancellation of hundreds of agreements with outside contractors have already had a chaotic ripple effect.
In the long term, the VHA’s role as a medical research powerhouse, a leading clinical education provider for healthcare professionals, and a backup public hospital system during pandemics or other emergencies will also be jeopardized. Veterans who have filed tens of thousands of disability claims with the VA-run Veterans Benefits Administration (VBA) will face longer delays getting them approved.
Local Leadership Uncertainty
One regional VA administrator contacted by the Washington Monthly (who asked not to be identified) described widespread uncertainty among their colleagues about how to plan for the looming cuts.
“Are we following Office of Management and Budget (OMB) rules, or the rule of law, which requires that we follow certain guidelines, for example, people with the most seniority are the last to go, employees who are veterans are the last to go, employees with high-performance ratings ditto?”
There is little confidence that Republican political appointees—eager to impress Elon Musk’s DOGE team and the White House by meeting their staffing headcounts—have a fundamental understanding of who is “mission critical” at the VHA and who is not. For example, many employees were illegally fired by the first Trump administration under the VA Accountability and Whistleblower Protection Act of 2017, which included housekeepers and food service workers.
As one VHA manager asks, who will feed hospitalized veterans and keep facilities clean if you lay off support staff and don’t replace them? Who will change the sheets on patients’ beds or deep clean a room to prevent the spread of serious hospital-acquired infections like MRSA or Clostridium difficile (C-Diff)?
Another VA official pointed out the adverse safety impact of Collins canceling many agreements with private-sector vendors. One contract covering the Togus, Maine VA Medical Center—since restored after a protest by Senator Angus King, the state’s independent U.S. Senator—was with a firm supplying a radiation safety officer. One VHA leader commented, “How can you safely deliver radiation if you cannot monitor how much you’re giving? How stupid can you be?”
Telehealth Threatened
One well-documented in-house strength of the VHA is its telehealth services. They can even help veterans with kidney problems—not for in-person treatments like dialysis but related meetings with their physicians. One clinician told the Monthly that telehealth is critical for veterans in states like Hawaii, Guam, Alaska, Montana, or Wyoming, with few nephrologists. Many VHA patients with mental health problems also use telehealth sessions to access therapists, who are in short supply in many parts of the country.
Secretary Collins has claimed incorrectly that such services are equally available in the private sector. In fact, in telehealth, the VHA has a significant advantage over private providers because it can operate on a multi-state basis. In the private healthcare industry, if a doctor, nurse, nurse practitioner, physician assistant, or therapist treats an out-of-state patient, they must be licensed in both their state and the patient’s/
The VA’s “Anywhere-to-Anywhere” rule, implemented in 2018 and bolstered in 2020, allows “VA health care professionals to deliver health care in a state other than their home state of licensure, registration, certification, or other state requirement.” This permits doctors, nurses, psychologists, and other providers “to care for any of the VHA’s nine million patients, without regard to state licensing requirements which remain a legal obstacle to other healthcare systems wider use of telemedicine.”
Claims Processing Delays?
Even before the arrival of DOGE cost cutters, VBA staff members faced the challenge of processing new PACT Act-related claims based on 23 medical conditions, ranging from bronchial asthma to rare cancers, which are now considered presumptively related to either burn-pit and other chemical exposures in the military.
VA officials fear that impending job cuts will make it harder for veterans to get medical exams, enabling them to join registries maintained for victims of Agent Orange, Gulf War syndrome, burn-pit, and asbestos exposure.
A union-sponsored survey of several thousand VA staffers conducted in 2022 by the Veterans Healthcare Policy Institute found that most VBA respondents were experiencing unmanageable claims processing workloads. Even then, this was causing more than 60 percent to consider leaving their jobs.
Most VHA participants in this survey said their facilities needed more frontline and administrative/support staff. However, vacancies were not being filled, and sufficient recruitment of new staff was not underway. More than two-thirds reported that their facility’s beds, units, or programs had been closed due to local staffing shortages and budget deficits, even in places with continuing patient demand.
Life and Death Stuff
Three years later, VHA managers—not just union members—foresee such conditions getting much worse, not better. They express particular concern about how cuts to research and direct care will adversely affect patients undergoing cancer treatment.
Patients on clinical trials or even undergoing traditional cancer treatment at the VHA can’t just switch providers overnight. If there is no longer sufficient staff to provide care, their clinical trial will be ended, with no guarantee of its continuation outside the VHA. Outside the veterans/ healthcare system, there can be much longer waits just for an appointment with an oncologist,
“This is life and death stuff,” a VHA administrator told us. “We don’t treat cancer because it’s benign; we treat it—and right away—because it can kill you right away.”
One 50-year-old Army veteran who knows the need for timely treatment is Jose Vasquez, the New York City-based director of Common Defense, a progressive veterans’ organization.
On March 6, his group held an emergency Zoom call on saving the VA with more than 350 participants nationwide. Many of the latter were surprised to see Vasquez appear on the screen lying in bed and dressed in a hospital johnny.
“I am coming to you live from the Manhattan VA,” Vasquez explained. “I’ve just had surgery for pancreatic cancer, and the idea that the Trump administration would want to cut 83,000 positions and fire that many people from VA facilities is ludicrous. The VA just saved my life.”
“It’s getting real,” Vasquez warned. “They’re coming after our veterans’ benefits, but we’re not going down without a fight”—a message echoed by other vets on the call. They pledged to bombard politicians and the press with their stories of life-changing experiences with VA programs and services.
As Common Defense member Vedia Barnett, a disabled vet, told Time this month: “I am not just concerned for myself—I am terrified for our senior veterans. They will bear the brunt of this cruel decision… leaving our most vulnerable without the care they desperately need and deserve.’
