President Trump's pick to lead the Department of Veterans Affairs is hearing skepticism from senators about his ability to lead the sprawling and often-troubled agency ahead of what could be a contentious confirmation hearing next week.
Ronny Jackson, who now serves as the White House physician, has no experience running a bureaucracy like the VA, which has left senators in both parties questioning whether President Trump put personal ties above qualifications in making the nomination.
“Look, he has some issues with management,” Sen. Jon Tester (Mont.), the ranking Democrat on the Senate Veterans’ Affairs Committee, said about Jackson. “He hasn’t really overseen a large group, and so we’ll sort through that.”
Jackson, whose nomination caught most of Washington by surprise, has been holding private meetings with senators all week, trying to convince Democrats and some Republicans that he is qualified for the position.
He’s also telling Democrats that he opposes efforts to privatize the agency by outsourcing veterans’ care to private-sector health-care providers at taxpayer expense.
Jackson is an active duty Navy admiral who has served as physician to three presidents. Prior to being selected as the White House physician in 2006, he led a small team of combat surgeons in Iraq.
But senators in both parties are worried Jackson lacks the expertise to lead the second largest bureaucracy in the federal government.
“Ultimately, I need to reach the conclusion that I have confidence in the person to lead a huge organization that desperately needs strong leadership,” said Sen. Jerry Moran (R-Kan.), who also sits on the Veterans’ Affairs Committee.
The agency has a $180 billion annual budget, with a staff of more than 370,000 employees. It handles three major categories for America's veterans: medical care, benefits and burials/memorials.
The medical side of the agency has been dogged by scandal.
In 2014, Eric Shinseki resigned as secretary after an official watchdog report found “systemic” instances of falsified records and inappropriately long waiting times at VA facilities across the country.
When asked by The Hill, Moran told reporters that Jackson “doesn’t have the experience you’d think would traditionally be required at the VA.”
But he said that did would not “preclude me from reaching the conclusion that he’d be a good secretary.”
“I need to be assured that despite that experience, he has other qualifications, capabilities, characteristics that make him the person who could be the secretary,” Moran said.
Sen. Mike Rounds (S.D.), another Republican on the Veterans’ Affairs Committee, told The Hill that Jackson knows about health care, but needs to show he can tackle the unique challenges at the VA.
“The question is going to be, how do you move rapidly into that part of managing a bureaucracy that does not want to be managed?” Rounds said. “I think since he has very limited background in terms of managing groups, it’s particularly important we hear from him what his thoughts are going to be about how he steps into that kind of a challenge.”
Gary Augustine, executive director of the Washington office of the Disabled Veterans of America, said if Jackson is confirmed, he has a steep learning curve ahead.
“He can learn, but I think his biggest challenge is understanding the scope of the VA,” Augustine said. “[Jackson’s] going to have to learn all that the VA is. It’s a large bureaucracy. That will be a big challenge for him, learning all the different departments, the employees . . . . it goes on and on. It’s a holistic organization that takes care of veterans and all their needs.”
Augustine added that in his experience, the VA is a challenging agency for anyone to run.
“This is my fourth or fifth secretary, so everyone has to learn, and it’s a large undertaking,” Augustine said.
Past secretaries have typically won bipartisan support in confirmation votes. Former Veterans Affairs Secretary David Shulkin, who Trump wants to replace with Jackson, sailed through the committee on a unanimous vote last year, but it’s not clear that will happen with Jackson.
Privatization is a line that Democrats won’t cross, and Jackson has not completely persuaded committee Democrats of his opposition to it.
“He said the right things about privatization, he said he’d stand up to Trump,” Sen. Sherrod Brown (D-Ohio) said after meeting with Jackson. “I want to see some evidence that he will … I guess what I want to know is he willing to be fired to stand up against privatization?”
Shulkin blamed his ouster on forces within the administration that he said are pushing hard for privatization, and Brown said he doesn’t think Jackson has a full understanding of the consequences.
“I think that he doesn’t know the pressure he’ll get from the Koch brothers, from the President himself and [vice president] Pence, because they want to privatize the VA,” Brown said.
Brown was referring to Charles and David Koch, conservative billionaires who back the group Concerned Veterans for America (CVA), which is pushing to loosen current restrictions on veterans receiving private-sector care.
Democrats and veterans’ advocates are concerned that the White House is taking those calls for privatizing the VA system seriously, but the VA has denied that there is any push to privatize its health system.
