WASHINGTON, D.C. — Internal warnings from Veterans Affairs hospitals across the country reveal growing alarm over health care disruptions caused by sweeping cuts implemented under the Trump administration, including the halting of life-saving cancer clinical trials and layoffs of essential staff.
Earlier this year, VA doctors in Pennsylvania raised the alarm in an internal email, warning top officials that veterans were losing access to critical treatments for conditions including metastatic head and neck cancer, kidney disease, and traumatic brain injuries. “Enrollment in clinical trials is stopping,” they wrote. “Veterans lose access to therapies.”
Though some decisions have since been partially reversed — allowing certain trials to resume — others remain stalled, underscoring the widespread upheaval within the nation’s largest integrated health care system. The VA, which serves nearly nine million veterans, has already shed thousands of employees this year and plans to eliminate at least 70,000 more through layoffs and voluntary buyouts in the coming months.
The push to downsize comes despite the 2022 PACT Act, a bipartisan law mandating expanded care and benefits for veterans suffering from toxic exposure. The Trump administration, however, appears to be steering the VA in the opposite direction, aiming to return the agency to its pre-PACT scale.
“We love our veterans,” former President Donald Trump said in February. “We are going to take good care of them.” But behind the scenes, dozens of internal emails obtained by ProPublica suggest otherwise, with physicians and administrators pleading for reprieve from cuts they warn are already endangering lives.
In March, VA officials in the Pacific Northwest flagged the termination of a key contract that maintained cancer registries used to track treatment and recurrence. The Department of Government Efficiency (DOGE), a White House initiative overseeing the VA’s restructuring, had marked the contract for “immediate termination.” Similar concerns were raised in Detroit, where officials warned of the “inability to track oncology treatment and recurrences.”
Other consequences of the cuts include layoffs of social workers in Colorado, who were vital in helping homeless veterans access housing. Though the layoffs were later reversed, local officials say their brief absence left a gap in critical services.
“This is not a slash-and-burn exercise meant to punish high-ranking officers,” said Defense Secretary Pete Hegseth in a separate context earlier this week, defending military leadership cuts. But inside the VA, officials suggest a chaotic and hasty overhaul is already degrading care.
In Pittsburgh, two clinical trials to treat veterans with advanced head and neck cancer remain delayed due to hiring freezes. A third study on opioid addiction continues to run, but with a reduced team after layoffs, according to Alanna Caffas, head of the Veterans Health Foundation, a local nonprofit that partners with the VA.
“It’s insane,” Caffas said. “These veterans should be able to get access to research treatments, but they can’t.”
Despite repeated assurances from the administration, the internal issue briefs — formal warnings sent up the chain of command — paint a stark picture of strained resources, disrupted care, and a medical workforce bracing for further cuts. The memos serve as a troubling counterpoint to public claims that the administration is simply reforming the VA for efficiency.
VA press secretary Pete Kasperowicz downplayed the concerns, insisting that internal warnings merely reflect a “robust and well-functioning system to flag potential issues.” He acknowledged plans to use artificial intelligence for claims processing and emphasized that no hospital closures are currently planned.
Still, a document drafted by DOGE in March proposed the closure of up to 29 VA hospitals and introduced sweeping consolidation and automation measures — a roadmap for what could be a dramatic transformation of veteran care.
For veterans and their advocates, the cost is already apparent.
“Veterans’ lives are on the line,” said one VA oncologist, speaking anonymously. “Let us go back to work and take care of them.”
Rosie Torres, founder of Burn Pits 360, called the emerging crisis “gut-wrenching.”
“If they are killing contracts that may affect the delivery of care, then we have a right to know,” she said.
Congressional leaders, including Rep. Mark Takano (D-Calif.), who co-authored the PACT Act, expressed alarm. “The Biden administration understood what it meant to pay for the cost of war,” Takano said. “It seems the Trump administration does not.”
Secretary Doug Collins, Trump’s pick to lead the VA, is scheduled to testify today before the Senate Veterans Affairs Committee — his first appearance on Capitol Hill since taking office. Lawmakers are expected to press him for clarity on the administration’s long-term vision for veteran care amid mounting concerns from within his own agency.
