⚡NIMITZ NEWS FLASH⚡

“U.S. Department of Veterans Affairs Budget Request for Fiscal Years 2026 and 2027 Advance Appropriations”

House Veterans Affairs Committee

May 15, 2025 (recording here)

HEARING INFORMATION

Witness & Written Testimony (linked):

• The Honorable Doug Collins: Secretary, U.S. Department of Veterans Affairs

Keywords mentioned:

• Fiscal discipline, community care, workforce reduction, transparency, Elizabeth Dole Act, veteran suicide, electronic health record (EHR) modernization, housing assistance, VASP program, whistleblower protection, accountability

IN THEIR WORDS

OPENING STATEMENTS FROM THE COMMITTEE

• Chairman Mike Bost stated that the VA’s budget proposal for the upcoming fiscal years was serious and promising. He criticized the Biden administration for previous financial mismanagement at the VA, citing an alleged shortfall and lack of fiscal discipline. He accused Biden-era VA officials of misusing hiring and pay authorities, alarming veterans, and shifting blame. Chairman Bost then defended VA Secretary Doug Collins and the Trump administration against accusations of dismantling VA services, claiming that transparency and accountability had improved significantly since last year.

• Ranking Member Mark Takano expressed disappointment with Sec. Collins’s tenure, stating that while he had initially been optimistic, the Secretary’s lack of transparency and failure to answer oversight questions had eroded trust. He cited concerns over clinical trial pauses, unauthorized budget shifts to private care, and the goal of firing 83,000 VA employees. He accused the Secretary of creating a culture of fear within the VA, intimidating staff, and disregarding the experiences of veterans and frontline workers. The Ranking Member urged Sec. Collins to be forthcoming, answer questions fully, and take accountability, asserting that the VA is not for sale and must not be used to advance political agendas.

SUMMARY OF KEY POINTS

• Secretary Doug Collins affirmed his commitment to making the VA more efficient and veteran-focused, stating that his goal was to eliminate red tape and empower frontline staff. He pushed back on accusations of workforce reductions causing harm, noting that the bureaucracy had grown unsustainably. He argued that the VA’s performance had declined despite large funding increases and workforce expansions, and he stated that many metrics were getting worse. Sec. Collins highlighted recent progress under his leadership—including a 21% reduction in the claims backlog—and pledged to answer questions honestly and seek common ground with the Committee.

• Rep. Jack Bergman asked Sec. Collins to elaborate on VA-supported studies related to psychedelic-assisted therapies, such as MDMA, particularly for PTSD and traumatic brain injury (TBI). The Secretary responded that the VA was actively reviewing 11 studies, both internal and external, and noted that preliminary outcomes were positive when coupled with counseling. He called for rigorous oversight and collaboration with the Department of Health and Human Services (HHS) and the Department of Defense (DOD).

• Rep. Bergman then asked whether expanding access to accredited representatives could help improve veterans' disability claims outcomes. Sec. Collins agreed but argued that the system should not require outside help for veterans to access earned benefits. He suggested simplifying internal processes and questioned the logic of making veterans provide information that the VA already has.

• Rep. Bergman also raised the importance of the VA being responsible for accreditation to improve appeals outcomes. Sec. Collins stated that while accreditation of outside individuals was not fully under the VA’s purview, the department was willing to support congressional efforts. He also defended the use of community care as VA care and rejected claims that it was a handout to private hospitals.

• Rep. Julia Brownley asked why VA supervisors were being asked to sign non-disclosure agreements (NDAs) that did not appear to protect whistleblowers and raised concerns about spyware on employee computers. The Secretary stated that the NDAs restated existing federal confidentiality laws and did not limit whistleblower protections. He claimed that the agreements aimed to protect sensitive workforce restructuring information and that whistleblower channels remained operational.

• Rep. Brownley inquired about the implementation timeline for the Elizabeth Dole Act, specifically Section 120, which lifts the 65% cap on non-institutionalized care. Sec. Collins said that internal planning was underway and implementation was expected within months, though the January date might be moved up. He acknowledged the urgency and personal relevance of the issue, given his own family experience with disability care. Rep. Brownley encouraged the Secretary to implement the law quickly to save money and meet veterans’ preferences for home-based care.

• Rep. Mariannette Miller-Meeks asked whether veterans who begin community care can decide to stay in that system. Sec. Collins agreed that the VA MISSION Act intended for the veteran to make that choice, and he criticized internal VA resistance to community care.

• Rep. Miller-Meeks asked about the long-term role of the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program. Sec. Collins said that the program was valuable but reiterated that veteran suicide numbers had not improved since 2008 despite increased funding. He expressed urgency in reaching veterans not currently connected to the VA.

• Rep. Miller-Meeks raised concerns about slow and costly construction and leasing delays for VA clinics. Sec. Collins admitted that the procurement system was broken, lacked clear accountability, and needed congressional help to streamline.

• Rep. Chris Pappas asked whether the Secretary would engage with New Hampshire veterans and stakeholders during the VA’s feasibility study to turn the Manchester VA into a full-service hospital. Sec. Collins confirmed that the feasibility study began that week and that stakeholder engagement would be a priority.

• Rep. Pappas questioned the timing and communication around the VA’s decision to end the Veterans Affairs Servicing Purchase (VASP) mortgage assistance program. The Secretary replied that VASP ended on May 1 because it lacked a congressional mandate and had been diverting funds from other programs. Rep. Pappas pushed back, sharing the story of a constituent who narrowly missed qualifying and asked whether Sec. Collins would support a foreclosure moratorium. Sec. Collins declined to commit to a moratorium but stated that VASP’s continuation would have required billions in mandatory funding. He asked Congress to develop a replacement program.

• Rep. Greg Murphy asked Sec. Collins to rate the VA’s efficiency and raised concerns about the overexpansion of personnel and inefficiency under the previous administration. Secretary Collins said that the VA’s systems—including HR, contracting, and IT—were far less efficient than industry standards.

• Rep. Murphy criticized the long-delayed electronic health record (EHR) overhaul and asked how the Secretary was fixing the program. Sec. Collins described a full reset where he eliminated unnecessary committees and streamlined communication between the VA and Oracle. He reported that the approach allowed expansion to 13 sites in Michigan and aligned the VA's strategy with the DOD’s past success.

• Rep. Murphy supported the integration of community care and claimed that the lack of EHR interoperability was hurting veterans. He also reiterated support for the team-based anesthesia model. Sec. Collins agreed and emphasized that improving communication and standardization was key to integrating VA and community care.

• Then, Rep. Murphy advocated for hyperbaric oxygen therapy (HBOT) for TBI and suicide prevention and asked Sec. Collins to drop the VA’s past opposition to his bill. The Secretary responded that the VA would provide its research and work with Congress as it considers the bill.

• Rep. Sheila Cherfilus-McCormick asked if the VA prioritized housing for veterans, including flexible assistance such as transportation and hygiene support. Sec. Collins affirmed support for veteran housing but declined to commit to hypothetical or narrowly defined scenarios. Rep. Cherfilus-McCormick followed up on whether VA-owned land should be used to support veteran homelessness efforts. The Secretary said that it depended on the suitability of the land, refusing to give a blanket yes or no.

• Rep. Cherfilus-McCormick questioned why elements of the Elizabeth Dole Act addressing housing had not yet been implemented. Sec. Collins responded that there were 72 provisions in the Dole Act and that his team had completed 9, were on track with 55, and were working through the rest. He underscored that the VA was actively reviewing implementation priorities.

• Rep. Cherfilus-McCormick warned about potential regression in homelessness prevention and asked what would replace VASP and support homeless veterans. Sec. Collins replied that the VA was utilizing existing programs and partnerships with HUD to assist homeless veterans and criticized prior administrations for leasing VA land to non-veteran uses in places like Los Angeles.

• Rep. Cherfilus-McCormick then shifted to inquire about addressing disparities without the Office of Equity Assurance. Sec. Collins insisted that the VA was committed to equitable service delivery regardless of background and that any veteran denied benefits due to discrimination should contact VBA or his office directly.

• Rep. Derrick Van Orden praised Sec. Collins for terminating the VASP program, criticizing it as an inefficient and unauthorized program. He outlined concerns about the bloated VA bureaucracy, presenting a chart showing disproportionate growth in administrative staff compared to doctors and veterans served. He asked what Congress could do to help. The Secretary agreed and reported that enrollment had remained flat despite PACT Act increases. He pointed to poor oversight over payroll and HR, with multiple redundant systems still in place.

• Rep. Morgan McGarvey asked Sec. Collins to commit to preserving the VHA Innovation Ecosystem, which had improved care and saved hundreds of millions through initiatives like VetText, Uber rides, and remote smart mats. The Secretary confirmed his support, stating that innovation should be encouraged and that employees would not be punished for good-faith mistakes.

• Rep. McGarvey said that the VA’s research capacity could benefit all Americans and then asked whether the VA was working to improve In Vitro Fertilization (IVF) access for women veterans. Sec. Collins confirmed that the VA was implementing the President’s executive order and would update Congress accordingly.

• Rep. McGarvey asked whether artificial intelligence (AI) would ever fully replace humans in adjudicating disability claims. Sec. Collins stated that while automation could streamline simple claims, final decisions on eligibility would continue to involve a human reviewer.

• Rep. Kimberlyn King-Hinds raised concerns about the 18-month vacancy of the only VA administrative specialist in the Northern Mariana Islands and asked for an update. Sec. Collins announced that the position would be filled, with the new employee starting on June 16.

• Rep. King-Hinds also asked about delays in opening the Vet Center outstation in the territory. Sec. Collins replied that the facility was still in the leasing process but noted that the counseling service was already recruiting staff in preparation for the site’s opening.

• Rep. Delia Ramirez voiced concern about the VA abandoning diversity, equity, and inclusion (DEI) efforts and asked whether the Secretary was committed to meeting veterans where they are. Sec. Collins confirmed that he was and stated that he supported serving all veterans equally.

• Rep. Ramirez said that she had been told the VA had paused outreach efforts and had not received a response to a letter she sent on March 6. Sec. Collins stated that outreach was still ongoing, called the reported pause “malicious compliance,” and committed to following up on her letter. He reiterated that restricting outreach was unacceptable and not in line with the VA’s goals.

• Rep. Ramirez asked how the Secretary would address healthcare disparities, especially following the closure of the Office of Equity Assurance. Sec. Collins directed veterans seeking to report discrimination to whistleblower and VBA channels, and he reaffirmed that all veterans who had earned benefits would receive them regardless of identity.

• Rep. Ramirez then turned to the subject of gender-affirming care. Sec. Collins pledged that veterans currently receiving such care would continue to receive it but stated that the VA would not add sex reassignment surgery to its offerings.

• Rep. Tom Barrett asked how the VA planned to use increased funding for EHR modernization efforts to ensure successful implementation. The Secretary stated that the VA restarted the EHR process from scratch, focused on employee training, imposed realistic timelines, and prioritized holding Oracle accountable. He reported that safeguards were being put in place, including AI integration, to improve care delivery.

• Rep. Barrett asked how the VA was encouraging external providers to participate in the External Provider Scheduling (EPS) program and reduce wait times. Sec. Collins explained that third-party administrator contracts had been delayed due to inaction by the previous administration. He reported that the VA was revising the contract request for information (RFI) with hundreds of proposed changes and discussed the need to modernize outdated practices like faxing and CD transfers.

• Rep. Barrett suggested coordinating EHR upgrades with EPS rollout to improve efficiency. Sec. Collins agreed and replied that Deputy Secretary Paul Lawrence was now actively overseeing implementation. He expressed confidence in the current trajectory and welcomed collaboration with the Committee.

• Rep. Herb Conaway asked whether veterans who lose Medicaid coverage would be eligible for VA health care under Priority Group 6. The Secretary responded that he did not foresee such a situation but did not give a definitive yes or no.

• Rep. Conaway asked if the VA would provide cash subsidies to veterans who lose access to SNAP. Sec. Collins replied that veterans were exempt from the SNAP work requirements and did not directly answer the subsidy question.

• Rep. Conaway raised concerns about Department of Justice (DOJ) access to VA data and asked if personnel retained or misused any sensitive veteran information. Sec. Collins assured the Committee that DOJ personnel had not retained or misused veteran data and followed standard VA protocols.

• Rep. Conaway then asked how many researchers had been dismissed and whether clinical trials had been canceled. Sec. Collins said that no researchers had been fired and no clinical trials had been canceled. He noted that over 1,500 clinical trials were ongoing but acknowledged there was no central oversight.

• Rep. Abe Hamadeh praised Sec. Collins for increasing accountability and reducing bureaucracy, contrasting it with what he called “Democratic fearmongering.” He asked for a list of services excluded from the hiring freeze. The Secretary emphasized that doctors, nurses, and critical support staff like plumbers and room cleaners were protected. He also criticized Senate delays in confirming three VA appointees, including a CFO and a wounded veteran, saying it hindered operations and contradicted claims of supporting veterans.

• Rep. Nikki Budzinski referenced the VA's high trust scores and criticized the administration’s staffing cuts and support for an executive order stripping union rights. She asked how the VA would implement the EHR system amid potential staffing reductions. Sec. Collins replied that no cuts had yet been made to the Office of Information and Technology (OIT) and claimed that over 300,000 essential positions were protected.

• Rep. Budzinski pressed Sec. Collins on whether the VA was using technology to replace workers. The Secretary replied that technology would improve efficiency, especially for administrative transactions like mortgage and education benefits, but would not replace frontline services. He then said that the department was still conducting interviews for its open Chief Information Officer (CIO) position.

• Rep. Morgan Luttrell asked Sec. Collins to work with the DOD to create a seamless transition process for service members entering the VA system, ensuring timely and accurate access to benefits and healthcare. Sec. Collins agreed and stated that he had already begun discussions with the Secretary of Defense to improve the TAP program and spoke on the importance of warm handoffs, particularly for those with mental health concerns.

• Rep. Tim Kennedy raised concerns about low morale among VA staff due to job insecurity and staff cuts and asked how the Secretary planned to make reductions without harming care. Sec. Collins explained that the reductions focused on duplicative administrative roles, not frontline staff, and restated that no sudden firings were occurring.

• Rep. Juan Ciscomani urged the Secretary to protect an Arizona-based suicide prevention program, citing high veteran suicide rates in the state. Sec. Collins committed to working with the Congressman and claimed he wanted to ensure similar programs had measurable outcomes and potential for expansion.

• Rep. Ciscomani praised the decision to move the Office of Survivors Assistance to the Office of the Secretary and asked how it would help. Sec. Collins responded that this move would allow for more compassionate, timely support for survivors and described the change as an effort to treat survivors with greater empathy and responsiveness.

• Rep. Kelly Morrison expressed concern about how VA workforce reductions could affect morale and care, and she asked for confirmation that direct care workers and support staff like housekeepers would not be cut. Sec. Collins confirmed that clinicians and patient support staff had already been exempted from reductions and reiterated that care delivery would not be impacted.

• Rep. Morrison shared that Minneapolis VA staff had questioned whether Sec. Collins cared about veterans, asking how he planned to improve morale. Sec. Collins expressed frustration over misinformation, reiterated that frontline workers were not being cut, and said that he was personally working to combat the fear caused by inaccurate reporting.

• Rep. Morrison then asked about VA efforts to enroll 1 million more women veterans and whether this would require more clinical staff and space. Sec. Collins agreed with the goal and added that optimizing staff and space through the reorganization would support expanded capacity for women veterans.

• Rep. Jen Kiggans praised the VA’s investment in nurse residency and clinical programs and asked about the Secretary’s plans to better integrate advanced practice nurses like CRNAs into VA care. Sec. Collins responded that scope of practice issues were under review and acknowledged the ongoing debate while affirming the importance of continuing that work.

• Rep. Kiggans asked Sec. Collins to improve the usability of VA websites so veterans could more easily access and understand their benefits. The Secretary agreed and underscored the need for streamlining digital systems to better serve veterans, calling it a mission failure if veterans had to rely on congressional offices for help accessing earned benefits.

• Rep. Maxine Dexter asked the Secretary to confirm his commitment to veteran suicide prevention. Sec. Collins affirmed the shared priority and expressed a desire to increase physician hiring caps.

• Rep. Dexter questioned why former VA Inspector General Michael Missal, known for his suicide prevention efforts, was fired by President Donald Trump. Sec. Collins said that he had no knowledge. Rep. Dexter also raised concerns about the current Inspector General nominee, Cheryl Mason, citing potential conflicts of interest due to her political appointment and connection to recent VA workforce changes. Sec. Collins defended her qualifications.

• Rep. Dexter echoed her colleagues’ concerns about VA employees’ morale and the fear of retaliation. She asked Sec. Collins how he would rebuild trust. Sec. Collins replied that he would continue building trust through visits and transparency.

• Rep. Keith Self thanked Sec. Collins for reinstating chaplains' ability to minister according to their conscience and praised him for focusing the VA on outcomes. He then asked about the future costs of the EHR system. Sec. Collins admitted that the original 2028 deadline would not be met, and he is renegotiating contracts with Oracle. He criticized the prior administration’s handling of EHR and described current efforts to clean up systemic inefficiencies.

• Rep. Nancy Mace praised Sec. Collins and the Trump administration for ending gender-affirming surgeries at the VA and canceling DEI-related contracts. The Secretary clarified that ongoing hormone treatments from the DOD would continue. He noted that $6.1 million had been redirected from DEI contracts to other care areas.

• Rep. Chris Deluzio questioned the Secretary about clinical trials delayed or stalled due to workforce actions. Sec. Collins said that trials for head and neck cancer had not started initially but were now recruiting. Rep. Deluzio pressed for data on other trials and discussed the importance of timely care access. He also raised concerns about morale and lack of privacy for mental health appointments in shared office spaces. Sec. Collins agreed that such arrangements violate VA policy and should be corrected by leadership.

• Ranking Member Takano presented a spreadsheet from the VA’s reorganization team showing potential savings from cutting clinical roles, including thousands of nurses and psychologists. He claimed that this contradicted the Secretary’s statements that no clinical staff would be cut. Sec. Collins called the document a predecisional draft and insisted that he had directed the protection of frontline healthcare roles.

• The Ranking Member also criticized the deferred resignation program (DRP), noting that 2,500 clinicians had applied and were being denied. Sec. Collins confirmed the denials and said that many applicants were close to retirement.

• Ranking Member Takano expressed concern over unfilled medical center director positions and asked Sec. Collins to commit to exempting them from the hiring freeze. Sec. Collins agreed, but he did not commit to sharing a Reduction in Force (RIF) plan with Congress before its execution.

• Chairman Bost invited Sec. Collins to highlight anything not yet discussed. The Secretary underlined that misrepresentations about workforce cuts were harming morale and claimed that much of the inefficiency lay in bloated middle management, not clinical roles. He reiterated that the VA’s mission was veteran care, not bureaucracy, and defended his actions as necessary reforms.

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A NOTE FROM THE TEAM

The publication of this Nimitz News Flash was delayed due to team travel at the end of last week. We appreciate your patience and look forward to more timely updates this week!

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