Leadership Shakeup at VA: Search Underway for Under Secretaries for Health and Benefits

The Department of Veterans Affairs has begun a formal search for new under secretaries for benefits and health, two significant positions that have been under acting leadership since the recent change in presidential administrations.

The decision arrives as the VA faces a time of considerable transformation, marked by extensive staffing cuts and an intensified effort to enact health system reforms during the Trump administration.

Deputy Secretary Paul Lawrence, who held the position of under secretary for benefits from 2018 to 2021, has been selected to lead the commissions that will propose candidates to President Donald Trump. The Under Secretary for Benefits manages programs, including disability compensation, the GI Bill, home loans, and pensions, providing support to over 6 million veterans and their families. The position has been unfilled since Josh Jacobs left. Currently, Michael Frueh, the Principal Deputy Under Secretary for Benefits, is serving in an acting capacity.

The Under Secretary for Health oversees the Veterans Health Administration (VHA), which employs over 370,000 individuals and operates a network of 172 medical centers, along with more than 1,100 clinics and facilities throughout the country. This position also guides medical research and workforce training within the VA system.

Dr. Shereef Elnahal vacated that post, and Steven Lieberman is now serving as the acting under secretary for health — a role he previously held from July 2021 to July 2022.

The upcoming Under Secretary for Health will be pivotal in revitalizing the VA’s electronic health record modernization initiative, set to recommence in 2026 with implementation at 13 new locations. The role also includes supervision of the Mission Act, which broadens veteran access to community care providers beyond the VA system.

At his confirmation hearing for the position of deputy secretary, Lawrence committed to an active involvement in the future of the VHA and VBA: “I pledge to work with you to get VA’s electronic health record modernization effort back on track… and put veterans at the center of everything the department does,” he stated on Feb. 19.

The search occurs as part of initiatives to downsize the VA workforce, with 2,400 probationary employees already terminated and plans in motion to cut up to 80,000 more positions, as reported by department sources.

Critics contend that the cuts will negatively impact service delivery and slow down benefit processing, particularly as the VA implements the PACT Act, which broadens eligibility for benefits related to toxic exposure. However, VA Secretary Doug Collins responded firmly during his visit to the Carl Vinson VA Medical Center in Georgia.

“We still have numerous doctors and nurses in our system who are engaged in administrative tasks rather than assisting patients,” Collins stated, highlighting that the job reductions will focus on administrative roles, not those involved in direct patient care.

The search committees, comprising VA officials, community leaders, and industry experts, will evaluate and propose finalists to the White House. President Trump is not obligated to accept the recommendations, and any final nominee will need to undergo Senate confirmation, a process that may extend over several months.

As the VA advances its staffing overhaul and healthcare modernization objectives, these appointments will be crucial in defining the department’s future direction.

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