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Donald Trump promised big changes to the Department of Veterans affairs as President during the campaign and whether or not those changes become a reality rely in part of whether or not Congress wants to go along with him.
Mr. Trump has suggested major changes to the way the department is run with some likely to easily pass and others possibly being more difficult. For example, Mr. Trump wants to establish a 24/7 White House hotline for veterans to voice complaints about the VA and to form a commission that will look into “all the fraud, cover-ups, and wrongdoing that has taken place in the VA.” Both those can be done without Congressional approval and can be up and running on day one if Mr. Trump wishes.
Other promises will prove to be more difficult because it will require Congressional approval. Mr. Trump has promised to make it easier to get rid of VA employees, which is much easier said than done due to the bureaucracy of the department. He's also promised to make it easier for veterans to get the care they need "wherever and whenever they need it," but that will also require the Congress to completely overhaul the current structure of the VA and will prove to be a herculean task, to say the least.
The hardest promise that Mr. Trump will be able to deliver on is the "wherever and whenever" promise due to the way the system is set up, but it is within Congresses authority to change that system if they so choose.