Photo by Megan Lee
Veterans who get their health care from “The VA,” actually the cabinet-level Department of Veterans Affairs, need to be aware that the Trump administration is quietly working to privatize the healthcare facet (Veterans Health Administration, or VHA) of the VA.
In May of 2014, it was alleged that 40 veterans had died while waiting for appointments at the VHA hospital in Phoenix, Arizona. This claim was soon disproven, but investigation revealed that management at that hospital had created a policy of awarding bonuses to hospital employees who misrepresented appointment times. The resulting scandal led to the Veterans Access, Choice, and Accountability Act of 2014, and a three-year trial program known as Veterans
Choice. Based upon the very real circumstances wherein many veterans lived a sizable distance from the nearest VHA facility, and some of those facilities lacked the equipment or professional staff to deal with the veteran’s unique medical or mental status, the Choice program allowed a private vendor company to assign those vets to obtain care at a private or for-profit provider, with payment to that provider to come out of the VA’s budget. At least one of the vendor companies initiated a policy of paying the civilian providers exactly half of what they had billed, and putting the other half into their own corporate coffers.
By 2017, the Choice program had resulted in $2 billion in cost overruns, including $90 million in overbilling by its two main contractors. Before long, a large percentage of private providers refused to see VA/Choice referrals. The contractor companies ignored the problems and referred more and more veterans, regardless of location, to the private sector.
The Choice program was replaced by 2018’s Mission Act, which handed the ball to another vendor corporation, Community Care, which promptly outsourced even more veterans to for-profit walk-in clinics without a referral. Even worse, those private providers are not required to adhere to the VHA’s standards of care, and there is no provision for oversight by the VA to ensure quality of care. Again, payments for these questionable services come out of the VA’s budget. By 2019, the VHA had approximately 67,000 openings for doctors, nurses, psychiatrists, and psychologists, but there were no provisions to increase wages for those positions. Payouts from the VA budget to private providers chosen by Community Care have skyrocketed. Veteran suicides continued to increase at a rate far exceeding that of the general public.
Will referrals of veterans healthcare to the private sector actually result in shorter appointment 
times, or any improvement in the levels of care provided? According to one government study, 77 percent of all U.S. counties face severe shortages of practicing psychiatrists, psychologists, or social workers. Fifty-five percent, all rural counties, have no mental health professionals at all. (Southwest Virginia is an example). Even when private-sector psychiatrists are available, many are unwilling to accept either private insurances or federal reimbursement. Under such “market conditions,” not only do private-sector patients wait too long for appointments, according to the National Institute of Mental Health, 40% of Americans with schizophrenia and 51% suffering from bipolar disorder go untreated in any given year.
By contrast, data available on Capitol Hill in 2018 showed that the waiting time to see a VHA mental health professional averaged four days! And, the VHA personnel are trained to deal with the unique mental issues encountered by combat veterans such as PTSD. Proponents of VA privatization have doggedly refused to require any specialized training for the professionals to whom veterans will be outsourced. While campaigning for a second term as President, Donald Trump denied any familiarity with Project 2025, a guidebook created by the ultra-conservative Heritage Foundation with wide-ranging recommendations for the second Trump regime. Currently, adhering to the Project 2025 script, Trump / DOGE are working to gut the VA which is terribly understaffed, by cutting staff another 80,000.
Even more troubling, the Veterans ACCESS Act, currently being reviewed by committees in both the House and Senate, will, if passed, increase outsourcing of VA medical and mental health patients to the private medical industry. Hidden in the depths of the ACCESS ACT like a ticking time bomb is a provision intended to dismantle the VHA system quicker than you can say “privatization,” enabling all veterans seeking help for addiction or mental health challenges to walk into virtually any private medical or mental health provider and request outpatient care without any VA authorization, referral, approval, or oversight of the care provided.
The ultimate goal of the ACCESS Act, as stated in the Project 2025 playbook, is to eliminate all VA hospitals in approximately three years, and increase the number of Community Based Outpatient Clinics (CBOCs) to re-make VA health care into a chain of facilities resembling “urgent care” clinics. Within a very few years, the VA would be transformed into an insurance company, only able to pay the private industry from its $369 billion annual budget.
This project is already under way. Elon Musk’s DOGE has already fired 2,400 VA employees, a Reduction in Force (RIF) order was issued February 26th, and the goal is to reduce the VA’s employee count by 80,000 in the short term.
It should be noted that passage of the PACT Act, allowing VA coverage of ailments related to toxic substances such as Agent Orange in Vietnam veterans, and smoke from toxic burn pits in Iraq and Afghanistan, has resulted in the addition of 400,000 more VA patients, and is expected to add another 400,000 in the near future. DOGE has also cut the VA’s research into muscular dystrophy, ALS (Lou Gehrig’s Disease), and assorted cancers.
President Trump’s new Secretary of Veterans Affairs Doug Collins has predicted that cuts to the VA’s workforce will “eliminate waste, reduce management and bureaucracy…and increase workforce efficiency.” 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.”
Surveys indicate that 92% of veterans currently getting their health care from the VA prefer to get their care from it. Studies consistently show that VA health care is equal to or better than private-sector care without even considering that the VA is the only entity suited to treat medical and psychological issues specific to military service.
Again, the Veterans ACCESS Act is awaiting action in committees in both the U.S. Senate and the House of Representatives, and veterans are urgently needed to contact their Reps and Senators and urge them to deny this unscrupulous bill. A call to the U.S. Capitol switchboard at (202) 224-3121 will guide you to the specific phone number for your Representative or Senator. If you hope to have VA medical care in the (near) future, you need to call today.
The post Veterans VA Healthcare is Threatened appeared first on CounterPunch.org.
This content originally appeared on CounterPunch.org and was authored by John Ketwig.