The incoming president is "not inclined" to keep the department's current secretary Bob McDonald in his administration, a senior transition official told CNN on Monday. Instead, Trump is considering several potential successors who would align more with the sweeping VA overhaul Trump championed on the campaign trail as he railed against what he called the "most corrupt" and "most incompetently run agency in the United States."
A slew of veterans groups has publicly and privately urged Trump to retain McDonald, a former corporate CEO and Republican donor who was tapped for the VA post in 2014 after health care scandals at the department erupted and has been largely successful at implementing incremental reforms. A group of 20 veterans groups wrote Trump, saying McDonald is "overseeing the largest transformation in the department's history" and whose reforms are showing "early signs of success."
But keeping the current VA secretary may not jive with Trump's anti-establishment rhetoric and campaign promises during the 2016 campaign. And given his campaign's focus on veterans, whom he wildly claimed "are being treated worse than illegal immigrants," the pick may be of critical importance to his base of support.
First among Trump's 10-point reform plan for the department was a vow to "appoint a VA secretary whose sole purpose will be to serve veterans." And he has promised to make it easier to fire VA officials. McDonald, meanwhile, has opposed hardline bills pushed by Republicans in Congress to make it easier to fire VA employees, saying "we can't fire our way to excellence."
Trump's shortlist for the top VA post has from the start included Rep. Jeff Miller, the chairman of the House committee overseeing the VA, who has been one of the department's harshest critics -- sometimes extending his criticism beyond the headline-worthy scandals -- from his chairman's pulpit and has argued for exactly the types of measures that would ease the path to firing more VA employees.
Miller has also long backed a provision central to Trump's plans to reform the VA, one that would allow veterans to access private health care with a veteran's card if they cannot be accommodated quickly enough at a VA facility, even if they live near a VA center -- a provision many veterans services organizations have either opposed or expressed skepticism about, questioning the cost and the impact on VA-run health care.
Miller's lack of military service has been another source of qualms among veterans groups. He would be the first VA secretary to have never served in the military.
Pete Hegseth, Scott Brown in the mix
But two other candidates for the VA post have drawn much stronger criticism from the network of veterans service organizations: Fox News contributor Pete Hegseth and former Massachusetts Sen. Scott Brown, who are both still in the mix, according to a senior Trump transition official.
Brown, who has most forcefully publicly lobbied for the job, has been criticized for his lack of experience running a large organization akin to the VA.
Hegseth, meanwhile, would be the incarnation of the President-elect's anti-establishment rhetoric.
A former Army National Guard captain, he served in Iraq and Afghanistan and went on to lead Concerned Veterans for America, a conservative veterans advocacy group outside the mainstream veterans service organizations, which are largely non-political.
Concerned Veterans for America have called for among the most radical of overhauls of the Department of Veterans' Affairs health care delivery, pushing for a proposal to privatize a portion of the VA's health care administration.
"If Trump picks Hegseth, it's going to be war," Iraq and Afghanistan Veterans of America's executive director Paul Rieckhoff told the New York Times earlier this month.
A source who met earlier this month with Trump transition officials said the officials prodded leaders of veterans groups on VA health care reform, including privatizing VA services. And while the veterans representatives pushed back on that consideration, the feedback seemed to fall on "deaf ears," the source told CNN.
Trump's transition team is still "actively searching" for candidates, a senior Trump transition official said.
Thad Allen, Michelle Howard also under consideration
That search on Monday extended to Adm. Thad Allen, the retired head of the US Coast Guard who oversaw the response to the Deepwater Horizon oil spill and met with Trump on Monday at Trump's Mar-a-Lago residence.
Trump is also considering Adm. Michelle Howard, the Navy's first female four-star admiral and the current commander of US Naval Forces in Europe.
Should she be nominated to the post, Howard would be the fourth woman named to a cabinet-level position in Trump's administration.
Trump has named officials to join his cabinet faster than most presidents, but has yet to pick a nominee to lead the Department of Veterans Affairs.
Trump must still also pick nominees for the positions of secretary of the Department of Agriculture, director of national intelligence and US trade representative.