Chapter 20. Department of Veterans Affairs

    Chapter Author with input from Darin Selnick, Paul R. Lawrence, and Christopher Anderson

  • Brooks D. Tucker

    former Acting Chief of Staff, US Department of Veterans Affairs (VA); former Assistant Secretary for Congressional and Legislative Affairs at the VA; and a former Marine Corps Lt. Col. He helped craft the policy framework for President-elect Trump’s transition team._

Key Points

  • On Day One, eliminate Biden VA policies new administration
  • On Day One, remove all senior Biden appointees/federal appointees
  • Act early to be ready for Day One labor reform implementation and legal challenges
  • Eliminate VA support for abortion, gender reassignment surgery, diversity initiatives, and align all policies with conservative pro-life values
  • Increase private sector delivery of VA health services, administration of benefits

STC 2025 Commentary

Tucker has limited criticism of the Biden administration’s governance of the VA; his discussion suggests a grudging respect for the present management of the VA, apart from chronic problems like slowness, inadequate hiring, and inheritance of a growing caseload of claims related to exposure to toxins. His opposition to “Left” policies on gender, diversity and equity, and to abortion and gender assignment surgery services for veterans are in line with other authors and Project 2025’s overall goal of eradicating gender, DEI and diversity reforms from government policies. His call to increase use of private non-VA providers, clinics, and companies to help assess VA disability claims reflect a conservative position that favors shifting federal dollars and authority to the private sector, where possible.

Full Summary

Tucker opens his review and call for reforms of the VA by stating the agency was in poor shape back in 2014, and improved by 2020 by adopting a “Veteran-centric” approach to the VA’s mission providing for veterans’ needs and experiences in the key areas of health care, benefits, and memorial affairs. While reviewing management challenges facing the sprawling VA, his chief focus for reform is a call to eliminate social policies related to the promotion of gender, equity, and inclusivity — or the “Left’s pernicious trend of abusing the role of government to further its own agenda.”

The VA currently serves 18 million veterans nationally; of these 6.4 million of 9.1 million enrolled use the VA for health care; the remainder use employer-sponsored plans, Tricare, Medicare, and Medicaid. The VA operates 172 inpatient VA Medical Centers (VAMCs), which are an average of 60 years old, and 1,113 Community Based Outpatient Clinics (CBOCs), which are newer facilities. The VA also manages a Community Care Network (CCN) through contracts with Optum and TriWest, third-party health care administrators.

Meanwhile, VA benefits are administered through 56 Regional Benefits Offices (RBOs) and hundreds of satellite sites around the country.

While crediting the Biden administration for maintaining good VA governance practices, Tucker critiques its failure to maintain “a genuine ‘Veteran-centric’ philosophy, with respect to health care delivery and its ‘bias’ in expanding the unionized federal employee workforce.” He sharply criticizes the VA’s policy of “social equity and inclusion” in departmental policy discussions that, he says, affect only a small number of veterans — a veiled reference to LGBTQ+ soldiers, particularly transgender veterans. He aims vitriol at the VA’s provision of

legal abortion “for the first time,” calling it part of “the grotesque culture of violence against the child in the womb,” and argues that the VA lacks the legal authority and clinical competency to do perform the medical procedure.

Tucker cites a persistent lag in processing and delivering timely benefits to veterans as a problem that the next administration will inherit, given a current backlog of cases that multiplied over decades as more attention was given to the long-term health harms to veterans caused by their field exposure to defoliant chemicals and airborne toxins, including Agent Orange during Vietnam and newer chemical weapons since then. The VA has chronically struggled to hire enough people to process new disability claims and adjudicate appeals, Tucker states. Although VA budgets are high, the agency must improve its service delivery to veterans.

Proposed reforms include:

  • Rescind all VA clinical policy directives deemed contrary to principles of conservative governance, starting with abortion services and gender reassignment surgery
  • Focus on shifting demographics, regional migration and needs of older versus new veterans
  • Restore and implement Trump administration VA MISSION policy to expand health care delivery to more third-party, non-VA private health care providers that Biden administration decreased; expand Community Based Outpatient Clinics (CBOCs)
  • Adopt a Veteran’s Bill of Rights and codify VA MISSION policy to clarify veterans benefits and support greater access to private health providers by revising Community Care regulations (particularly Sections 101, 103, 104, 152, 161)
  • Encourage VA Medical Centers to seek out relevant academic and private sector input to improve patient experience
  • In fiscal oversight, conduct an independent audit of the VA like the 2018 DoD
  • Review rising infrastructure costs and VA facility use to align with needs
  • Extend the Under Secretary for Health’s term to five years and consider appointing them to a second five-year term “to protect the USH from political transition”
  • Streamline the process for reviewing disability claims, improve management, hire more private companies to help, develop a new pilot “Express 30” commitment to review claims in 30 days
  • Upgrade the VA’s performance by embracing technology and tech training for personnel
  • Hire more veterans and their spouses to work in the VA
  • Eliminate/rescind all Biden VA policies on Day One of a new administration
  • On Day One, transfer all executive-level appointees to ensure political control of the VA
  • Hire more Limited Term Appointment Senior Executive Service positions (up to 3 years)
  • Be prepared to enact labor reforms quickly and anticipate the legal challenges
  • Sunset the Office of Accountability and Whistleblower Protection (OAWP)
  • De-link the Human Resources Administration and Office of Security and Preparedness (OSP) as their missions are too different