Balgarianovinite.com
Health care companies and legislators are presiding over a shift toward privatized veterans’ care, attracting support from prominent Republicans including Defense Secretary Pete Hegseth and Vice President J.D. Vance. Policymakers are now confronted with a critical question, one that also arose during President Donald Trump’s first term: Should the Department of Veterans Affairs remain the direct provider of care, or should there be a move toward outsourcing health services to the private sector?
Veterans Affairs Secretary Doug Collins, strongly supported by the Koch-backed Concerned Veterans for America, has overseen unprecedented staff reductions in VA health centers across the nation and worked to expand the use of private providers. Collins argues that “money and people do not solve the problems,” even as demand for veterans’ health care continues to outpace the department’s capacity to provide it. Instead, Collins’ goal is to present veterans with more care choices by directing them to non-VA, private facilities.
While backers of the proposal say the plan would expand access to care, some warn that this process could gut the VA system, which consistently ranks as well as or better than comparable private facilities. Over 9 million veterans receive all their care within the VA, often involving highly specialized treatments. By shifting them to a fragmented and costlier for-profit system, massive gaps in care can emerge.
Sensing a potential shift under the Trump administration, private health care companies and industry associations have focused their political spending on veterans’ care policy.
Follow the money
The push to privatize veterans’ health care has piqued the interest of members of the VA’s Community Care Network, companies that provide health services when the VA cannot.
One of these companies is UnitedHealth Group, where employees and PACs affiliated with the Optum Serve division donated $125,410 to the members of the House and Senate committees overseeing veterans’ affairs during the 2024 election cycle. They also donated $221,082 to the House and Senate Armed Services committees. Additionally, UnitedHealth was one of many in the health sector that lobbied against the 2024 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, which includes new parity-of-care standards.
Other major health care organizations lobbying on the bill included Blue Cross Blue Shield, the American Hospital Association and the American Medical Association. The bill ultimately passed in March 2024, and directs more funding to private providers while expanding the capabilities of non-VA entities in veterans’ health care.
Another group involved in the VA’s Community Care Network is TriWest Healthcare Alliance, which connects veterans to community-based health services. TriWest spent $190,000 on lobbying in the first three quarters of 2025, putting the company on track for its largest spending year since 2021. (TriWest’s biggest lobbying expenditure occurred in 2019, reaching nearly $800,000; this was soon after enactment of the VA MISSION Act, which dramatically expanded veteran community care services.)
Members of the House Veterans’ Affairs Committee received nearly $4.5 million in contributions from the health sector: $2.2 million from political action committees, and another $2.2 million from individuals. Among the top donors was the American Optometric Association. Health professionals also ranked seventh among the top industries contributing to the committee in the 2024 election cycle, donating a total of $2.4 million, with 60 percent going to Republicans.
The Senate Veterans’ Affairs Committee received similarly large totals in the 2024 election cycle: $6.9 million from health sector political action committees, and another $16.8 million from individuals. Health professionals ranked sixth among top industries donating to the Senate committee, contributing a total of $11.9 million.
The American Legion, one of the nation’s largest veterans interest groups, strongly opposes the privatization of veterans’ health care. Since 2022, its lobbying spending has surged, reaching $760,000 in 2023 and 2024, with 2025 projected to hit the same level. Paralyzed Veterans of America, another prominent veterans interest organization, spent $265,065 on lobbying and has actively engaged on multiple bills related to the privatization of veterans’ care, including the Veterans Health Care Freedom Act and legislation amending external provider scheduling programs.
The push toward privatization
A central part of the current move toward privatization is the Veterans’ ACCESS Act, introduced in early 2025 by Rep. Mike Bost (R-Ill.) and passed out of the House Veterans Affairs Committee. The ACCESS Act would work to ease eligibility thresholds for private care and enforce pilot programs to increase health access. These new systems would allow veterans to receive mental health and substance use services outside the VA, without any prior authorization or intervention from the department.
Groups lobbying on the bill include Americans for Prosperity, also linked to the Koch network, which advocates for a “personal option” to access private community care facilities. Disabled American Veterans, American Psychological Assn Services and Blue Cross Blue Shield have also tried to exert influence.
The proposal is appealing to rural veterans who live hours from the nearest VA facility. In North Dakota, where the only full-service VA hospital is in Fargo, many veterans hitch a ride in a VA van for the 140-mile trip to get care; requests for a van ride must be scheduled 72 hours in advance. One Iraq War veteran in South Dakota makes an eight-hour round trip to see her provider, and estimates she spent more than $1,000 in travel costs in a single year. Bost’s ACCESS Act would transfer routine needs and services to private-sector providers, so that VA vans and long drives are no longer the only option.
Yet even as the bill promises better access for rural veterans, it has come under scrutiny for pushing the VA toward an insurance-style payer model. Many of the VA’s core services don’t translate well into a private insurance model; veterans have higher rates of mental health conditions than the general population, yet private-sector care for these conditions is often limited and expensive. Sending veterans to already overwhelmed private providers, especially as millions of rural Americans lose Medicaid or American Affordable Care Act-granted coverage, could worsen care access.
Decades of research shows that VA hospitals and clinics provide care equal to or better than the private sector across most medical conditions, including in mental health, long-term care, and treatment for service-connected conditions such as PTSD and toxic exposures. A recent survey by Iraq and Afghanistan Veterans of America found that only 31 percent of veterans receiving community care believed their outside providers understood their medical needs. By directing veterans to private facilities, the VA’s direct-care capacity is in danger of eroding.
Experts predict a shift in the VA’s role from provider to payer, making the department more of a financier than a health care system. As more veterans turn to private facilities, veteran care may become a substantial revenue source for private insurers and contractors.
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