Under Secretary for Health

Under Secretary for Health
Post	Under Secretary for Health
Body	United States Department of Veterans Affairs
Incumbent	Vacant
Style	The Honorable
Reports to	United States Secretary of Veterans Affairs
Appointer	President of the United States
Formation	1989
Precursor	Administrator of Veterans' Affairs

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Under Secretary for Health

The Under Secretary for Health is the senior executive responsible for directing the Veterans Health Administration, overseeing clinical, operational, and policy matters affecting medical care for United States military veterans. The office interfaces with federal entities such as the Department of Defense, the Centers for Medicare & Medicaid Services, the National Institutes of Health, and Congress via committees including the United States Senate Committee on Veterans' Affairs and the United States House Committee on Veterans' Affairs. The Under Secretary shapes programs that intersect with stakeholders like the American Legion, the Disabled American Veterans, and the Veterans of Foreign Wars.

Role and responsibilities

The Under Secretary for Health manages the Veterans Health Administration network of Veterans Affairs medical centers, outpatient clinics, and specialty programs, aligning operations with statutes such as the Veterans' Health Care Eligibility Reform Act and directives from the Secretary of Veterans Affairs. Responsibilities include overseeing patient safety initiatives linked to Joint Commission standards, coordinating research partnerships with the National Institutes of Health and the Department of Defense, and directing workforce policies involving professionals credentialed by bodies like the American Medical Association and the American Nurses Association. The Under Secretary administers programs that interact with federal benefits systems such as Medicare and TRICARE, and implements information systems integrating with the Electronic Health Record Modernization efforts and standards from the Office of Management and Budget.

The role evolved from prior leadership posts created as the Veterans Health Administration expanded after the World War II and Vietnam War eras. Formalization of an Under Secretary-level leadership occurred during reforms responding to inquiries by congressional panels including hearings before the United States Senate Committee on Veterans' Affairs and reports from the Government Accountability Office. Prominent officials in adjacent eras influenced the office through engagement with institutions like the Department of Health and Human Services and initiatives catalyzed by events such as the Iraq War and the War in Afghanistan (2001–2021), which affected demand for services and rehabilitation programs administered by the VHA.

The Under Secretary is nominated by the President of the United States and requires confirmation by the United States Senate. Nominees have ranged from physicians credentialed by the American Board of Internal Medicine to administrators with backgrounds at the Department of Defense or major health systems like the Mayo Clinic and the Cleveland Clinic. Tenure reflects presidential terms and administrative continuity, with acting officials sometimes drawn from senior VHA executives or career Senior Executive Service members. Confirmation processes have involved scrutiny from hearings presided over by chairs such as senators on the United States Senate Committee on Veterans' Affairs and input from advocacy groups including Paralyzed Veterans of America.

The Under Secretary heads the Veterans Health Administration and supervises executives such as the Deputy Under Secretaries, the Chief Medical Officer, and the Chief of Staff, coordinating regional leadership across Veterans Integrated Service Networks. The office reports to the United States Secretary of Veterans Affairs and liaises with other federal agency leaders including the Secretary of Defense and the Secretary of Health and Human Services. Operational connections include collaboration with academic partners like the Johns Hopkins University School of Medicine, University of California, San Francisco, and Boston University medical centers, and with professional organizations such as the American Psychiatric Association and the American College of Surgeons.

Major initiatives overseen by the Under Secretary include modernization of electronic health records in coordination with the Office of Information and Technology, expansion of mental health and suicide prevention programs collaborating with the Substance Abuse and Mental Health Services Administration, and integration of women’s health services developed with input from groups like Service Women's Action Network. Programs under the Under Secretary include prosthetics and rehabilitation aligned with research at the Walter Reed National Military Medical Center, homelessness interventions coordinated with the Department of Housing and Urban Development, and telehealth deployments that leverage partnerships with technology firms and standards bodies including the National Institute of Standards and Technology.

The Under Secretary’s office has been subject to oversight following incidents such as wait-time scandals and quality-of-care investigations reviewed by the Government Accountability Office and reported in hearings before the United States Senate Committee on Veterans' Affairs. Controversies have prompted reforms tied to accountability mechanisms involving the Office of Inspector General (United States Department of Veterans Affairs), legislative responses by members of Congress, and policy adjustments influenced by advocacy from organizations like the American Civil Liberties Union and veteran service organizations. Congressional oversight has produced statutory changes affecting governance, funding, and transparency.