Outside the Beltway

Chaos at the Veterans Administration?

Massive cuts are seriously undermining the mission.

James Joyner · Monday, March 10, 2025 · 5 comments

NYT (“Chaos at the V.A.: Inside the DOGE Cuts Disrupting the Veterans Agency“):

While Trump administration officials have promised to preserve core patient services, initial cuts at the V.A. have nonetheless spawned chaotic ripple effects. They have disrupted studies involving patients awaiting experimental treatments, forced some facilities to fire support staff and created uncertainty amid the mass cancellation, and partial reinstatement, of hundreds of contracts targeted by Mr. Musk’s Department of Government Efficiency.

The changes have shaken the veterans department, which stands out in the labyrinth of agencies and offices under siege by Mr. Trump and Mr. Musk.

It is in many ways a natural target for reform — a bureaucratic behemoth with roughly 480,000 employees, some 90,000 contracts and a documented history of scandals and waste. But it also treats 9.1 million veterans, provides critical medical research and, according to some studies, offers care that is comparable to or better than many private health systems. Even Project 2025, the conservative governing blueprint assembled by Trump allies, said the V.A. had transformed into “one of the most respected U.S. agencies.”

The V.A. is also one of the most politically sensitive departments in the government, serving a constituency courted heavily by Republicans, including Mr. Trump, who has made overhauling the agency a talking point since his 2016 campaign.

Now, with V.A. Secretary Doug Collins vowing a much deeper round of cuts — eliminating some 80,000 jobs and reviewing tens of thousands of contracts — some Republican lawmakers are warning that the tumultuous process risks undoing recent progress.

There are rumors that Congress has the authority to legislate on budgetary matters, but I have not been able to confirm.

Among the 2,400 employees fired from the V.A. since Mr. Trump’s inauguration are workers who purchase medical supplies, schedule appointments and arrange rides for patients to see their doctors. Many are veterans themselves. All were “probationary” employees, meaning they were relatively new on the job and had fewer legal protections. Some may be reinstated, pending court action.

[…]

Although the Veterans Affairs Department is better known for the health care it provides, conducting scientific research is one of the agency’s core missions, offering veterans early access to cutting-edge treatments that are still in clinical trials.

With 170 hospitals nationwide — and patients who tend to volunteer for studies at higher rates than civilians — the V.A. has pioneered studies that often seek to enroll large numbers of patients at multiple sites across the country.

Some of the agency’s research focuses on conditions that disproportionately afflict veterans like traumatic brain injury, spinal cord and blast injuries. But the V.A. is also credited with landmark discoveries such as aspirin’s ability to prevent heart attacks, the first cardiac pacemaker and the nicotine patch.

Mr. Trump’s Jan. 20 executive order freezing government hiring cut off many of the V.A.’s critical research staff midway through studies, said Rashi Romanoff, the chief executive of the National Association of Veterans’ Research and Education Foundations, an association that supports partnerships between the veterans department and nonprofits.

If their appointments are not renewed, “any work with the V.A. must be suspended; they can’t have contact with patients; they have no access to data,” Ms. Romanoff said.

[…]

In an initial push in late February, the V.A. tried to cancel roughly 875 contracts. The list of cuts was “provided” by DOGE, according to emails reviewed by The Times, with a directive that “terminations should begin as quickly as possible.”

“No more paying consultants to do things like make Power Point slides and write meeting minutes!” Mr. Collins wrote in a social media post announcing the cuts.

But senior V.A. officials were soon making frantic appeals to roll some of them back.

In an email, one official wrote that the contracts on the termination list included over 100 that “were deemed to be mission critical,” adding that their cancellation would “lead to catastrophic mission failure for essential veteran programs or health care operations.” The email highlighted services like sterilizing medical equipment, maintaining boilers and generators, filling prescriptions and overseeing human clinical trials, some of which were previously highlighted by The Washington Post.

Within minutes, Dr. Steven Lieberman, the acting under secretary for health, underscored the message. “Please reconsider the decision being made,” Dr. Lieberman wrote in an email reviewed by The Times.

Early the next morning, the V.A. tried to pump the brakes.

“ALL — PLEASE HALT ANY CONTRACT TERMINATIONS THAT ARE IN PROGRESS,” another official wrote, highlighting his words in yellow.

But many contractors had already been notified that they were losing their work, emails show. By the next week, the V.A. had managed to walk back some of the terminations, saying it would cancel 585 of the original contracts.

[…]

Mr. Kasperowicz, the V.A. spokesman, said that the contracts that were canceled “were identified through a deliberative, multilevel review” involving senior department leaders and contracting officials.

So far the V.A. has refused to reinstate some contracts because the work does not involve direct interaction with patients or their families, emails shared with The Times show.

But one hospital administrator said many positions are critical even if they do not entail direct patient care — such as those who purchase medical supplies.

“Lots of people don’t understand how important these roles are,” the administrator said. “They are critical. They’re trained and certified. We can’t just replace them with random hospital employees.”

No, we’ll replace them with AI. I’m sure that will work great.