Amid the rhetorical fog of their game-changing presidential debate in June, Donald Trump and his then-opponent only dealt with the Department of Veterans Affairs (VA) in passing. 

Former president Trump claimed that, after he vacated the White House, “crazy Joe Biden” no longer allowed military veterans to choose between VA care and private sector alternatives to it. When he was in the White House, Trump asserted, VA patients could “get themselves fixed up” in private hospitals and medical practices, rather than waiting “three months to see a doctor.”  The results of this outsourcing were “incredible,” and earned his administration “the highest approval rating in the history of the VA.” 

In response, President Biden understandably failed to make two points in response, either due to cognitive decline or cognitive dissonance. One, out-of-control spending on private care has left the VA-run Veterans Health Administration (VHA) with a projected $12 billion budget shortfall for fiscal year 2025—which is not good news for veterans.  And two, a Democrat in the White House didn’t abandon privatization since there has been more of it under him than Trump.

Biden instead pivoted to talk about the PACT Act of 2022, which has helped nearly a million post-9/11 vets file more successful disability claims based on their past exposure to burn pits in Iraq and Afghanistan. Over the next decade, the PACT Act authorizes hundreds of billions of dollars for effective delivery of their medical care and financial benefits—but all of that is dependent on a well-functioning VA.

This brief and unilluminating exchange left unaddressed the real challenges facing the federal government’s third largest agency. The VHA operates the nation’s largest public healthcare system and provides high-quality, direct care (not insurance coverage) for former service members, who have low incomes or service related medical problems.  But, in the September sequel to the presidential debate in June—with so many other things to talk about—veterans affairs became a topic little discussed by Trump or VP Kamala Harris.

Vance vs. Walz

The next opportunity for a more substantive exchange about the past, present, and future of VA care will be Tuesday night, Oct. 1.  During their first and probably only vice-presidential debate, two former non-commissioned military officers will have the chance to embrace or reject the costly and disastrous bipartisan experiment with VA outsourcing that began under Obama, continued under Trump, and expanded under Biden. 

Not surprisingly, Governor Tim Walz is the one more likely to do that. Because, on the campaign trail, Senator J. D. Vance– a fellow beneficiary of VA educational benefits–has been, in Trump-style, bashing the VA and talking up privatization.  

 In a recent podcast interview with Shawn Ryan, a former Navy SEAL turned influencer, Vance claimed the agency is so slow moving and uncaring that “veterans spend three hours on the phone trying to get an appointment” and you even “have people commit suicide, because they’re waiting 28 days to get an appointment with a doctor.” The solution, according to Vance, is “give people more choice. I think you will save money in the process.”

After winning the first of six House races, before becoming governor of Minnesota, Walz joined the House Veterans Affairs Committee (HVAC)—a low-status committee assignment spurned by many aspiring politicians. In 2018, he joined just 69 other House Democrats in opposing the VA MISSION Act, one of Donald Trump’s proudest legislative achievements and the basis for his 2024 campaign pledge to make VA “patient choice” more widely available. 

Walz warned, accurately, that MISSION Act outsourcing would force the VA to “cannibalize itself” by diverting billions of dollars from direct care delivery to reimbursement of private-sector providers. This incremental defunding of VHA hospitals and clinics now threatens to leave them in what Walz called a “can’t function situation.”

In Congress, Walz also became an advocate for fellow veterans with service-related conditions. His own hearing damage resulted from repeated exposure to artillery blasts, during 24 years of National Guard training exercises. He won applause for co-sponsoring a bill, focused on suicide prevention services; it was name after a Marine veteran who killed himself in 2011 after long struggles with PTSD and depression. 

A Union Ally (Sometimes) 

Walz’s role as ranking Democrat on a then Republican-led HVAC is fondly recalled by the American Federation of Government Employees (AFGE), which represents VA employees in his home state. During his first run for Congress, the then-high school teacher and coach reached out to local AFGE leader Jane Nygard, who discovered that “he’s not someone who just says something to make you happy, he actually takes action.”  

According to Nygard, “whenwe had issues with the St Paul VA, which had bad management and low staffing, Congressman Walz, a fellow union member, listened to our union. He got the Federal Mediation and Conciliation Service involved and we ended up having a three-day retreat with upper management. Eventually, upper leadership retired and labor relations improved.”

The one bad mark on Walz’s union report card is his vote in favor of the VA Accountability and Whistleblower Act of 2017. This Trump-era effort to strip VA workers of their due process rights in disciplinary cases was challenged in court by AFGE. To his credit, Biden’s VA Secretary Denis McDonough ended a five-year legal battle over implementation of the Act by reaching a settlement with the union last year. Thousands of unfairly fired workers became eligible for reinstatement or back pay, at a total cost estimated to be hundreds of millions of dollars, according to the Federal News Network. 

Other workers or managers terminated for “grievous misconduct” were not covered by this deal. Nevertheless, Trump has promised to “fire every corrupt VA bureaucrat who Joe Biden outrageously refused to remove from the job.” A campaign spokesman for Vance recently hailed the MISSION Act as “bipartisan legislation that expanded veterans’ access to quality care and cut needless red tape.” Tim Walz’s opposition to it was “not the kind of leadership veterans need in Washington,” the spokesman said.

Party Platform Differences

To do anything at the VA different or better than Biden did–or Trump before him–Walz and Harris first need to win in November. They can both boost veteran voter turnout, particularly in battleground states, by zeroing in on the skimpiness of the GOP’s plan for “Taking Care of Our Veterans”—all 47 words of it!

This lone paragraph, buried in the Republican platform adopted in Milwaukee, leads off with immigrant bashing. The Party pledges “to end luxury housing and Taxpayer benefits” for border-crossers and “use those savings to shelter and treat homeless Veterans.” In addition, a second Trump Administration will “expand Veterans’ Healthcare Choices, protect Whistleblowers, and hold accountable poorly performing employees not giving our Veterans the care they deserve.” 

The equivalent Democratic Party platform statement is far more substantive. It covers veteran homelessness and suicide, PACT Act implementation, improving mental health programs, new services for female veterans, support for family members caring for VA patients, and cracking down on scams targeting veterans who file disability claims over their toxic exposures.

“Going forward,” the Democrats declare, “we will strengthen VA care by fully funding inpatient and outpatient care and long-term care, and by upgrading medical facility infrastructure.” Unfortunately, this otherwise laudable campaign pledge fails to acknowledge the reality of VA outsourcing, under Biden, which has further diverted funding from VA direct care and infrastructure upgrades for the last four years.

Tying Trump-Vance to Project 2025

At least some VA defenders in the Democratic Party are tying Trump and Vance to the VA-related recommendations of Project 2025. As Iraq war veteran and U.S. Rep. Chris Deluzio (D-PA.) points out, that Heritage Foundation playbook for the GOP “takes dead aim at veterans health and disability benefits.” 

In August, Deluzio warned readers of Military.com that his Republican colleagues on the HVAC have often “sided with corporate interests to outsource care” for VA patients. And now their presidential transition planners at the business-backed Heritage Foundation want to refer even more vets to “costly private facilities, a fiscally reckless move that…has ballooned costs for the VA.” 

According to Deluzio, the “ultimate endgame of these plans is to dismantle the VA’s own clinical care mission—should send shivers down the spines of America’s veterans and those who want the best care for them.”

On the campaign trail, Trump and Vance have been diverting attention from that “endgame” by positioning themselves, over and again, as defenders of “patient choice.” At a mid-August event at a Veterans of Foreign Wars hall in western Pennsylvania, Vance referenced the very real healthcare access problems of “our veterans living in rural areas.” He assured his invitation-only crowd that, if “those who put on a uniform and serve our country… need to see a doctor, we got to give them veteran’s choice to give them that ability to see a doctor.” 

In Detroit, at a late August convention of the National Guard Association, where he was warmly received, Trump again accused the Biden-Harris Administration of gutting his many “VA reforms” related to “choice” and “accountability.” He hailed VA outsourcing as a great system of “rapid service,” in which patients “go to an outside doctor…get themselves fixed up and we pay the bill.”  

Between now and November 5, veterans need a lot more factual information about VA privatization to counter the steady drumbeat of “fake news” they’re getting from Trump, Vance, and the GOP.  Let’s hope that now retired National Guard Sergeant Waltz steps up to the plate and takes a winning swat at the former Marine corporal from Ohio who became a Yale-educated lawyer and multi-millionaire venture capitalist with little personal need for the VA services so important to working class vets in his own state and others.

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