Biden taps former Obama aide to lead VA

White House Chief of Staff Denis McDonough at a 2013 Pentagon event. (DOD photo)

President-elect Joe Biden named Denis McDonough, who served as White House chief of staff under the Obama administration, to lead the Department of Veterans Affairs.

If confirmed, McDonough will be just the second non-veteran to head the agency, which has more than 300,000 employees and a budget closing in on $250 billion annually. VA delivers health care and benefits to more than 9 million veterans.

McDonough has a reputation as a workhorse and a problem-solver. Among other accomplishments, he is credited with assembling the team that responded to the initial failure of the HealthCare.gov website, the portal constructed to allow consumers to purchase health insurance under the Affordable Care Act. He also helped shepherd the Veterans Choice Act to passage. The bill passed in Obama's second term expands options for those in VA care to receive compensation for private sector treatment.

The appointment took some veterans groups and others by surprise.

The American Federation of Government Employees, which represents VA employees, had touted former Rep. Patrick Murphy (D-Pa.) for the post in November.

Murphy himself welcomed the appointment in a Dec. 10 tweet, saying that McDonough is a "good man and cares deeply about meeting the challenges the VA faces today. He'll be a steady hand at the wheel in meeting our nation's most sacred obligation to care for those who wore the uniform."

Former VA CIO Roger Baker called the pick "a good choice." While Baker expects some discussion about McDonough's standing as a non-veteran during the confirmation process, "the key question is who's going to be able to get the most done for VA and for veterans over the next four years," he said -- adding that he expects McDonough to succeed "given his reputation as someone who can make things happen in Washington."

Another former VA senior official told FCW the McDonough appointment is a surprise "given he isn't a veteran," and added "I'm a little surprised he wants the job – it is one of the hardest jobs in government and he knows that" from his experience as chief of staff.

Former VA chief Shulkin and Bob McDonald, who led VA late in the Obama administration, also released statements approving the choice.

The left-leaning veterans service organization VoteVets said McDonough "is just what the VA needs right now and we're absolutely enthusiastic about President-elect Biden's choice."

Rep. Mark Takano (D-Calif.), the chairman of the House Veterans Affairs Committee, applauded the move.

"He has a demonstrated record of solving problems, " Takano said in an emailed statement. "I am confident that he understands the importance of healthcare and veterans policy, values the voices of VSOs, and unlike the current Secretary, will actively work with Congress to support our veterans-- especially through the COVID-19 pandemic."

If confirmed, McDonough inherits the technically complex project of replacing the VA's homegrown electronic medical health record system Vista with a commercial system provided by Cerner. The project is budgeted at $16 billion over 10 years, and may end up costing much more. Additionally, the VA continues to be challenged by the implementation of the Choice Act and restoring the morale of the unionized workforce after four years of adversarial relations with the Trump administration.