Collins is awaiting a confirmation vote from the Senate, which will determine whether he becomes the 12th secretary of veterans affairs. He had bipartisan support among the Senate Veterans’ Affairs Committee, with members voting 18-1 to advance him to a full floor vote.

The Washington Examiner spoke with two veteran CEOs and a veteran congresswoman to find out what they want Collins to work on at the VA if he is confirmed.

Mental healthcare

A recent VA report showed that 6,407 veterans died by suicide in 2022, a small increase from 2021, but the lowest mark in 12 of the previous 14 years. However, veterans still died by suicide at almost double the rate of the civilian population.

The VA’s job is to get veterans mental healthcare when they need it, but the suicide crisis could be a sign that the agency continues to fail at one of its core initiatives.

Rep. Anna Paulina Luna (R-FL), an Air Force veteran who left the service as a senior airman, said the No. 1 issue she would like to see addressed is veterans who are on suicide watch. She said the last VA secretary, Denis McDonough, “put politics over service members” but believes Collins is the right choice.

“The biggest problem that we actually have is that people go into the military whole, they come out less than whole, and we’re unwilling to fix that deficit,” said Vetcomm CEO Kate Monroe, who served in the Marine Corps and is a disabled veteran.

“In some cases, it’s like, yeah, whatever,” she said. “We’ll pay for it like an insurance claim, but we’re not going to fix it like we really don’t care if you’re broken.”

Monroe’s solution to the problem is a mandatory mental health check six months before veterans exit the service for good.

“Because if you exit people with a poor mental state and they are also poor in their wallet, that [isn’t] a good recipe for success,” she said. “The system is definitely broken.”

Veteran homelessness

One area in which the VA has made progress is veteran homelessness. A January 2024 count showed 32,882 veterans who experienced homelessness, 7.5% less than in 2023. The estimated number of veterans experiencing homelessness in the United States has also decreased by 55.6% since 2010.

Mission Roll Call CEO Jim Whaley, a retired Army lieutenant colonel, called the lack of improvement on conditions such as veteran homelessness an “embarrassment to our country” but said he believes the work veterans support organizations do with the administration will give them their best chance to improve them.

Whaley added that Collins has been communicating with the veteran community and that the Trump administration has been vocal in their support of veterans, things he believes are critical to the mission of improving conditions.

When it comes to homelessness, Monroe claimed that the recent problem stemmed from Veterans Affairs Supportive Housing funds being appropriated to migrants when they should have been directed toward veterans. That claim was disputed by the Biden administration, though the VA did use its Financial Services Center when contracted by ICE to process payments by medical providers to migrant care.

Her solution would be to offer tax credits to businesses that offer veterans jobs to bolster veteran employment after service, therefore reducing homelessness caused by veterans who are jobless after service.

Where veterans will receive care

The VA has often been maligned for its complex system that veterans have to navigate to receive care, long wait times, and poor access to healthcare in rural areas.

Privatizing the VA as a blanket solution for the imperfect care veterans get under the department has been viewed as a less-than-ideal solution, given that it may result in veterans receiving care below the quality of the VA. The VA is designed to treat veterans and specializes in their care.

But Monroe and Whaley suggested veterans should be able to go to local, non-VA medical providers if necessary.

“We have to be open to having healthcare provided by local medical facilities,” Whaley said. “And so VA has to be open to that and open to ways of working with the best in class medical facilities. I think every American wants to see veterans get the healthcare that they deserve. And so that means that we have to have a more holistic access to care.”

Monroe is not afraid to say that privatization of the VA would be “amazing” for veterans.

“It needs to happen because the VA is just a big insurance company that doesn’t want to pay, and that’s how they treat veterans,” she said. “A lot of the funds would be better managed and auditable and accountable for if a third party stepped in and took more of this community care aspect back.”

The VA already has a version of private care, VA Community Care, in place only for when the VA cannot provide the care needed. Whaley and Monroe believe that program needs to be encouraged more as well.

Vice President JD Vance, a Marine Corps veteran, said before the election that he would consider privatizing portions of the VA.

“I think that there are areas where the VA actually works very well,” he said. “So I would not say, ‘Get rid of the whole thing.’ But I would say, ‘Give people more choice.’ I think you’ll save money in the process.”

Balancing the budget

The VA asked for $6.6 billion in funds from Congress in November 2024 to address a fiscal 2025 budget shortfall. A large reason for the VA’s budget problems is the “significantly increased demand in our system” as a result of the PACT Act, which expanded eligibility for veterans exposed to toxic substances during their military service, according to Shereef Elnahal, a former VA undersecretary for health.

The Trump administration has already begun looking for parts of the VA to cut down on to secure its budget. The department recently announced it cut around $14.1 million worth of DEI positions and contracts within the agency.

Whaley and Monroe supported the move, saying the agency could be more efficient in how it works and redirect freed funds toward veteran care. Monroe said she thinks the system is “bloated” and that privatization could also balance the budget. She has had VA-affiliated people within her organization tell her that there are “10 people doing the job of one person” in the department but that community care could increase the return on investment on VA-issued funds.

Whaley said he thinks the agency can enjoy some efficiencies but would draw a hard line at cutting reimbursement to veterans for their healthcare claims.

Vance has expressed interest in cutting some positions at the VA. “Probably 90% to 95% of the people at the VA are fantastic human beings, but then you’ve got a small slice of the VA [who are] bad apples that makes it really hard for everybody else to do their job,” he said.

“This is why veterans spend three hours on the phone trying to get an appointment. This is why you have people commit suicide because they’re waiting 28 days to get an appointment with the doctor. It’s a small sliver of the VA, but you can fire those people, right? Give the people who are doing their job a raise. Fire the people who aren’t doing their jobs.”