Lawmakers and veterans service organizations are clashing over the possible "privatization" of the broken Department of Veterans Affairs under the Trump administration, even though nobody in either party has proposed such a plan.
Some Democrats and veterans groups have begun to sound the alarm over what they describe as plans by Republicans to "privatize" the VA. But other veterans groups and Republicans argue privatization has never been part of the conversation surrounding VA reform, and say warnings over privatization are a "strawman" tactic designed to distract from the VA's massive failures.
"It's a deliberate attempt to mislead people about Donald Trump's reform plan and others' reform plans, including House Veterans' Affairs Committee Chairman Jeff Miller's reform plan," Dan Caldwell, legislative director at Concerned Veterans for America, told the Washington Examiner.
Caldwell noted Democrats' privatization rhetoric has failed to pass muster with multiple fact checkers.
During the presidential race, Hillary Clinton earned a "mostly false" rating from Politifact for claiming Trump supported a privatization "agenda." Sen. Bernie Sanders and Clinton each earned "three Pinocchios" from the Washington Post fact checker for railing against Republican-backed privatization.
Miller, Sen. John McCain and other prominent veterans' advocates in Congress have led bipartisan efforts to strengthen veterans' ability to seek care outside the VA system, and passed legislation in 2014 that established the VA's Choice Program. That program allowed veterans to bypass the VA if they lived too far from a facility or couldn't land a timely appointment, and Caldwell and others say embracing that change isn't the same as privatization.
"It's a false attack designed to undermine these reforms, because what this is ultimately really about is preserving the argument for single-payer healthcare, which many on the left obviously want," Caldwell said.
"Many on the left, for many years, held up the VA as an example of the government wanting to do single-payer healthcare," he added. "This is ultimately [about] proving that government-run, top-down healthcare works."
Trump's 10-point plan for VA reform does not include a proposal for privatization.
Even so, veterans service organizations such as the American Legion say they are worried that privatization of the VA might be on the table when the new administration takes over. A spokesman for the American Legion did not return a request for comment.
Democrats in Congress also seem resistant to the upheaval Trump has promised to bring to federal agencies.
Rep. Mark Takano, acting ranking Democrat on the House Veterans' Affairs Committee, told Politico last week that he opposed "radical change" of the VA system. "Radical change is really unnecessary and a misuse of what Donald Trump thinks is his mandate," Takano said.
In a subsequent statement to the Examiner, Takano clarified that he had been referring only to privatization, and he took aim at Concerned Veterans for America's perceived political leanings.
"President-elect Donald Trump ran on his promise to improve the care provided to America's veterans, but the early steps taken by his transition team have set off alarm bells in the veterans community," Takano said.
"The significant influence of the extreme conservative group Concerned Veterans for America, instead of more respected veterans organizations, has been particularly troubling. CVA's proposal for privatizing the VA, which is the 'radical change' I was referring to, is strongly opposed by a vast majority of veterans and nearly all of the groups that represent them," Takano added.
Democrats' characterization of CVA's reform plan as "privatization" have earned "Three Pinocchios" from fact checkers in the past, as the group has never proposed privatizing the VA. Like congressional Republicans and Trump himself, CVA has proposed increasing veterans' ability to seek private healthcare if they choose to do so while preserving their option to use VA care if they prefer the current system.
"It is intellectually lazy to say that any expansion of healthcare choice for veterans is privatization, and it shows an absolute misunderstanding of what privatization really is and how veteran healthcare works," Caldwell said.
Because CVA is backed by the political network of the Koch brothers, a pair of deep-pocketed Republican donors who have become frequent targets of the left, the veterans group is often subjected to attacks from Democrats wary of its influence on Republican lawmakers.
The Veterans Choice Act, which created a pilot program that gave some veterans "choice cards" to pay for care from private doctors, passed both chambers of Congress with bipartisan support in 2014. Many veterans service organizations, including the American Legion, AMVETS, Disabled American Veterans and Iraq and Afghanistan Veterans of America supported the creation of the Choice Program at the time.
The VA's own healthcare plan from 2015 suggested the agency should rely on private-sector doctors to improve veterans' access to treatment. But the agency has long ignored its ability to offer veterans the option to seek non-VA medical care, a broad authority it could use outside of the Choice Program if VA leaders allowed it.
A congressional aide told the Examiner that Congress had to legislate the Choice Program in order to force VA officials to exercise that authority, which they had declined to use during the wait time scandal that left dozens of veterans dead.
The Choice Program was born during President Obama's second term, whistleblowers exposed a nationwide effort to cover up long veteran wait times by creating fake patient waiting lists at 110 VA facilities. Those waiting lists covered up the fact that many veterans were waiting months to land a doctor's appointment.
But the VA hasn't fully used the program, and even asked Congress to put take money from the Choice Program to fund other priorities. That has angered Republicans, along with the failure of the VA to fire more than a handful of employees for their role in the wait time scandal. Some employees who were recommended for termination ultimately received more lenient punishments from agency managers.
The Trump transition team did not return a request for comment about the emerging fight over what to do with the VA. But for now, Democrats in particular are still warning about "privatization."
In an interview with Fortune published Saturday, current VA Secretary Robert McDonald spoke out against "wholesale privatization," which no Republican, Democrat or notable veterans group has proposed. But McDonald expressed support for using private sector doctors to cover gaps in VA care, something both parties actually agree on, although partisan rhetoric has long prevented them from acknowledging it.
"[W]hat I'm for is taking advantage of the private sector to provide the additional capability we don't have," McDonald said. "We've gone from less than 20 percent of our appointments being in the private sector to the point now where I believe we're at about 30 percent, or maybe even above that. So we're using the private sector to help build the capability that we haven't built or to do the things where we don't think we should build the capability."
The race to replace McDonald has heated up in recent weeks as high-profile figures like former Sen. Scott Brown and Sarah Palin have emerged as possible contenders for the VA's top job.
Miller, who will retire from his Florida congressional seat at the end of this Congress, is also a leading contender for the position. Pete Hegseth, formerly of CVA and currently a Fox News contributor, has been mentioned as a candidate as well.
Whoever takes the position will face an uphill battle to secure the reforms Trump promised on the campaign trail. Toughest among them will almost certainly be his formal pledge to fire "any employee who has jeopardized the health, safety or well-being of a veteran."
VA reform legislation has stalled in Congress previously when accountability provisions designed to give agency leadership more authority to fire officials have prompted resistance from federal employees' unions.