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Veterans Affairs' Under Secretary of Health David Shulkin attends an event at the National Press Club in Washington, D.C., on Wednesday, April 20, 2016.

Veterans Affairs' Under Secretary of Health David Shulkin attends an event at the National Press Club in Washington, D.C., on Wednesday, April 20, 2016. (Carlos Bongioanni/Stars and Stripes)

WASHINGTON – David Shulkin, President Donald Trump’s nominee for secretary of the Department of Veterans Affairs, could face some scrutiny about his plans to reform the agency Wednesday during his Senate confirmation hearing.

So far, some lawmakers have signaled at a quick confirmation for Shulkin, who already worked at the VA under President Barack Obama as the agency’s undersecretary of health. But some veterans tracking the process remain cautious about Shulkin’s plans for the VA, primarily regarding changes affecting how veterans receive private care at the government’s expense.

“I hope we can have an expeditious, but thorough, hearing, and get him sent up to the floor of the Senate and get him on the job as soon as possible,” said Sen. Johnny Isakson, R-Ga., chairman of the Senate Veterans’ Affairs Committee. “Our veterans don’t deserve to have a coach on the bench when we can put him on the field.”

Lawmakers on the Senate and House Veterans’ Affairs Committees have said they want to tackle big issues at the VA during this session of Congress, including working on measures to hold VA employees accountable, streamline the process veterans use to appeal disability claims and change how the VA works with outside providers to get veterans access to care.

Many veterans organizations, including Iraq and Afghanistan Veterans of America, urged Trump to retain former VA Secretary Bob McDonald to continue his work on those issues. IAVA leadership has gathered questions about Shulkin that they want answered before he’s confirmed, and the group is planning to pass the list of questions to lawmakers before the hearing Wednesday afternoon.

“[N]ew veterans are looking for him to share more about his vision for the future of the VA, his positions on key issues like privatization, and why he feels he’s the best candidate,” IAVA founder Paul Rieckhoff said Monday in a statement. “This week, we will all find out what the updated Trump vision for the VA looks like and how that compares with that of Dr. Shulkin.”

Rieckhoff previously said in an interview with Stars and Stripes that Shulkin could serve as a bridge between McDonald’s plan for the VA and Trump’s, but added: “We all have to be appropriately skeptical.”

Congress and VA leadership have been struggling to perfect the system for how veterans receive outside care since the temporary Veterans Choice Program was established in 2014. The program, which gives veterans options for care outside of the VA, was put in place following the discovery that veterans were subjected to long waits for care at VA facilities.

Veterans Choice is set to expire in August, and Trump has hinted at big changes to expand veterans’ options for outside care.

While leaders of various veterans organizations have been cautious of the idea -- arguing too much money toward non-VA health care could drain VA resources – Trump’s statements fall in line with conservative-leaning advocacy group Concerned Veterans for America, backed by billionaires Charles and David Koch.

One of CVA’s senior advisers has worked as part of Trump’s transition team, and the group has released a list of significant changes that it believes should be implemented at the department.

Like Rieckhoff, CVA said the confirmation hearing Wednesday will be a big indication of how VA reform would play out in the new administration.

“[T]he hearings are going to be incredibly important in determining which direction he wants to take the VA,” said Dan Caldwell, CVA’s director of policy. “I think during the confirmation hearing, there needs to be discussion… whether he supported many of the same reforms McDonald advocated for, and how he would be different from them. There needs to be more specifics provided.”

It’s likely Shulkin will also face questions about the 90-day federal hiring freeze that Trump imposed last week. Sen. Jon Tester, D-Mont., ranking member of the Veterans’ Affairs Committee, led Democrats in opposing the freeze at the VA and asking for an exemption for job-seeking veterans.

Acting VA Secretary Robert Snyder announced he would exempt many VA positions from the freeze for public safety reasons. The exemptions do not include vacant positions at the Veterans Benefits Administration, which is working on a backlog of claims for pension and disability compensation.

Bill Rausch, director of veterans nonprofit Got Your 6, said he’s just as interested to hear from senators on Wednesday.

At the end of the congressional session last year, lawmakers settled on a veterans reform bill that included only pieces of what the VA and veterans groups were hoping to accomplish. Parts of the 57-page legislation was taken from the 400-page Veterans First Act, which never made it to a Senate vote.

In his last weeks as VA secretary, McDonald urged Congress to prioritize VA reform.

“VA will never be reformed with the work of one person,” Rausch said. “It’s going to take the Senate Veterans’ Affairs Committee, the House [Committee on Veterans’ Affairs] and all the veterans groups working together. We’re talking about reforming the second largest bureaucracy in the federal government.”

If the Senate confirms Shulkin’s nomination, he will be the first person without military service to hold the post. Prior to working at the VA, Shulkin was a chief executive at several health care facilities in New Jersey, including Morristown Medical Center, Goryeb Children’s Hospital and the Atlantic Rehabilitation Institute.

The confirmation hearing starts at 2:30 p.m., Eastern Standard Time, and will be streamed online at veterans.senate.gov.

wentling.nikki@stripes.com Twitter: @nikkiwentling

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Nikki Wentling has worked for Stars and Stripes since 2016. She reports from Congress, the White House, the Department of Veterans Affairs and throughout the country about issues affecting veterans, service members and their families. Wentling, a graduate of the University of Kansas, previously worked at the Lawrence Journal-World and Arkansas Democrat-Gazette. The National Coalition of Homeless Veterans awarded Stars and Stripes the Meritorious Service Award in 2020 for Wentling’s reporting on homeless veterans during the coronavirus pandemic. In 2018, she was named by the nonprofit HillVets as one of the 100 most influential people in regard to veterans policymaking.

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