The Department of Veterans Affairs headquarters in Washington DC on 13 February. Photograph: Bloomberg/Getty Images
The Department of Veterans Affairs has imposed new guidelines on VA hospitals nationwide that remove language that explicitly prohibited doctors from discriminating against patients based on their political beliefs or marital status.
The new rules, obtained by the Guardian, also apply to psychologists, dentists and a host of other occupations. They have already gone into effect in at least some VA medical centers.
Under federal law, eligible veterans must be given hospital care and services, and the revised VA hospital rules still instruct medical staff that they cannot discriminate against veterans on the basis of race, color, religion and sex. But language within VA hospital bylaws requiring healthcare professionals to care for veterans regardless of their politics and marital status has been explicitly eliminated from these bylaws, raising questions about whether individual workers could now be free to decline to care for patients based on personal characteristics not expressly protected by federal law.
Explicit protections for VA doctors and other medical staff based on their marital status, political party affiliation or union activity have also been removed, documents reviewed by the Guardian show.
The Department of Veterans Affairs is the nation’s largest integrated hospital system, with more than 170 hospitals and more than 1,000 clinics. It employs 26,000 doctors and serves 9 million patients annually.
In an emailed response to questions, the VA press secretary, Peter Kasperowicz, did not dispute that language requiring medical staff to treat patients without discriminating on the basis of politics and marital status had been removed from the bylaws , but he said “all eligible veterans will always be welcome at VA and will always receive the benefits and services they’ve earned under the law”.
He said the rule changes were nothing more than “a formality”, but confirmed that they were made to comply with Trump’s executive order. Kasperowicz also said the revisions were necessary to “ensure VA policy comports with federal law”. He did not say which federal law or laws required these changes.
The VA said federal laws and a 2013 policy directive that prohibits discrimination on the basis of marital status or political affiliation would not allow patients within the categories removed from its bylaws to be excluded from treatment or allow discrimination against medical professionals.
As concerned as they were about the new policies themselves, medical experts were equally worried about the way they came about. Sources at multiple VA hospitals, speaking on condition of anonymity because of fear of retaliation, told the Guardian that the rule changes were imposed without consultation with the system’s doctors – a characterization the VA’s Kasperowicz did not dispute.
Such a move would run counter to standards established by the Joint Commission, a non-profit organization that accredits hospitals. Kasperowicz said the agency worked with the Joint Commission “to ensure these changes would have no impact on VA’s accreditation”.
At its annual convention in Chicago this week, the American Medical Association’s 733-member policymaking body passed a resolution reaffirming “its commitment to medical staff self-governance … and urges all healthcare institutions, including the US Department of Veterans Affairs, to ensure that any amendments to medical staff bylaws are subject to approval by medical staff in accordance with Joint Commission standards”.
The changes are part of a larger attack on the independence of medicine and science by the Trump administration, Caplan said, which has included restrictions and cuts at the National Institutes of Health and the Centers for Disease Control and Prevention, where the secretary of the Department of Health and Human Services, Robert F Kennedy Jr, last week fired every member of a key panel that advises the government on vaccines. The Guardian has earlier reported on a VA edict forbidding agency researchers from publishing in scientific journals without clearance from the agency’s political appointees.
The changes also affect chiropractors, certified nurse practitioners, optometrists, podiatrists, licensed clinical social workers and speech therapists.
In making the changes, VA officials cite Donald Trump’s 30 January executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. The primary purpose of the executive order was to strip most government protections from transgender people. The VA has since ceased providing most gender-affirming care and forbidden a long list of words, including “gender affirming” and “transgender”, from clinical settings.
By Aaron Glantz
Mon 16 Jun 2025 06.00 EDT