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“Veterans at the Forefront: Secretary Collins on the Future at VA”

Senate Veterans Affairs Committee Hearing

May 6, 2025 (recording here)

HEARING INFORMATION

Witness & Written Testimony (linked):

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

Keywords mentioned:

• Reform, workforce reduction, bureaucracy issues, community care, clinical trials, Electronic Health Record (EHR) system, budget allocation, disability claims, staffing shortages, congressional oversight

IN THEIR WORDS

OPENING STATEMENTS FROM THE COMMITTEE

• Chairman Jerry Moran welcomed VA Secretary Doug Collins to his first appearance before the Committee since confirmation and thanked him for accepting the invitation with ease. He acknowledged the hard work of VA staff, many of whom are veterans, but criticized the VA bureaucracy for impeding progress and failing to serve all veterans effectively. Chairman Moran highlighted bipartisan achievements such as the VA MISSION Act and the PACT Act while claiming that more reform is needed. He expressed concern over recent workforce reduction plans, contract cancellations, and employee terminations, urging that changes be driven by data, veteran needs, and coordination with stakeholders—not arbitrary targets.

• Ranking Member Richard Blumenthal praised the Committee’s bipartisan work but sharply criticized the Secretary for omitting mention of the PACT Act in his testimony and for the administration’s recent policy changes. He entered several documents into the record, including impact statements from VA employees, reports of planned job cuts, and concerns about degraded mental health services. The Ranking Member accused Sec. Collins of arbitrarily firing thousands of staff, including Veterans Crisis Line (VCL) workers, delaying facility openings, and proposing severe staff cuts that would hurt health care access and benefits processing. He argued that reforms should be precise and constructive, warning that current actions could cause a self-inflicted disaster for veterans and VA services.

SUMMARY OF KEY POINTS

• Secretary Doug Collins stated that since taking office, he had listened to veterans and VA employees and found a deeply entrenched, inefficient bureaucracy in need of reform. He argued that simply increasing staffing and funding had not improved outcomes, citing longer wait times and increased disability claim backlogs despite the addition of over 52,000 employees during the previous administration. Sec. Collins claimed that the goal of a 15% staffing reduction was not arbitrary, but necessary to eliminate waste and redirect resources toward veteran care, maintaining that mission-critical roles like doctors and claims processors would be preserved. He underscored that reforms were being carried out thoughtfully and transparently and that the VA is not a jobs program, but a veteran-serving agency that must be restructured to meet its true mission.

• Chairman Moran asked Sec. Collins to identify the VA’s most significant concerns and to reflect on what is working and what should be done differently. Sec. Collins responded that one of his biggest challenges was combating misinformation and navigating a deeply broken bureaucracy. He shared that it took over a week to obtain a complete employee list due to disorganized HR systems and cited worsening wait times and suicide rates despite increased funding and staffing. The Secretary restated that the VA needs systemic reform, not minor adjustments.

• The Chairman also asked about plans to appoint an Inspector General (IG). Sec. Collins said that he supported the nomination and had encouraged the White House to proceed, elaborating on the importance of oversight in helping the department meet performance goals.

• Chairman Moran inquired about expanding community access to mental health residential rehabilitation treatment under the VA MISSION Act. Sec. Collins confirmed that the update was in progress and noted the importance of working with the Department of Justice (DOJ), the Department of Defense (DOD), nonprofits, and veterans service organizations (VSOs) to improve mental health care access.

• Ranking Member Blumenthal challenged the claim that cutting 83,000 employees would address VA problems, asserting that it would not resolve wait times, backlogs, or system inefficiencies. He accused Sec. Collins of using deceptive metrics for wait times and misleading the Committee. When asked about costs incurred from wrongful terminations, Sec. Collins said that less than 0.5% of employees had been let go and defended the process, though he did not provide exact cost figures.

• The Ranking Member demanded a list of terminated positions and future termination plans. The Secretary replied that the department had submitted information but would follow up with further details. He stressed that the VA was assessing workforce size based on need, not targeting frontline providers like doctors or nurses.

• Sen. Tommy Tuberville expressed appreciation for the changes he had seen in Alabama’s VA system and asked why the VA budget had expanded despite a stagnant veteran population. Sec. Collins explained that while total veteran numbers were declining, enrollment had stayed steady at 9.1 million, and annual veteran deaths also contributed to demand changes. He went on to say that budget growth reflected mandatory spending and program expansion, but increased staffing had not led to better outcomes due to bureaucratic inefficiencies.

• Sen. Tuberville asked about reducing administrative burdens that prevent doctors from seeing more patients. Sec. Collins said that the department was reviewing excessive paperwork and duplicative coding systems and referenced streamlining internal processes to improve care.

• Sen. Patty Murray criticized a new VA policy limiting congressional engagement, citing her own experience being blocked from hosting a veteran roundtable at a Seattle VA. She asked that the written policy be shared with all members of Congress. Sec. Collins acknowledged an inconsistent application of the unwritten policy and said that the written version aimed to improve coordination between legislative and budget offices.

• Sen. Murray also raised concerns about how proposed staffing cuts would affect Electronic Health Record (EHR) deployments. Sec. Collins responded that staffing reviews were separate from EHR rollouts and did not involve frontline workers. When asked about paused clinical trials, the Secretary claimed that he placed a 90-day hold to evaluate ongoing studies but could not provide numbers on affected trials or veterans.

• Sen. Marsha Blackburn praised the Secretary for the VA’s progress on the EHR modernization initiative and asked about employee participation in EHR training. Sec. Collins reported that training compliance had improved and highlighted streamlining efforts to reduce delays caused by VA-Oracle coordination issues.

• Sen. Blackburn then asked how many employees had been terminated. Sec. Collins estimated that around 1,000 probationary employees had been released.

• Regarding the budget, Sen. Blackburn asked how modernization funds would be used. Sec. Collins said that the budget prioritized frontline care, research, and community care. He stressed that despite reform rhetoric, the budget showed no cuts to healthcare or benefits.

• Wrapping up, Sen. Blackburn asked how to reduce delays in community care approvals. Sec. Collins acknowledged internal roadblocks and stated that he had made clear to VA staff that community care access was a legal obligation and priority.

• Sen. Mazie Hirono confronted the Secretary about inconsistencies in reported employee terminations, noting that the Committee had been told 2,400 people were let go, not 1,000. Sec. Collins clarified that some employees were reinstated following court orders and that litigation was ongoing.

• Sen. Hirono pressed for exact savings figures from terminations. Sec. Collins initially said that he would need to follow up but later cited $14 million saved from ending diversity, equity, and inclusion (DEI) programs, with funds redirected to disability and prosthetic services. Sen. Hirono asked what other programs were cut and where the savings went. Sec. Collins replied that some contracts were renegotiated or terminated and promised to provide documentation.

• Sen. Hirono questioned whether the Secretary knew the breakdown of the VA’s 470,000 employees. Sec. Collins admitted that the VA lacked centralized data and described a disorganized system inherited by his administration. When pressed on paused clinical trials, Sec. Collins could not provide numbers on how many trials or veterans were impacted, prompting Sen. Hirono to criticize his lack of preparation and refusal to commit to returning for further testimony. Sec. Collins only promised to provide the requested information but did not commit to returning.

• Sen. Thom Tillis shared that he was approached by concerned individuals about the proposed 83,000 VA workforce reductions and asked Sec. Collins to explain how those positions were being evaluated. The Secretary responded that the 15% figure was a starting goal, not a confirmed cut, and said that the agency was reviewing inefficiencies within a large bureaucracy. Sen. Tillis expressed openness to changes that improve veteran services and underlined that final decisions should be based on results, not discomfort. He noted that a rescissions package would ultimately determine congressional action and withheld judgment until such a proposal was presented.

• Sen. Maggie Hassan questioned Sec. Collins about the public goal to cut 80,000 VA employees and its likely impact on veteran healthcare. She highlighted that only 54,000 employees work outside the Veterans Health Administration (VHA), implying that most cuts would necessarily affect frontline healthcare staff. The Secretary insisted that the goal was to improve care and eliminate inefficiencies, not to indiscriminately fire providers. Sen. Hassan pressed him on a lack of consultation with the VA’s Chief Medical Officer (CMO) and criticized the administration for moving forward with broad cuts without transparent planning or analysis.

• Sen. Bill Cassidy asked about the now-defunct VA Servicing Purchase (VASP) program, which had assisted veterans during COVID. Sec. Collins explained that VASP was a discretionary, non-appropriated program that placed the VA in an inappropriate role managing mortgages and property and that future solutions like partial claims would better support veterans. Sen. Cassidy then advocated for the VetPAC proposal, a bipartisan initiative modeled after MedPAC to provide objective guidance on VA reform, and asked the Secretary to provide technical assistance. Sec. Collins agreed to follow up and voiced support for the concept.

• Sen. Cassidy also raised concerns about unchecked community care utilization, to which Sec. Collins responded that a working group was reviewing equity, authorization practices, and third-party administrator contracts to improve oversight and coordination.

• Sen. Angus King criticized the VA’s lack of transparency regarding 585 canceled contracts, noting that his request for a list went unanswered for two months. Sec. Collins replied that some contracts were still being renegotiated and promised to follow up soon.

• Sen. King also challenged the VA’s use of 2019 staffing levels as a target, calling the benchmark arbitrary and incompatible with expanded responsibilities like those under the PACT Act. Sec. Collins replied that 2019 was used per an executive order focused on government efficiency and that new technologies could help meet veteran needs with fewer personnel. Sen. King emphasized that any restructuring should be guided by efficiency and data—not arbitrary quotas—and asked the Secretary to share internal reports due for completion. Sec. Collins stated that the reports were still in progress and were not ready for release.

• Sen. John Boozman asked Sec. Collins to commit to briefing the Appropriations Committee on the VA’s fiscal year 2025 spending plan, which had prompted questions. Sec. Collins agreed to provide a briefing.

• Sen. Boozman then asked whether the VA would reconsider proposed IT funding cuts pending an ongoing review by the DOJ. Sec. Collins said that the issue was under review and he was open to collaboration.

• Sen. Boozman voiced concern about veterans now at risk of foreclosure due to the end of the VASP program and asked how the VA planned to help. The Secretary responded that the VA was not equipped to manage property ownership and was supporting legislative solutions such as partial claims.

• Sen. Boozman also asked about cuts to remote temperature monitoring programs for diabetic veterans. Sec. Collins admitted that he was unprepared to answer and would follow up.

• Finally, Sen. Boozman asked about the VA’s interest in studying psychedelics for PTSD and traumatic brain injury (TBI). Sec. Collins confirmed that several studies were underway, most with external partners, and he expressed openness to working with Congress to expand access to promising treatments.

• Sen. Bernie Sanders pressed the Secretary on union rights, criticizing the Trump administration’s executive order that restricted collective bargaining at the VA. Sec. Collins maintained that the order was about national security interests but failed to directly justify treating unionized VA workers as a threat.

• Sen. Sanders also pushed for stronger veteran outreach and questioned why many veterans remain unaware of their earned benefits. Sec. Collins agreed on the need for better transition efforts from the DOD to the VA and committed to improving outreach.

• Sen. Sanders also mentioned the healthcare workforce shortage at the VA—2,500 doctors and 6,600 nurses—and advocated for increased recruitment, debt forgiveness for medical students, and expansion of military medical schools. Sec. Collins agreed and supported broader efforts to grow the national healthcare workforce.

• Sen. Kevin Cramer echoed concerns about healthcare staffing and underused rural infrastructure. He suggested better leveraging critical access hospitals and DOD facilities for community care. Sec. Collins agreed and described current efforts to partner with community and DOD hospitals. Sen. Cramer also noted that the VA hired 52,000 new staff under the Biden administration, but wait times and backlogs still increased.

• Sen. Tammy Duckworth condemned the firing of 2,400 probationary VA employees, calling it a “failure” that disrupted care and benefits access. She asked the Secretary to review and reinstate affected employees. Sec. Collins responded that most were reinstated and defended the action as necessary but agreed to look into remaining issues.

• Sen. Duckworth also challenged Sec. Collins on continued staffing gaps in the VCL and underscored the importance of support staff. The Secretary confirmed that no call operators were let go and offered to review any remaining cases.

• Sen. Dan Sullivan praised Sec. Collins for issuing a scam alert about Camp Lejeune attorney fees and for reducing Alaska's veteran claims backlog. He criticized Democratic colleagues, specifically former SVAC Chairman Jon Tester, for failing to cap attorney fees and credited Sec. Collins with doing more for Alaska veterans in three months than the prior administration did in four years.

• Sen. Elissa Slotkin criticized the VA’s handling of workforce reductions, accusing Sec. Collins of poor planning and sloppy execution, especially after employees were fired and quickly rehired. She raised concerns about losing essential non-clinical staff (e.g., IT, claims processors), which could impede access to care. Sec. Collins emphasized that no doctors or nurses were being cut and reiterated that a finalized workforce plan was still in progress.

• Sen. Jim Banks asked how the nearly $5 billion VA budget increase would be used. Sec. Collins explained that funds would support community care, infrastructure, and mental health, while also citing systemic inefficiencies. Sen. Banks underlined that cutting bureaucracy could improve service, and Sec. Collins noted that savings from workforce reductions would be reinvested in direct care services and technology.

• Sen. Banks also mentioned veteran suicide. Sec. Collins expressed frustration that despite massive spending, rates had not meaningfully decreased since 2008. He advocated for innovative treatments like psychedelics and better nonprofit partnerships.

• Sen. Banks then asked about workforce attrition. Sec. Collins said that some staff left via early retirement or natural attrition and not all cuts involved involuntary separations.

• Sen. Banks mentioned the prior administration’s misleading budget figures. Sec. Collins confirmed that the VA was still working to clean up budgetary issues and pledged to avoid political budget surprises.

• Ranking Member Blumenthal expressed frustration that Sec. Collins had not provided the requested data about specific job cuts and contract cancellations. He cited the Secretary’s repeated public statements indicating a goal to cut 15% of the workforce—approximately 80,000 positions—and warned that this would inevitably affect frontline staff like nurses and social workers. Sec. Collins again denied that such cuts were finalized and insisted that healthcare quality would be protected.

• Ranking Member Blumenthal asked if the Secretary would support a bill to cap attorney fees in Camp Lejeune cases. Sec. Collins said that he had not reviewed the bill but supported efforts to stop predatory practices.

• The Ranking Member asked if the VA would ensure privacy for telehealth professionals. Sec. Collins replied that privacy protections were already in place and denied reports in the New York Times alleging otherwise, promising to provide a line-by-line rebuttal.

• Ranking Member Blumenthal also brought up research contract renewals. Sec. Collins stated that no contracts had been canceled to his knowledge and explained that some were under review based on standard expiration timelines.

• The Ranking Member asked whether Sec. Collins viewed Medicaid as important for veterans. The Secretary eventually acknowledged that it is important to those who use it but initially struggled with the question’s framing.

• Chairman Moran confirmed that the Secretary was working with the White House to secure a new IG. He then gave Sec. Collins a chance to add his own remarks before closing. The Secretary reiterated that he would not publicly release pre-decisional documents that might scare veterans or employees and that the VA was committed to improving care and access.

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