Project 2025: It Isn't Veteran-Centric
P2025 seeks to remand veteran responsibilities to the "private sector" (Scroll to the end to listen)
“Veteran-Centric” is a term from 45’s administration. It arose from the passage of the VA Mission Act of 2018.
The current VA leadership team of Biden appointees has adopted some of their predecessors’ governance processes. However, they have not sustained the previous Administration’s commitment to a genuine “Veteran-centric” philosophy, most notably with respect to the delivery of health care, and harbor a bias toward expanding the unionized federal employee workforce that has not always been aligned with a focus on “Veteran-centric” care.
Project 2025, page 642
Essentially, P2025 framers define “veteran-centric” care as enabling veterans to utilize private-sector community care centers outside the VA system. Third-party administrators process claims and handle payments. Think of this out-sourcing of services as the VA’s Medicare Advantage plan.
Contrast this private-sector outsourced care model with a veteran physician scientist’s definition of “veteran-centric” care.
I served as a Marine Corps officer for 10 years before becoming a physician-scientist. My perspectives on military life and medicine, therefore, developed independently. These 2 worlds crossed paths during residency at the Philadelphia Veterans Affairs (VA) Medical Center. Here, my military service helped me be a better physician. It was also where I first shared my military experiences with my fellow VA physicians, most of whom lacked this experience. Many aspects of the military seemed foreign to them, despite their years of service caring for veterans. As a physician and veteran, I have learned that a better understanding of military culture and its effects on veterans’ perceptions of health care strengthens the physician–patient relationship. Failing to appreciate these differences can result in veterans’ and physicians’ perspectives being misaligned when managing a veteran’s health.
SOURCE: Edward P Manning MD PhD, National Institutes of Health
Project 2025 aims to send veterans to private clinics and hospitals not affiliated with the VA, many of which will have no veterans with military service experience on staff. This approach harms veterans in several ways.
There also is growing concern in Congress and the veteran community that the VA is poorly managing and in some cases disregarding provisions of the VA MISSION [Maintaining Internal Systems and Strengthening Integrated Out-side Networks] Act of 2018 that codify broad access for veterans to non-VA health care providers.
Project 2025, page 642
Project 2025 defaults to private-sector outsourcing of services that the federal government has traditionally provided. This approach causes two problems for veterans:
Veterans make up around 30% of the federal workforce (300,000 employees.) Project 2025’s stated mission to deploy Schedule F to fire tens of thousands of federal workers will directly impact veterans, working both within and beyond the VA. (SOURCE: Project 2025 The Worst-Case Scenario for Veterans by Michael Embrich)
For VA users, Project 2025’s twisting of the meaning of “veteran-centric” care will negatively impact the timeliness, quality and cost of veteran healthcare.
In January, NPR did a story about how older Americans feel trapped in Medicare Advantage plans HERE. P2025’s “veteran-centric” approach will replicate these limited options and private-sector red tape for veterans.
The Trump Administration made Community Care part of its “Veteran-centric” approach to ensure that veterans would be able to participate more fully in their health care decisions and have options if or when the VHA was unable to meet their needs. The Biden Administration has watered down that effort, has sought various procedural ways to slow the rate of referrals to private doctors, and at some facilities is reportedly manipulating the Community Care access standards required by the VA MISSION Act of 2018. If the makeup of Congress is favorable in 2025, the next Administration should rapidly and explicitly codify VA MISSION Act access standards in legislation to prevent the VA from avoiding or watering down the requirements in the future.
Project 2025, page 645
We’ve seen a version of the language participate more fully in their health care decisions before. We covered it in our newsletter Project 2025: How It Cuts Employee Benefits Without Increasing Wages.
Here’s the specific P2025 language from that newsletter:
Wages vs. Benefits. The current tax code has a strong bias that incentivizes businesses to offer employees more generous benefits and lower wages. This limits the freedom of workers and their families to spend their compensation as they see fit—and it can trap workers in their current jobs due to the jobs’ benefit packages.
Project 2025, page 697
Any time Republicans tell Americans they should have “freedom” to make decisions for themselves, look for the catch. In almost every instance, these changes give Americans fewer options, more bureaucracy, higher stress, and less money. Our veterans deserve better.
Project 2025 will force veterans to use private-sector “community clinics” staffed with people who have no military experience. Claims and payments for these services will be outsourced to private-sector third parties, which operate like for-profit insurance companies. Project 2025 will also leave around 300,000 federal veterans unemployed.
For a party that professes to care about those who have served our country, Fascist Republicans have nothing but contempt for our veterans. We cannot let them win in November.
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Calls to Action to Keep P2025 From Ruining YOUR Life
Check your voter registration or register to vote: I Will Vote
Support Democratic campaigns directly in competitive races: Blue24
Support earlyworm’s 2024 Giving Guide: earlyworm
Report a Project 2025 incident: Not On Our Watch
Mail postcards to swing-state voters: Postcards to Swing States
I also wanted to mention my husbands urologist is a veteran, in the reserves, and a flight surgeon for NASA; and he works for a hospital in the Texas Medical Center BUT he spends most of his time at the VA and am grateful he does this to help other doctors and the patients with his experience and medical knowledge. He is a gem!
When I worked as a social worker in geriatrics, I fielded many a call from distressed patients that were saddled with extra costs from Medicare Advantage Plans. (you are dealing with an insurance company). I told them to call Medicare and ask to return to Traditional Medicare. They will re-enroll you in the allotted time frame. As a prior salesperson I know the sales reps are very convincing with many unsuspecting elders. The Advantage Plans might work for some people but my experiences working with clients have proven otherwise. Our veterans deserve better!!!
Thank you Andra for your excellent reporting and explaining! A special thanks for your IG meme! Spot on and love how you referenced pages for the fact checkers to look at. I am so grateful for you! I was pondering how to put one together and I knew I needed to reference pages and if I got it wrong it would be flagged!