San Francisco VA Health Care System (Photo: VA.gov)
The VA has announced plans for the largest restructuring of the Veterans Health Administration since 1995. The department claims changes will simplify management, reduce bureaucracy, and improve consistency across the nation’s largest integrated health care system.
Under the proposal, the VA would reduce the number of Veterans Integrated Service Networks from 18 to five, with each reporting directly to the under secretary for health. The plan would also eliminate the VHA chief operating officer position and realign central office staff under senior health leadership. VA officials say the changes are designed to cut duplication, improve accountability, and strengthen communication across policy, technology, and clinical operations.
The restructuring follows years of criticism from federal watchdogs, including the Government Accountability Office and the VA’s own inspector general, which have raised concerns about unclear roles, overlapping responsibilities, and inconsistent standards across the VISN system. Created to decentralize decision-making, VISNs grew far beyond their intended size, adding layers of administration that critics say slowed care delivery.
The American Legion National Commander, Dan K. Wiley, responded to the proposal with cautious support, emphasizing the need for accountability and results for Veterans.
“The American Legion has a long history advocating for increased accountability and efficiency in the Department of Veterans Affairs, particularly regarding access to timely, quality health care for our nation’s Veterans,” Wiley said.
He cited longstanding concerns raised by independent auditors about inefficiencies and leadership failures within the current system. Wiley said the organization was briefed on early details of the plan, including the elimination of long vacant positions, and stressed that changes should not disrupt care.
“Any changes in structure or staff will not disrupt or delay Veteran healthcare,” he said.
As the VA refines its proposal, Wiley stated that The American Legion plans to continue sharing direct feedback from Veterans with both Congress and the department.
“Veterans now – and in the future – must have a VA that delivers for them,” he said.
Reaction on Capitol Hill has been mixed. House Veterans Affairs Committee Chairman Mike Bost (R-Ill.) has expressed support for restructuring the agency, while Rep. Mark Takano (D-Calif.), the committee’s ranking Democrat, has called for formal hearings. Takano criticized the VA for developing the plan without broader consultation and raised concerns about a lack of transparency and bipartisan input during the process.
Alongside the VHA reorganization, the VA also announced changes to its community care program, including reducing the number of regions overseeing care provided outside the VA system. Those contracts could total up to $1 trillion over 10 years, expanding options for Veterans but also raising questions about oversight and implementation.
VA officials have stressed that the reorganization is not intended to reduce staffing at medical centers or clinics. While the department plans to eliminate tens of thousands of vacant positions, it maintains that patient care and frontline operations will not be affected. Critics, including some lawmakers, have warned that workforce reductions could strain an already stressed system.
The VHA reorganization is expected to begin in early 2026 and unfold over two years. As details continue to emerge, Veterans organizations, lawmakers, and advocates are watching closely to see whether the changes lead to measurable improvements in access, accountability, and care for Veterans nationwide.
Author: Rikki Almanza
Rikki is a Web Content Coordinator for the American Legion, Department of California. With a deep-rooted family connection to the military, Rikki is committed to using her skills and knowledge to provide valuable assistance and resources to servicemembers and veterans.
