Smart budget cuts at the VA could help preserve critical services

The Hill

18-06-2025

What does it mean to keep a promise to our veterans and to the next generation? With the national debt surpassing $36 trillion, a serious assessment of federal spending, including within the Department of Veterans Affairs, is not just prudent, it's necessary.
This isn't an ideological debate. It's arithmetic. Nearly one in every four dollars the federal government spends is borrowed. Interest on the debt exceeds what we spend on national defense. If we continue on this path, we risk crowding out critical programs, including those that serve our veterans and their families.
The VA is the second-largest federal agency by budget, behind only the Department of Defense. Since 2001, its annual budget has increased more than 500 percent, from $45 billion to over $320 billion in 2024. By next year, the VA has requested a nearly 10 percent increase.
Much of that growth is warranted. We have fought two decades of war, expanded eligibility through legislation like the PACT Act, and developed advanced care for physical, mental and environmental health needs. But budget growth hasn't always translated into better outcomes.
Although the number of veterans in the U.S. has declined from 26 million in 2000 to about 19 million today, the number of veterans using VA health care has more than doubled, from 2.7 million to 6.5 million.
Services have expanded, but inefficiencies have multiplied. A 2022 report by the Government Accountability Office found dozens of VA medical facilities operating at less than 30 percent capacity. Efforts to modernize or consolidate these centers have stalled due to political resistance, despite evidence that realignment would improve care and reduce costs.
The VA's electronic health record modernization effort has also been plagued by cost overruns, delays, and coordination failures. Despite billions in spending, the system remains fragmented and difficult to navigate for many veterans.
This isn't about making harmful or arbitrary cuts to benefits. Veterans have earned their care, and we must honor that promise. But upholding that promise also requires us to ask whether every dollar spent is actually improving outcomes.
The Congressional Budget Office has identified several policy changes that could reduce waste and improve service delivery. These include consolidating underused infrastructure, eliminating duplicative services across agencies, modernizing procurement and supply chains, and adjusting income thresholds for certain non-service-connected benefits. These reforms would not eliminate services. They would make sure funding is directed to areas of greatest need, expanding access, reducing wait times and investing in prevention and mental health support.
This conversation matters now more than ever. As interest payments on the debt rise, they threaten to crowd out all other spending. The government already spends more than $950 billion a year just to service the national debt, and that number is expected to grow. In 2025, mandatory spending — things like Social Security, Medicare and debt interest — will account for 74 percent of the federal budget. That leaves only 26 percent for everything else, including veterans' care.
If we don't address inefficiencies now, we may soon face a future where essential services are on the chopping block. Reforming the VA is not just a budgetary issue, it is about securing the future of veterans' care in a fiscally sustainable way.
Some argue that any talk of reform is a betrayal. But the real betrayal is allowing waste and dysfunction to persist. Veterans do not need broken systems wrapped in patriotic language. They need care that is accessible, responsive and built for their realities. That means investing in what works — technology upgrades that improve outcomes, partnerships that bring care to rural areas, and early interventions that prevent bigger crises down the road.
Veterans' organizations should not shy away from these conversations. We should lead them. That includes demanding transparency, performance metrics and meaningful oversight. It also means acknowledging that the VA, like every other agency, must adapt to a rapidly changing fiscal and demographic landscape.
The VA's mission is to care for those who have borne the battle. Fulfilling that mission doesn't mean avoiding hard questions. It means confronting them with honesty, clarity and courage. Reforming the system is not abandonment — it is the only way to keep our promise.
In a time of mounting debt and growing needs, fiscal responsibility and moral obligation are not in conflict. They are aligned. Veterans and their families deserve a system that works, and future generations deserve a country that can afford to keep its promises. We can have both, but only if we are willing to do the hard work now.
Mike Desmond is the strategic director of government affairs and advocacy at Mission Roll Call, a nonpartisan organization dedicated to amplifying the voices of veterans and their families. He is a former CIA officer and Special Operations veteran.