WASHINGTON, D.C. – Today, U.S. Senator Tammy Baldwin (D-WI) pressed the Trump Administration on the Department of Veteran Affairs’ (VA) decision to cut staff and restructure the Veterans Health Administration (VHA)—which would eliminate critical resources for VA hospitals, cut positions, and jeopardize care for Wisconsin veterans.
“I have heard from veterans, healthcare providers, and community organizations across Wisconsin who have expressed deep concern that this restructuring could weaken access to timely, high-quality care for veterans who rely on the VA system. While the VA has stated that field operations will remain unaffected by this restructuring, those assurances must be supported by transparent plans and clear metrics for success. Local communities need to know that access to care will not be compromised through the pursuit of administrative efficiency,” Senator Baldwin wrote in a letter to VA Secretary Doug Collins.
Wisconsin is home to several major VA medical centers, providing essential care for thousands of veterans. However, as the Trump Administration has already cut the VA workforce by 30,000 employees in the past year, Wisconsin veterans face challenges in accessing timely, high-quality care. Senator Baldwin pushed back on these cuts and demanded they be reversed, stressing that dramatic reductions in staff would jeopardize veterans’ earned care and benefits.
Now, Secretary Collins has proposed a plan to decrease the number of Veterans Integrated Service Networks (VISNs), which provide critical support to VA medical centers, from 18 to 5. This restructuring would only exacerbate the challenges already faced by these medical centers.
“The administration is eliminating positions that provide healthcare services to veterans, reducing the VA’s ability to meet the growing and evolving needs of veterans. Public reporting indicates that many of the positions were only vacated in the last year through resignations and retirements caused by the administration’s actions. Reductions in these positions may deepen staffing shortages, lengthen wait times, and place additional strain on remaining personnel,” Baldwin continued.
Senator Baldwin demanded answers to the following questions:
- How will the consolidation of VISNs and reduction of approximately 30,000 billets affect the oversight structure and operational capacity of VA medical facilities serving Wisconsin veterans?
- What analysis has the VA conducted to assess the impact of this restructuring on access to care, appointment wait times, and health outcomes in Wisconsin?
- Please provide specifics regarding anticipated staffing changes at Wisconsin VA facilities and the measures in place to avoid service disruptions.
- What steps will the VA take to ensure that veterans in rural communities in Wisconsin continue to receive timely and uninterrupted care?
- How will the VA measure the success of the restructuring in terms of improved care, reduced administrative duplication, and accountability? Please include benchmarks and timelines.
- Please provide a detailed accounting of the expected costs of the initiative, including upfront investments and projected savings. Explain how these costs will be managed without negatively impacting veteran care.
- Please provide a detailed accounting of all unfilled VA billets that are slated for elimination in Wisconsin.
- How will the reduction of unfilled billets affect service delivery at VA medical centers, outpatient clinics, and rural facilities in Wisconsin?
- What measures will the VA take to ensure that reductions in unfilled billets do not compromise access to care, appointment availability, or quality of services?
- How will the VA monitor the impact of these workforce reductions and adjust staffing allocations if service disruptions or staffing shortages occur?
A full version of this letter is available here and below.
Dear Secretary Collins,
I write to express serious concern regarding the Department of Veterans Affairs’ (VA) proposed restructuring of the Veterans Health Administration (VHA), known as the Restructure for Impact and Sustainability Effort, which will reduce staffing levels at VHA.
Veterans in Wisconsin already face challenges in accessing timely, high-quality care and this restructuring would seem to only exacerbate these challenges for thousands of veterans in Wisconsin. The scale of this overhaul and planned workforce reductions raise questions and require oversight.
The VA has claimed that the VHA restructuring and workforce reductions will reduce administrative overhead, consolidate Veterans Integrated Service Networks (VISNs), and create new health service areas. Wisconsin is home to several major VA medical centers that provide essential care to veterans. The William S. Middleton Memorial Veterans Hospital in Madison serves a large population across multiple counties. It offers a full range of inpatient and outpatient services. The VA Milwaukee Healthcare System, centered at the Clement J. Zablocki VA Medical Center and linked with multiple community-based outpatient clinics throughout eastern Wisconsin, serves more than 234,000 veterans. In 2025 alone, tens of thousands of veterans received care through this system. The Tomah VA Medical Center serves approximately 26,000 veterans across a broad rural region. It provides primary and specialty care services that are critical to rural communities. Many Wisconsin veterans also rely on VA medical centers located in neighboring states like Minnesota where the Minneapolis VA hospital provides care for veterans in western Wisconsin. Ensuring these centers have sufficient staff, resources, and operational stability is fundamental to the VA’s mission and to the health of the veterans and their families.
I have heard from veterans, healthcare providers, and community organizations across Wisconsin who have expressed deep concern that this restructuring could weaken access to timely, high-quality care for veterans who rely on the VA system. While the VA has stated that field operations will remain unaffected by this restructuring, those assurances must be supported by transparent plans and clear metrics for success. Local communities need to know that access to care will not be compromised through the pursuit of administrative efficiency.
I am concerned about the workforce reductions included in this plan through the elimination of thousands of unfilled VA billets. The administration is eliminating positions that provide healthcare services to veterans, reducing the VA’s ability to meet the growing and evolving needs of veterans. Public reporting indicates that many of the positions were only vacated in the last year through resignations and retirements caused by the administration’s actions. Reductions in these positions may deepen staffing shortages, lengthen wait times, and place additional strain on remaining personnel. While these reductions are described as a rebalancing of resources, the loss of experienced personnel could directly affect appointment availability and continuity of care. Demand for veteran care in Wisconsin continues to grow, especially in rural areas, and this restructuring could reduce the ability of Wisconsin’s VA facilities to meet the growing needs of veterans.
Over the last year, the VA has reduced its workforce by roughly 30,000 positions across the department and is eliminating thousands of additional vacant medical positions. I am concerned about how these cuts will be coordinated with ongoing operations at the facilities veterans rely on every day. Without clear planning and coordination, these reductions will strain existing staff and hinder VA facilities’ ability to provide timely, high-quality care and continuity of services to veterans.
Veterans, healthcare providers, and community stakeholders deserve clarity on how the VA will continue its commitment to serving those who have served our nation under this plan.
Therefore, I request detailed responses to the following questions:
- How will the consolidation of VISNs and reduction of approximately 30,000 billets affect the oversight structure and operational capacity of VA medical facilities serving Wisconsin veterans?
- What analysis has the VA conducted to assess the impact of this restructuring on access to care, appointment wait times, and health outcomes in Wisconsin?
- Please provide specifics regarding anticipated staffing changes at Wisconsin VA facilities and the measures in place to avoid service disruptions.
- What steps will the VA take to ensure that veterans in rural communities in Wisconsin continue to receive timely and uninterrupted care?
- How will the VA measure the success of the restructuring in terms of improved care, reduced administrative duplication, and accountability? Please include benchmarks and timelines.
- Please provide a detailed accounting of the expected costs of the initiative, including upfront investments and projected savings. Explain how these costs will be managed without negatively impacting veteran care.
- Please provide a detailed accounting of all unfilled VA billets that are slated for elimination in Wisconsin.
- How will the reduction of unfilled billets affect service delivery at VA medical centers, outpatient clinics, and rural facilities in Wisconsin?
- What measures will the VA take to ensure that reductions in unfilled billets do not compromise access to care, appointment availability, or quality of services?
- How will the VA monitor the impact of these workforce reductions and adjust staffing allocations if service disruptions or staffing shortages occur?
The Department of Veterans Affairs carries a profound responsibility to fulfill our nation’s commitment to those who have served. As the VA moves forward with significant organizational changes, it is imperative that Congress, veterans, and the communities that support them have full transparency regarding the risks and benefits of this effort.
I look forward to your prompt and thorough response.
Sincerely,
