Vindictive. It’s a word increasingly synonymous with today’s politics, courtesy of the party in power. According to Cambridge Dictionary, it means “having or showing a wish to harm someone because you think that they harmed you; unwilling to forgive.” Unfortunately, it’s through this lens that the GOP — led by former President Donald Trump — now openly admits it views its political opposition. And nowhere is that mindset more clear than in a set of quietly enacted changes now affecting millions of veterans and healthcare professionals at the Department of Veterans Affairs (VA).
According to internal documents obtained by The Guardian, new rules implemented by the VA — following a January executive order signed by Trump — now permit VA doctors and medical staff to refuse treatment to veterans based on factors such as political affiliation, marital status, or union membership. While race, religion, and sex remain protected categories, other characteristics have been explicitly removed from hospital anti-discrimination language, allowing individual providers to legally deny care to certain patients.
In other words, under the Trump administration’s revised VA guidelines, a doctor could refuse treatment to a Democrat or an unmarried veteran, with no violation of VA policy.
This shift isn’t just about who gets care — it’s also about who’s allowed to give it. The same changes permit VA medical centers to deny employment or fire staff based on their political beliefs, union activity, or even their marital status. These rollbacks affect nearly every clinical position in the VA system, including psychologists, social workers, dentists, and nurses.
The rationale for these unprecedented rule changes stems from an executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” issued on January 30. Though framed around opposing gender-affirming care, the order has since led to the elimination of a wide range of patient protections across the VA — including restrictions on certain terminology like “transgender” and “gender-affirming” from all clinical contexts.
The implications are broad and troubling. According to Dr. Kenneth Kizer, former chief healthcare official for the VA under President Clinton, the new rules open the door to discrimination “on the basis of anything that is not legally protected,” including a veteran’s reason for seeking care — such as reporting sexual assault — or their personal behavior, like alcohol use.
Medical ethics experts are sounding the alarm. Dr. Arthur Caplan, a bioethicist at NYU, called the rules “extremely disturbing and unethical.” He warned they effectively allow care to be politicized and weaponized, saying, “You keep your politics at home and take care of your patients. This flips that standard on its head.”
Indeed, the changes go against long-standing standards of hospital governance, including those established by the Joint Commission, the independent accrediting body for U.S. hospitals. According to The Guardian, VA medical staff were not consulted before the changes took effect — a breach of protocol that raised further concerns among medical associations. At its annual convention this week, the American Medical Association (AMA) passed a resolution affirming the principle of medical staff self-governance and calling for any changes to hospital bylaws to be approved by clinicians themselves.
While VA officials insist that “all eligible veterans will always be welcome,” they have not denied that staff can now decline to treat veterans based on non-protected categories — or that staff hiring decisions may be influenced by personal beliefs. In areas where healthcare options are limited — such as rural regions or among vulnerable groups like women and LGBTQ+ veterans — the effects could be especially severe. Some veterans may be forced to travel hundreds of miles for care, or worse, go without care entirely.
The policy shift is just the latest in a string of moves that critics say reflects a larger campaign by the Trump administration to exert political control over science, medicine, and federal institutions. This includes firings at the Centers for Disease Control and the National Institutes of Health, and restrictions on VA researchers publishing in scientific journals without approval from political appointees.
Whether these actions will be challenged in court remains to be seen. But the chilling effect is already clear: the largest healthcare system in America — one that serves 9 million veterans — has opened the door to selective care, ideological gatekeeping, and the institutionalization of political revenge in a space that was meant to be governed solely by health, ethics, and the Hippocratic Oath.
In a democracy, politicizing care for those who served the country is more than policy. It’s a test of national character. And if these changes are any indication, that test may already be failing. Go beyond the headlines…
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