VA's top health administrator departs, replacement named
John Bartrum, the Department of Veterans Affairs' top health administrator, has resigned from his position as Under Secretary for Health effective June 30, 2025. Dr. Lee Payne, currently serving as Deputy Under Secretary for Health, will step in as acting Under Secretary while the administration determines a permanent replacement. Bartrum cited a desire to focus on his family and health as his reason for departure, along with plans to support the administration's efforts from the private sector.
The Under Secretary for Health position oversees the Veterans Health Administration, the nation's largest integrated healthcare system. This role carries responsibility for managing 171 VA medical centers and more than 1,000 outpatient clinics that provide care to approximately 9 million veterans annually. The position also controls the budget and strategic direction of all VHA operations, making it one of the most consequential leadership roles affecting veterans' access to healthcare services.
Bartrum's tenure was notably brief and historic in several respects. President Trump nominated him on June 2, 2024, and the Senate confirmed him in a 53-43 vote on December 18, 2024. He became the first Under Secretary for Health without a physician background, breaking from the traditional requirement for medical credentials in the role. A retired Air Force Reserve major general, Bartrum succeeded Dr. Shereef Elnahal, who resigned on January 20, 2025, during the presidential transition. Bartrum was also the first confirmed Under Secretary for Health to serve under Trump, as the position remained unfilled by a confirmed appointee throughout Trump's entire first administration.
During his short time in office, Bartrum pointed to several initiatives as accomplishments, including the relaunch of the VA's troubled electronic health record modernization program, reorganization of the Veterans Health Administration structure, and efforts to establish a center in Los Angeles focused on veteran homelessness. VA Press Secretary Quinn Slaven thanked Bartrum for his leadership and noted his 17 months of service to the department, which included time working as a transition team member and senior advisor to VA Secretary Doug Collins before his confirmation.
Dr. Lee Payne brings both military medical experience and familiarity with large-scale health system management to the acting role. A retired Air Force major general and specialist in internal and emergency medicine, Payne has served at VA since November 2024, supporting the electronic health record program among other responsibilities. His background includes commanding three military hospitals, directing the Defense Department's electronic health record modernization program, and managing DoD diagnostics and testing efforts during the COVID-19 pandemic.
Bartrum's departure creates additional leadership uncertainty at the VA, as two of the department's three Under Secretary positions now lack permanent leadership. The Under Secretary for Benefits position remains unfilled after nominee Karen Brazell withdrew last October amid opposition to her role in the administration's federal workforce reduction efforts. Only Under Secretary for Memorial Affairs Sam Brown, confirmed in July 2024, currently holds a permanent Under Secretary position.
For disabled veterans relying on VHA services, leadership transitions at this level can signal potential policy shifts or operational changes, though day-to-day healthcare delivery typically continues without immediate disruption. Veterans enrolled in VA healthcare should monitor communications from their local medical centers regarding any changes to services or procedures that may result from the leadership transition. Those experiencing issues with care access or quality should continue working through patient advocates at their facilities and consider contacting veterans service organizations if problems persist during this period of administrative change.