Recent Trump administration cuts and hiring freezes across veteran health care and research will have a snowball effect on public health for all Americans, experts say.

The Department of Veterans Affairs has fired over 2,400 employees since Feb. 13, which includes cuts across the Veterans Health Administration, the VA’s health care system. Over 1,400 were probationary workers. The firings are on top of an existing federal hiring freeze, which could mean up to 10,000 veterans no longer get research-based treatment by April 20, according to the National Association of Veterans’ Research and Education Foundations.

“The ripple effects of this go beyond immediate research to things like oncology and mental health and behavioral health and opioid use disorder, all the areas that VA leads that the whole country really benefits from,” association CEO Rashi Romanoff told The Nation’s Health.

Some of the freezes and firings have been walked back following public outcry. Specific exemptions were made for clinical staff in VA hospitals, and the VA temporarily pulled back on its decision to cancel billions in contracts that would affect post-traumatic stress disorder outreach, cancer care, toxic exposure assessments and more, according to the Associated Press.

However, the cuts and freezes could still have a devastating effect on future generations of the U.S. health care workforce. Through its partnerships with local academic medical centers, the VA trains more than 70% of the nation’s practicing physicians, Romanoff said. That includes trainees, medical students and health professional training programs, all of which could be threatened. There are also concerns about a ban on participation in national conferences and censorship of research that has to do with health equity, according to The American Prospect.

Over 9.1 million veterans receive VA health care. In addition to its over 371,000 health care professionals and support staff, the VA includes 113,000 health profession trainees and nearly 16,000 VA-affiliated medical faculty members.

The hiring freeze could mean the loss of $35 million in research funding and the suspension or end of 370 non-VA funded studies and clinical trials by April 20, according to the veterans research association. Romanoff said her organization fields daily calls from researchers who say they are unable to hire critical research staff or are concerned about their own research appointments.

“Beyond just studies closing altogether or studies leaving the VA, I think the pieces of this that get me really concerned are things related to patient safety,” Romanoff said. “You want to make sure you can hire things like study coordinators, patient coordinators and all the folks that help monitor adverse events."

There are about 6,500 researchers for the VA across the country and about 3,800 of them are on time-limited appointments. The time-limited positions are typically renewed based on available research funding, and as many as 200 are up for renewal in the near future, Romanoff said.

A massive loss of scientists could spell the end of VA research, according to Sen. Patty Murray, D-Wash., a member of the Senate Veterans’ Affairs Committee.

“I’m hearing from longtime VA researchers in my home state of Washington who are right now being told to immediately stop their research and pack their bags,” Murray said in a Feb. 13 news statement. "This callous across-the-board firing threatens to decimate so much of the lifesaving research our veterans depend on."

Several organizations, including National Association of Veterans’ Research and Education Foundations, were part of a Feb. 20 Friends of VA Medical Care and Health Research letter to federal lawmakers asking them to exempt all medical care and research positions from firings and hiring freezes. Romanoff said she remains hopeful that exemptions can be made for critical VA research to continue innovative work that has improved health for all, such as the creation of pacemakers and CT scans. She also pointed to benefits of work on toxic exposures and traumatic brain injury research.

“I think these are areas that all of us as Americans recognize that we need to invest in so that those that have served and their families can access the best quality care," Romanoff said.

Lab workers conduct research at the Fayetteville Veterans Affairs Coastal Health Care System in North Carolina in 2020. Photo courtesy Fayetteville VA Coastal Health Care.