Rod Lamkey/AP Photo
Secretary of Veterans Affairs Doug Collins testifies during a Senate Committee on Veterans’ Affairs hearing on Capitol Hill, May 6, 2025, in Washington.
When Doug Collins first appeared before the Senate Committee on Veterans’ Affairs (SVAC) for his confirmation hearing, his comforting bromides about his commitment to the VA and veterans lulled Democratic members, who, with only a few exceptions, voted to confirm Collins as President Trump’s new secretary of the Department of Veterans Affairs. As one Capitol Hill insider told the Prospect, many believed that, unlike Pete Hegseth or RFK Jr., Collins was “a man they could work with.”
Democrats on the House Committee on Veterans’ Affairs (HVAC) came to the same conclusion. Rep. Mark Takano (D-CA), ranking member of the HVAC, said he was ready to welcome the former Georgia congressman back into the fold because “I think we will be able to do some good work at VA with Doug Collins.”
Fast-forward four and a half months to May 6th, when Collins appeared for the second time in front of the Senate Committee, and May 15th, when he made his first appearance before the HVAC. Assessing his first months on the job, Democrats now clearly viewed Collins as someone working not with, but against, them—and against the nation’s veterans. They expressed anger at his firing of 1,000 probationary employees, his cancelation of hundreds of contracts with vendors that supply VA with critical resources, and his termination of VA researchers, thus interrupting clinical trials that could benefit veterans. And, of course, there was Collins’s vow to lay off 83,000 VA employees.
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In both hearings, Collins abandoned any pretense of collegiality. When confronted with uncomfortable facts and irrefutable arguments, Collins followed the three rules that Roy Cohn taught the young Donald Trump: “attack, attack, attack; admit nothing, deny everything; always claim victory.”
In the Senate hearing, Collins’s dodging and weaving began when he was questioned about his goal to cut 15 percent of the VA’s 480,000 employees, returning the nation’s second-largest federal agency to its 2019 workforce levels. This would, he stated in his written testimony, “strategically reduce staff to ensure VA’s budget is mostly going directly to veterans. We will accomplish this without making cuts to health care or benefits to Veterans or VA beneficiaries.”
Even SVAC chair Kansas Republican Sen. Jerry Moran expressed serious reservations about the proposed cost-cutting initiative. “This ought not to be about a set number but about rightsizing,” Moran said in the hearing. “The changes under way should be backed by data informed by veteran demand and focused on improving outcomes for the men and women the VA serves.”
In response, Collins asserted that the VA has no need for all its current workforce because the number of enrolled veterans has remained steady at approximately nine million for years. He was conveniently mute about the critical fact that the Veterans Health Administration (VHA) had, in FY2024 alone, set an all-time record delivering 7 percent more appointments than in 2023.
Collins also claimed that his plan did not threaten the jobs of any caregivers, but only gardeners, interior designers, human resource and payroll personnel, as well as the doctors and nurses who provide no direct care to patients. When several House members countered that VA employees had reached out to them to convey how demoralized they feel after receiving the administration’s “Fork in the Road” warnings of being possibly laid off in the downsizing, watching that happen to colleagues, and knowing their position was recently evaluated for whether it is “essential,” Collins blamed the employees for revealing their fears, and congressional Democrats for spreading false information.
Perhaps Collins’s most contemptable behavior came when he refused to accept any responsibility for his actions.
Collins also justified his goal of cutting VA staff because, he asserted, the VA has, since the late 1990s, added tens of thousands of administrators who work at the VA Central Office as well as throughout the VA’s Veterans Integrated Service Networks (VISNs), the regional offices that administer and coordinate VA health care.
To legislators who may be unfamiliar with the details of the 1990s restructuring of the modern VHA, 26 years ago VHA patient enrollment was only 3.4 million, not the more than nine million it is today. Over that same period, Congress has also added numerous new programs, with new reporting requirements. These include the Trump-era VA MISSION Act and the Biden-era PACT Act. The MISSION Act created a huge parallel private-sector health care network, the Veterans Community Care Program (VCCP). Congress has mandated that VHA administrators working in a special VCCP coordination office with an annual budget of a half-billion dollars oversee referrals to, and billing by, 1.7 million private-sector VCCP health providers.
As one VA observer who chose to remain anonymous observed, “Some VISN staff reductions could occur without loss of functional capability if such were done in a systematic and thoughtful manner. In doing so, however, it would be important to work with the Congress on what programmatic, reporting, and other requirements they are going to insist upon going forward.”
As for all those supposed underperforming doctors and nurses Collins wants to reassign or fire, some are chiefs of medicine, chiefs of staff, chiefs of nursing, or nurse managers who provide the kind of clinical leadership without which no hospital or health system can function. These administrative positions also require the very clinical background that Collins seems to dismiss.
Collins is correct when he says that some clinical staff now devote less time to providing clinical care. Why is that? Some have been reassigned just to schedule the accelerating number of referrals to the private sector. Others are busy trying to undo the damage wrought by another Trump-era policy. During Trump’s first term, a no-bid contract was awarded to Cerner (now owned by Oracle) to replace the VA’s in-house, user-friendly electronic health record (EHR) with an off-the-shelf alternative.
“Trying to help with the difficult conversion from the existing EHR to the new Cerner-Oracle system is a huge undertaking,” Ross Koppel, professor of medical informatics at the University of Pennsylvania, explains. “To do this, doctors and nurses have contributed hundreds of hours in which they pay extraordinary attention to the EHR and to patient safety. Serious errors have been repeatedly documented and addressed by Congress. This is stressing both patients and clinicians, particularly since all of this is happening while the VHA is reducing staff and seeking opportunities to use private medical services.”
Collins also elided the facts when he denounced VHA’s suicide prevention budget expansion since 2008 while the number of veteran suicide deaths remained constant. He neglected to explain that 2008 was the year the Veterans Crisis Line (VCL) was instituted (and suicide prevention coordinators were placed at each VA medical center). The VCL alone accounts for over half of the current suicide prevention budget, and among the 2,600 calls it receives daily, it facilitates 50 to 100 emergency dispatches, each a potential lifesaving rescue.
When it came to the Veterans Benefits Administration (VBA), Collins was no less disingenuous when he slammed the Biden administration for a purported increase in disability claims backlog. He conveniently ignored data readily available on VA’s website: The PACT Act, which compensates veterans exposed to toxins in their military service, has generated a surge of more than a million new claims. In 2024 alone, the VBA completed more than 2.5 million disability compensation and pension claims, an all-time VA record that exceeded the previous year’s record by 27 percent and reduced backlogged claims by 42 percent.
Perhaps Collins’s most contemptable behavior came when he refused to accept any responsibility for his actions. When Sen. Richard Blumenthal, ranking member of the SVAC, reminded Collins that firing people has serious cost ramifications if employees are reinstated, Collins raised his hands in exasperation, and exclaimed, “This is exactly what I am up against. I will not let you scare my veterans, scare my boys.”
At the end of the House hearing, ranking member Takano displayed a spreadsheet in which Collins’s team had calculated the cost savings that would result from a 15 percent reduction in every VA classification. The spreadsheet, Takano said, estimated that cutting 4,000 nurses would save $1 billion, while cutting 400 psychologists would save $110 million. Why, Takano asked the secretary, had Collins requested that his team conduct this kind of analysis given that he’d promised not to cut direct-care staff?
Instead of responding to the question, Collins began yelling at the ranking member, insisting that this was a leaked document, and was “not helpful.” In this and another exchange about his return-to-office order, Collins blamed subordinates for their “malicious compliance” in following his directives.
In repeatedly trying to deny responsibility for his actions or the impact of his policies, Collins, who served in the military for 20 years and retired as a colonel, exhibited behavior unbecoming of a military officer. In the military, the mark of a good officer is not only that he or she issues clear orders and makes sure they are properly executed but also takes responsibility for the net impact of their decisions.
As one military expert explained, "Command is a sacred trust. The legal and moral responsibilities of commanders exceed those of any other leader of similar position or authority.” Under both military doctrine and U.S. law, “command authority bears responsibility for the conduct of soldiers under its supervision.” If the troops commit mistakes, that’s a failure of leadership.
Democrats tried valiantly to focus on these failures. As they continue their probe, however, they will have to speak up more forcefully. Over the next few months, as Collins’s mass firings proceed, they will need to explain why taking the VA back to pre-Biden staffing levels is so misguided. In 2019, as the Prospect has reported, the VA was not overstaffed but actually short-staffed by at least 70,000 positions. According to a report by the Veterans Healthcare Policy Institute (in which the two authors are senior policy analysts), these staffing shortages made it difficult to deliver care or process veterans’ benefits claims in a timely manner. Ironically, just a year ago, when President Biden’s VA secretary Denis McDonough told Congress he might have to cut 10,000 full-time positions due to budget limits, Sen. Moran, who was then ranking member of the HVAC, blasted the proposal, calling it a “drastic” and “shortsighted” decision.
Democrats and any Republican colleagues with whom they can partner also need to be wary of the numbers trap Collins may be setting for them. Collins, as he has hinted, could fire “merely” 70,000 or even 50,000 VA employees. In so doing, he could appear to be eminently responsive and flexible, while still doing irreparable damage to the VA and the nation’s veterans.
On the afternoon after the Senate hearing, a group of 60 members of Common Defense, a progressive veterans’ organization that has launched a nationwide campaign called “VA: Not For Sale,” joined nurses and congressmembers on the steps of the U.S. Capitol to protest Collins’s plans. Common Defense’s executive director, Army veteran Jose Vasquez, spoke eloquently about the care he’s received: He’s recently had surgery and is now undergoing chemotherapy for pancreatic cancer at the Manhattan VA.
Vasquez later told the Prospect that Common Defense is adamantly opposed to arbitrary mass layoffs at the VA. “VA shouldn’t be firing 8, or 80, or 8,000, much less 83,000 employees. The VA needs to hire, not fire.” More importantly, Vasquez added, “instead of attacking VA doctors and nurses who contribute to our care in all kinds of ways, VA leaders should be supporting the dedicated caregivers who themselves sacrifice to support veterans like me.”
