By Leo Shane III, Military Times–

President-elect Donald Trump is evaluating a radical overhaul of veterans health care options even before he finalizes his pick for the next secretary of veterans affairs.

In comments to reporters late Wednesday, a transition official said Trump is considering a “public-private option” that would allow some veterans to get all of their medical care from private-sector physicians, with the government paying the bill.

“It’s one of the options on the table,” the official said. ”Definitely an option on the table to have a system where potentially vets can choose either or, or all private.”


Trump met with health care executives Wednesday to discuss the future of VA services, among other medical topics. That meeting included Cleveland Clinic CEO Toby Cosgrove, one of the front-runners for the top VA post.

Cosgrove has publicly backed plans to expand veterans’ access to care options outside VA, arguing such a move will free up specialists for patients with service-specific injuries while allowing faster appointments for other veterans.

But veterans groups have argued against many of those moves, saying it could undermine VA care by shifting resources away from department physicians best suited to diagnose and treat ailments facing veterans.

The fight has gotten heated throughout the campaign season, with charges of privatization and politicization being leveled by and against veterans advocates.

It’s unclear whether Trump’s latest proposal would cover all veterans, or all veterans currently receiving VA care, or only a smaller segment of that population.

About 9 million veterans — 40 percent of the total U.S. veterans population — use VA medical services or receive veterans benefits. VA officials said nearly one-third of all medical appointments conducted last fiscal year were with physicians outside the department.


Congress in 2014 approved a new Choice Card program, which allows veterans facing lengthy wait times or significant travel to visit private-sector clinics instead of VA facilities. But the program has faced mixed reviews, with VA officials saying it has limited use and critics saying department officials have undermined the program with unneeded bureaucracy.

During the campaign last summer, Trump promised to “ensure every veteran in America has the choice to seek care at the VA, or to seek private medical care paid for by our government.” Critics questioned how such a plan would work and what the potential costs would be.

Transition officials have not said when Trump is expected to make an announcement on his VA secretary pick.

Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at