Veterans aren’t happy about the latest pronouncements from theDepartment of Veterans Affairs.

The Hill reports that David Shulkin, Veterans Affairs secretary, istalking about broadening the role of private sector health care in providingcare for veterans, with the eventual goal ofeliminating of the need for veterans to go through the VA toapprove or coordinate their care.

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Shulkin, who previously worked as CEO of a private health caresystem, is quoted saying in a Wall Street Journal report, “The direction I’m taking this is to give veterans morechoice in their care, and be the decision maker for their care,which I fundamentally believe is a concept that has to beimplemented.”

But veterans’ groups disagree, with a spokeswoman for theVeterans of Foreign Wars being critical of his plan and tellingThe Wall Street Journal that the organization has notheard from the secretary about his health care concept. Othercritics warn that it is a step toward privatization, which wouldlimit funding to government-run facilities.

According to the Journal, inserting private sectorproviders into veterans’ care could take years.

But that’s not the only hornet’s nest that Shulkin is stirringup. ABC News reports that as part of its effort to expand private healthcare, the VA is also exploring the possibility of merging itshealth system with the Pentagon’s. While the VA says it will cutcosts, veterans’ groups say it could threaten the viability of VAhospitals and clinics.

Without providing any details, VA spokesman Curt Cashour calledthe plan a potential “game-changer” that would “provide better carefor veterans at a lower cost to taxpayers.” Others aren’t so sure,with Griffin Anderson, a spokesman for the Democrats on the HouseVeterans Affairs Committee, saying that the proposal, which wasproduced without Congressional input, would amount to a merger ofthe VA’s Choice and the military’s TRICARE private health careprograms. Committee Democrats independently confirmed thediscussions involved TRICARE, the report says.

Veterans’ groups were alarmed at the news, saying that they hadnot been consulted. In addition, congressional Democrats criticizedthe plan, pledging to oppose any VA privatization effort thatforces veterans “to pay out of pocket for the benefits they haveearned with their heroism.”

“Today, we see evidence that the Trump administration is quietlyplanning to dismantle veterans’ health care," House Minority LeaderNancyPelosi, D-CA, is quoted saying. Pelosi adds, “House Democratswill fight tooth and nail against any efforts to diminish ordestroy VA’s irreplaceable role as the chief coordinator, advocateand manager of care for veterans.”

They’re not the only ones expressing concern over the quietlydiscussed possibility. Health care experts have expressed surprisethat the VA would consider a TRICARE merger to provide private carefor millions of active-duty troops, military retirees and veterans,since each serves a unique patient group—with the VA treatingolder, sicker veterans, while TRICARE cares for generally healthierservice members, retirees and their families.

In addition, the way the two systems work is different: TRICAREis insurance paid by the government using private doctors andhospitals, while the VA provides most of its care via medicalcenters and clinics owned and run by the federal government, thoughveterans can also see private doctors through the VA’s Choiceprogram with referrals by the VA if appointments aren’t readilyavailable.

“My overarching concern is these are very dramatic changes inthe way health care is delivered to veterans,” Carrie Farmer, asenior policy researcher on military care at Rand Corp. who hasconducted wide-ranging research for the VA, says in the report.Farmer adds, “There haven’t been studies on what the consequencesare in terms of both costs and quality of care.”

Louis Celli, director of veterans’ affairs and rehabilitationfor The American Legion, says in the report that any attempts tooutsource services away from VA medical centers and clinics wouldbe financially unsustainable and likely shift costs unfairly ontoveterans with service-connected disabilities.

Celli points out that a similar change was made to TRICARE;military retirees were promised free care from military basehospitals. But then TRICARE began offering insurance to useprivate-sector care, and TRICARE beneficiary copays are now rising.“The precedent the TRICARE model sets is not something we wouldaccept on the VA side,” Celli says in the report.

The VA is seeking a long-term legislative fix for Choice byyear’s end.