Under a new Trump executive order, doctors at Veterans Affairs (VA) hospitals can now legally refuse to treat patients based on their politics or whether they’re married—meaning veterans who are Democrats or unmarried may be turned away.
The rule change, first reported by The Guardian, went into effect quietly and is already being enforced at some VA hospitals. It applies not just to doctors but also to psychologists, dentists, nurse practitioners, social workers, and other health professionals.
Previously, VA rules protected patients from discrimination based on things like political beliefs or marital status. Those protections are now gone.
The updated rules mean VA employees can deny care to veterans for any reason that isn’t specifically illegal under federal law. That still includes race, sex, religion, and disability—but no longer covers political party or marital status.
“It seems on its face an effort to exert political control over the VA medical staff,” said Dr. Arthur Caplan, a medical ethicist at NYU. He warned doctors might now feel free to ask patients if they voted for Trump—or punish them if they didn’t. “Those views aren’t relevant to caring for patients. So why would we put anyone at risk of losing care that way?”
VA staff can now also be hired or fired based on political beliefs, marital status, or whether they belong to a union. The new policy came straight from Trump’s January 30 executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”
While that order was marketed as a crackdown on transgender care, its reach is far broader. The VA has since banned terms like “transgender” and “gender-affirming” in medical settings and cut back on care for transgender veterans.
Dr. Kenneth Kizer, a former top VA official, said the new rules could lead to veterans being denied care for reasons like their political affiliation, alcohol or marijuana use, or even being a rape survivor. “They seem to open the door to discrimination on the basis of anything that is not legally protected,” he said.
The VA is America’s largest public healthcare system—9 million patients, 170 hospitals, and more than 1,000 clinics. It employs over 26,000 doctors. The idea that some veterans may now be denied care based on political views has shocked many in the medical community.
VA press secretary Peter Kasperowicz didn’t deny the rule change lets doctors refuse to treat veterans over politics or lifestyle choices. He said all veterans “will always receive the benefits and services they’ve earned under the law” but admitted the new policies were made to align with Trump’s executive order.
He called the changes “a formality,” though he didn’t say what federal law actually required them.
The new policy also slashes long-standing protections in VA hiring. Hospitals are no longer banned from rejecting staff based on sexual orientation, union membership, or political views. Until now, VA bylaws said medical staff couldn’t be discriminated against for “race, age, color, sex, religion, national origin, politics, marital status or disability.” Most of that is now gone.
“Extremely disturbing and unethical,” is how Caplan described the overhaul. “You keep your politics at home and take care of your patients.”
Veterans say the fallout will hit hardest in rural areas or among groups who already face barriers, like women and LGBTQ+ veterans. Navy veteran Tia Christopher, who was raped while serving, said many survivors will now face even longer delays and may be forced to drive hundreds of miles for care. “It could have a huge ripple effect,” she said.
Even worse, doctors inside the VA system say they weren’t consulted. Multiple hospital staff told The Guardian they feared retaliation if they spoke out publicly.
That could violate national hospital standards. The VA claims it checked with the Joint Commission, the group that accredits hospitals, and said the policy change won’t affect its standing.
But the American Medical Association isn’t convinced. At its annual meeting this week, the AMA passed a resolution urging all hospitals—including the VA—to follow rules that give medical staff a say in policy changes.
Caplan said the VA changes are part of Trump’s broader crackdown on science and medicine. His administration has already cut funding at NIH and CDC and gutted vaccine panels under Health Secretary Robert F. Kennedy Jr.
Earlier this year, VA researchers were also told they couldn’t publish in medical journals without clearance from political appointees.
The bottom line: under Trump’s new order, a veteran who served their country could now be denied care—because they voted for the wrong person.
