Key Takeaways
- •Secretary Collins committed to making himself available to testify before the committee as the VHA reorganization progresses, following up with a written commitment.
- •Secretary Collins defended the VHA reorganization, asserting it addresses 30 years of systemic issues like redundancies and slow decision-making to improve veteran care.
- •Rep. Takano (D-CA) pressed Secretary Collins (R) on his perceived silence regarding public attacks on VA nurse Alex Paretti, which Collins dismissed as a political opinion.
- •Republicans largely supported the VHA reorganization as necessary to streamline bureaucracy, while Democrats expressed distrust due to insufficient details and concerns about workforce impact.
- •The VA will continue developing the VHA reorganization plan, incorporating frontline feedback and addressing congressional concerns, while also seeking statutory changes for construction and salary caps.
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Hearing Analysis
Overview
The House Committee on Veterans' Affairs met on February 11, 2026, to evaluate a sweeping proposal by the U.S. Department of Veterans Affairs (VA) to reorganize the Veterans Health Administration (VHA). Led by Chairman Mike Bost (R-IL-12), the hearing focused on the Department’s plan to modernize a management structure that has remained largely unchanged since the mid-1990s. The reorganization aims to consolidate the existing 18 Veterans Integrated Service Networks (VISNs) into five larger regions, while creating specialized Health Service Areas (HSAs) to focus exclusively on clinical care delivery. Secretary Douglas Collins (Secretary, U.S. Department of Veterans Affairs) argued that the current system is riddled with redundancies and bureaucratic layers that hinder veteran care, while Ranking Member Mark Takano (D-CA-39) and other Democrats expressed deep skepticism regarding the plan's transparency, its impact on the workforce, and the potential for service disruptions.
Key Testimony
Secretary Collins testified that while the VHA is the nation’s largest integrated healthcare system, it has failed to operate with the efficiency of a modern enterprise. He provided data showing that between fiscal years 2019 and 2024, the VHA workforce grew by 14 percent, yet veteran encounters increased by only 6 percent. In some facilities, staff levels rose by 30 percent while patient encounters actually declined. Collins was joined by Mr. Gregory Goins (Acting Chief Operating Officer, VHA), who explained that the new five-VISN structure would strip away "bureaucratic" requirements from regional leaders, allowing them to focus on frontline operations. The Secretary also highlighted the need for statutory changes to address the VA’s salary cap, noting that the Department struggles to recruit specialists like anesthesiologists when private sector salaries far exceed federal limits.
Overview
The hearing was marked by significant partisan friction, beginning with Ranking Member Takano’s opening statement. Takano criticized the VA for attempting a "total reorganization" based on a "10-page slide deck" rather than the comprehensive, 134-page "Vision for Change" report that accompanied the 1995 reorganization. He accused the administration of a "performative" effort to dismantle the VA, citing the net loss of over 20,000 VHA employees since Secretary Collins took office, including 1,100 doctors and 2,300 registered nurses. Takano also held a moment of silence for Alex Paretti, a VA nurse in Minneapolis whose recent death became a flashpoint during the hearing. Democrats repeatedly questioned the Secretary’s leadership following Paretti’s death, with Rep. Delia Ramirez (I-IL-3) engaging in a particularly sharp exchange with Collins over the administration's rhetoric regarding VA employees.
Policy discussions centered on the legal requirements of Title 38 Section 510, which mandates that the VA provide a detailed report to Congress before implementing a major reorganization. Chairman Bost questioned whether the VA was circumventing this statute by beginning implementation before delivering a full plan. Secretary Collins insisted he would follow the law and provide the necessary reports once specific implementation targets were met. Additionally, the committee discussed the Electronic Health Record Modernization (EHRM) program. Mr. Goins assured the committee that the reorganization would not impede the EHRM rollout, which is scheduled for a major deployment in Michigan in April 2026.
Several members raised concerns about specific regional impacts. Rep. Kimberlyn King-Hinds (R-MP) noted the absence of U.S. territories on the reorganization maps, prompting Mr. Goins to clarify that oversight for the Northern Mariana Islands and the Caribbean would remain aligned with Southern California and Florida, respectively. Rep. Julia Brownley (D-CA-26) criticized the reorganization for failing to explicitly include the Department of Women’s Health in the new high-level organizational charts, despite statutory requirements in the Deborah Sampson Act. She also challenged the Secretary on reproductive health policies, specifically the VA's restrictions on abortion counseling and services.
Infrastructure and procurement were also key topics. Secretary Collins expressed frustration with the current statutory requirement involving the U.S. Army Corps of Engineers in VA construction projects. He argued that the Corps’ involvement, combined with unique VA building standards, leads to massive delays and cost overruns, citing a VAMC project in St. Louis that should take two years but is projected to take seven. Rep. Derrick Van Orden (R-WI-3) supported this view, suggesting that the committee work to move construction authority away from the Corps to improve accountability.
Key Testimony
The hearing concluded with a focus on next steps and transparency. Secretary Collins committed to providing the committee with a written legal opinion from the VA Office of General Counsel regarding the application of Section 510 to the reorganization. He also promised Rep. Timothy Kennedy (NY-26) that the Department would provide detailed workforce data for the Buffalo VA Medical Center, which the Congressman had been requesting for six months. While Republicans generally praised the Secretary for taking "courageous" steps to fix a broken bureaucracy, Democrats remained unconvinced, with Rep. Morgan McGarvey (D-KY-3) emphasizing that the committee cannot support a plan it has not fully seen. The Secretary agreed to return for future testimony as the reorganization progresses.
Transcript
Good morning. Committee will come to order. Without objection, the chair may declare a recess at any time. Now, before we begin today, I want to thank my friend, Secretary Collins, for being here today. Secretary Collins, you have testified before this committee on a few times, and we appreciate your appearing here again. He is accompanied by the Honorable John Bartrum, Under Secretary for Health; Mr. Mark Englebaum, Assistant Secretary of Human Resources and Administration; and Mr. Gregory Goins, the Acting Chief of Operations Officer for the Veterans Health Administration. This is a significant purpose of reorganization of the Veterans Health Administration, and I know that members of this committee have serious questions about how it will be implemented and how it will affect veterans with the workforce. Because of that, I want the committee members to have as much time as possible to engage directly with the Secretary, but understand that we are in a situation where it looks like they're going to call votes around 12:15. So we will want to make sure that each member, when we go to questions, that they will get five minutes, but five minutes only, and I'll gavel you down because we've got to stay on the time schedule so that the questions can be asked. Also, know that if we are votes are called at 12:15, the Secretary has a hard stop at 12:30, and this everything must stop by 12:30. So and I—
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