Project 2025 Tracker / What’s done, what’s next

Section 3 · The General Welfare

20 Department of Veterans Affairs

641–656 · Brooks D. Tucker

  • 4 done
  • 12 partially done
  • 1 attempted
  • 33 not started
  • 1 already true

Major recommendations (5)

What has happened

The Mandate said

“The next Administration should explore how VASRD reviews could be accelerated with clearance from OMB to target significant cost savings from revising disability rating awards for future claimants while preserving them fully or partially for existing claimants.”

What happened

Attempted

VA's only cost-driven amendment to the rating schedule in the window: an interim final rule amending 38 CFR 4.10, effective on publication, to stop examiners discounting the ameliorative effects of medication when rating a disability. VA said the rule was "needed immediately" to head off the Court of Appeals for Veterans Claims' decision in *Ingram v. Collins*, 38 Vet. App. 130 (2025), which "could be applied broadly to over 500 separate diagnostic codes, requiring re-adjudications of over 350,000 currently pending claims" — a workload and cost rationale, not the accelerated body-system VASRD review the Mandate describes, and one that reaches pending claimants rather than sparing them.

The Mandate said

“Rescind all departmental clinical policy directives that are contrary to principles of conservative governance starting with abortion services and gender reassignment surgery. Neither aligns with service-connected conditions that would warrant VA's providing this type of clinical care, and both follow the Left's pernicious trend of abusing the role of government to further its own agenda.”

What happened

Done

VA's final rule "Reproductive Health Services" (90 FR 61328, effective 2026-01-30) reinstated the exclusions on abortions and abortion counseling from the medical benefits package at 38 CFR 17.38(c)(1) and from CHAMPVA, undoing the 2022 interim final rule that had added them; it adopted the 2025-08-04 proposed rule without change. With the gender-dysphoria directive already rescinded and "Gender alterations" standing as an exclusion at 38 CFR 17.38(c)(4), both objects the Mandate names are in the asked-for state.

The Mandate said

“Rescind all departmental clinical policy directives that are contrary to principles of conservative governance starting with abortion services and gender reassignment surgery. Neither aligns with service-connected conditions that would warrant VA's providing this type of clinical care, and both follow the Left's pernicious trend of abusing the role of government to further its own agenda.”

What happened

Partially done

VHA Notice 2025-01(1) rescinded VHA Directive 1341(4), "Providing Health Care for Transgender and Intersex Veterans" (dated 2018-05-23), "[t]o comply with Executive Order 14168". Effective on publication, VA stopped offering cross-sex hormone therapy except to veterans already receiving it from VA or carrying it over from military separation, and the notice states flatly that "VA does not provide any other medical or any surgical therapy for gender dysphoria". (An erroneous draft rescission promulgated 2025-03-14 was declared void by the same notice.) The abortion directive was untouched at this date.

The Mandate said

“Increase automation. Hiring additional staff to process claims is costly, is inflexible, and has yielded mixed results. … The best way to provide benefits faster and more accurately is by using technology to perform most of the work.”

What happened

Partially done

A presidential directive aimed at the same delays, from the intake side. Executive Order 14426 of 2026-09-08 names "delays in healthcare coverage, benefits processing and payment" as the problem and orders the Secretaries of War and Veterans Affairs, within 180 days, to "create and deploy new digital tools using artificial intelligence and other emerging capabilities to streamline veterans' applications for and access to benefits" in a single source, and, within 30 days and at all times after, to share every Official Military Personnel File and Service Treatment Record with VA the moment a service member is discharged. The records half feeds the claims-evidence supply chain the ADS expansion already automates; the AI half is about applying for benefits, not deciding claims. A directive with no effect yet, and silent on VBA's decision work, so the Quote's test — technology performing most of the work — is no nearer. The `partial` repeats.

The Mandate said

“Embrace the expansion of Community Based Outpatient Clinics (CBOCs) as an avenue to maintain a VA footprint in challenging medical markets without investing further in obsolete and unaffordable VA health care campuses.”

What happened

Partially done

The count reached 38 new health care clinics opened since January 2025. It stays partial rather than done because the second half of the Quote — expanding clinics *instead of* investing further in obsolete VA health care campuses — has gone the other way: the same release records that VA will spend nearly $5 billion in FY 2026 on modernizing and repairing existing health care facilities, the largest Non-Recurring Maintenance investment in VA’s history.

Still to come

Executive action 29

  1. 651 Transfer career SES out of PA/PAS-designated VA positions on day one Major Day one Not started
  2. 650 Accelerate VASRD reviews to cut disability ratings for future claimants Major Not started
  3. 645 Create a veterans bill of rights Notable Not started
  4. 646 Implement MISSION Act Section 121 veteran health care options education program Notable Not started
  5. 646 Require public VHA reporting using Medicare ACO-style standards Notable Not started
  6. 646 Conduct an independent audit of the VA modeled on the 2018 DOD audit Notable Not started
  7. 647 Require VHA providers to see about 19 patients per day, matching DOD Notable Not started
  8. 649 Create an "Express 30" pilot for a veteran's first disability claim Notable Not started
  9. 651 Rescind all VA delegations of authority from the prior Administration Notable Not started
  10. 646 Return the Office for Innovation of Care and Payment to Enterprise Integration Minor Not started
  11. 646 Have VA Medical Centers seek academic and private-sector community input Minor Not started
  12. 646 Assess VHA facility misalignment and rising infrastructure costs Minor Not started
  13. 647 Pilot VA facility-sharing partnerships with local health care systems Minor Not started
  14. 647 Establish an SES VHA Care System Chief Information Officer position Minor Not started
  15. 647 Assess clinical appointment loads where wait times exceed MISSION Act limits Minor Not started

and 14 more →

Needs Congress 4

  1. 645 Codify VA MISSION Act Community Care access standards in legislation Major Not started
  2. 653 Sunset the VA Office of Accountability and Whistleblower Protection Major Not started
  3. 647 Extend the Under Secretary for Health's term to five years, renewable once Notable Not started
  4. 652 Authorize more non-career PA positions at the VA Notable Not started

All recommendations in this chapter

Every recommendation this chapter is the home of, in printed-page order.

  1. 644 Rescind VA clinical directives on abortion and gender reassignment surgery Done
  2. 645 Codify VA MISSION Act Community Care access standards in legislation Needs Congress Not started
  3. 645 Create a veterans bill of rights Not started
  4. 645 Issue new Secretarial directives to implement the VA MISSION Act Partially done
  5. 646 Implement MISSION Act Section 121 veteran health care options education program Not started
  6. 646 Return the Office for Innovation of Care and Payment to Enterprise Integration Not started
  7. 646 Overhaul the Family Caregiver Program expansion Partially done
  8. 646 Require public VHA reporting using Medicare ACO-style standards Not started
  9. 646 Have VA Medical Centers seek academic and private-sector community input Not started
  10. 646 Conduct an independent audit of the VA modeled on the 2018 DOD audit Not started
  11. 646 Assess VHA facility misalignment and rising infrastructure costs Not started
  12. 647 Expand Community Based Outpatient Clinics instead of aging VA campuses Partially done
  13. 647 Pilot VA facility-sharing partnerships with local health care systems Not started
  14. 647 Extend the Under Secretary for Health's term to five years, renewable once Needs Congress Not started
  15. 647 Establish an SES VHA Care System Chief Information Officer position Not started
  16. 647 Bring VA wait times into compliance with VA MISSION Act time frames Partially done
  17. 647 Assess clinical appointment loads where wait times exceed MISSION Act limits Not started
  18. 647 Require VHA providers to see about 19 patients per day, matching DOD Not started
  19. 647 Pilot extended weekday and Saturday VA appointment hours Done
  20. 647 Create pay exceptions for hard-to-recruit high-demand clinical services Partially done
  21. 648 Assess facilities with below-average Community Care referral rates Not started
  22. 648 Expand telehealth and rural broadband to serve veterans and cut costs Partially done
  23. 648 Assess VA recruitment and retention in competitive medical markets Not started
  24. 648 Aggressively recruit retired physicians to serve veterans Not started
  25. 648 Expand VA tuition assistance for service in rural or understaffed VAMCs Not started
  26. 648 Examine VA mental health workforce surpluses and deficits Not started
  27. 648 Assess Electronic Health Record transition delays and functionality problems Partially done
  28. 649 Set benefits performance targets and report performance publicly each quarter Not started
  29. 649 Create an "Express 30" pilot for a veteran's first disability claim Not started
  30. 649 Hire more private companies to perform disability medical examinations Partially done
  31. 649 Increase automation of VBA disability claims processing Partially done
  32. 649 Change VA rules to reduce improper benefit payments and fraud Partially done
  33. 650 Accelerate VASRD reviews to cut disability ratings for future claimants Not started
  34. 650 Reassess the VBA information technology top-line budget Not started
  35. 650 Have the VBA make the case for a larger share of VA IT funding Not started
  36. 650 Reform VBA human capital management to use more contractors on claims Not started
  37. 650 Improve the VBA acquisition workforce and private-sector outreach Not started
  38. 650 Establish a VBA knowledge exchange program with private-sector firms Not started
  39. 651 Rescind all VA delegations of authority from the prior Administration Not started
  40. 651 Transfer career SES out of PA/PAS-designated VA positions on day one Day one Not started
  41. 651 Review VA hybrid and remote work and restore in-person presence Done
  42. 651 Expedite acquisition of a new VA Human Resources IT (HRIT) system Attempted
  43. 652 Broaden VA pay and benefits for critical non-medical skill sets Not started
  44. 652 Maximize VA hiring and pay authorities from the RAISE Act and PACT Act Partially done
  45. 652 Train VA leaders and managers on workplace culture and reward performance Partially done
  46. 652 Increase VA hiring of veterans and military spouses Not started
  47. 652 Prepare a vetted roster of VA appointees with the Presidential Personnel Office Not started
  48. 652 Authorize more non-career PA positions at the VA Needs Congress Not started
  49. 652 Increase use of Limited Term Appointment SES positions at the VA Not started
  50. 653 Sunset the VA Office of Accountability and Whistleblower Protection Needs Congress Not started
  51. 654 Decouple Human Resources and Administration from the Office of Security and Preparedness Done