This article is an opinion essay written by 0Russell B. Lemle and Jasper Craven of the Veterans Healthcare Policy Institute. Task & Purpose welcomes submissions on Project 2025 and veteran healthcare topics.
As the November presidential election approaches, veterans deserve to know exactly what to expect regarding their hard-earned healthcare and disability benefits — and the overall future of the Department of Veterans Affairs (VA) — should former President Trump win re-election.
They needn’t look further than Project 2025, an intricate road map for veterans’ policy under a second Trump administration. The sweeping presidential agenda was produced by the Heritage Foundation and written by more than 140 contributors who previously worked for Trump.
By its own description, the 920-page Project 2025 was designed to be implemented beginning on day one of a second Trump administration. It addresses all aspects of the federal government, including the VA, and is part of an overarching effort to completely remake American government to fit an ultra-conservative doctrine.
Project 2025 proposes several alarming recommendations that could significantly reduce veterans’ access to healthcare. One would realign healthcare benefits to cover only “service-connected conditions,” – i.e., medical or mental health problems that were acquired or exacerbated by military service. Currently, once veterans prove they have a service-related condition, they can receive care for that problem as well as other conditions that they may develop. For example, a veteran whose leg was amputated in the military would not only have lifetime care for that problem, but also for the high blood pressure or cancer that they develop, in civilian life.
The Heritage blueprint argues for the Veterans Health Administration (VHA) to eliminate some clinical services that “don’t align with service-connected conditions.” If this strategy to authorize care based on service-connected disabilities is taken to its logical extension, other care, like for an amputee’s hypertension in the example above, would no longer be furnished. There are five million veterans who have a service-connected designation, and they all potentially stand to lose access for the bulk of their healthcare needs. Two million veterans without a service-connected designation could potentially be disenrolled from VA healthcare entirely. Such a draconian concept accords with the Koch-backed group Concerned Veterans for America, whose Veterans Independence Act proposes “tightening eligibility requirements for new enrollees at a certain date in order to reorient the VA back towards its mission of providing care for service-connected disabled veterans.” It is also a goal espoused in the Heritage Foundation’s Budget Blueprint for Fiscal Year 2023.
The 2025 plan would further require VHA facilities to “increase the number of patients seen each day to equal the number seen by DOD medical facilities.” It’s a directive that disregards the stark differences between the two populations. Veterans are, on average, 58 years old, compared to servicemembers, who have an average age of 28. Veterans are also far more likely to have multiple, co-occurring medical conditions compared to U.S. servicemembers. As a result, VHA healthcare providers need to spend more time with veterans during their appointments to effectively address their complex health needs. By demanding that VHA facilities match the patient volume at DOD facilities, Project 2025 risks shortchanging veterans and compromising the quality of care they receive by treating them as if they are in the prime of their youth.
The document also calls for identifying VHA medical facilities whose “referrals for Community Care are below the averages in other similar markets,” then goading them to increase outsourcing. Such a formula creates a vicious, never-ending cycle, for even when one facility improves and is dropped from the list, another is added. The approach relentlessly pushes the number of community care referrals higher, ultimately leading to the closure of VHA facilities and the privatization of care. In an Orwellian double-speak, the document refers to this downscaling of a system that veterans rely on as a “genuine ‘Veteran-centric’” philosophy.
Financial compensation for service-connected disability is also set to be reduced.
Project 2025 calls for a review of the VA Schedule for Rating Disabilities to “target significant cost savings from revising disability rating awards for future claimants.” Not only would these changes result in less money in the pockets of disabled veterans, but for those failing to meet the new standards, their eligibility for VA healthcare would disappear.
Heritage hopes these changes will be implemented immediately to “ensure political control of the VA.” In parallel, Trump has said he intends to implement so-called “Schedule F,” which would potentially remove hundreds of experts who hold vital, tailored knowledge and replace them with ideologues and loyalists who can ensure the disassembly of the VHA system.
The specific section of the document focused on gutting veterans’ health and disability benefits was written by Brooks Tucker, one of Trump’s former VA policy advisers. Another contributor to the section was Darin Selnick, another former Trump advisor who has called for dismantling the VHA.
The VA’s hallowed mission “to care for those who served in our nation’s military, and for their families, caregivers and survivors” is no longer assured. Such a mission has never been assured, but instead secured only through the grit and tenacity of veterans fighting to preserve and expand this national gem. In the upcoming election, the potential for an unprecedented loss of veterans’ hard-earned benefits is more real than ever.
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