Editor’s note: Colin Moore is writing a book on the history of the VA health care system.

Hawai‘i’s veterans have served their country in war and peace. Now, many face a new battle — accessing the health care and services they were promised.

With more than 82,000 veterans making up 7.5% of the civilian adult population, Hawai‘i has a notably large veteran community. For many of them, the Department of Veterans Affairs is more than a health care provider. It is a lifeline that offers specialized treatment, mental health services and long-term care designed specifically for those who served.

But the VA system is under threat. The Trump administration’s proposal to eliminate 80,000 VA jobs represents the largest workforce reduction in the department’s history. These cuts will hit Hawai‘i especially hard, straining an already understaffed system and creating even greater barriers for veterans who already struggle to access timely care.

Barriers To Care Will Get Worse

Unlike in many states, where veterans can drive to a nearby VA clinic, Hawai‘i’s veterans often face significant logistical challenges just to see a doctor. The Spark M. Matsunaga VA Medical Center serves not only veterans in Hawai‘i but also those in Guam, American Samoa and the Northern Mariana Islands. Veterans on Maui, Kaua‘i, and Hawai‘i island frequently face lengthy delays before they can fly to Honolulu for specialized care.

Even for those on O‘ahu, VA services are stretched thin. New patients seeking a primary care appointment at the Kāneʻohe clinic currently face an average wait time of 78 days, and some specialty services take even longer. While the VA has made improvements that reduced wait times for new patients by 11% last year, these job cuts will reverse that progress.

Hawai‘i’s Older Veterans Will Suffer

More than half of Hawai‘i’s veterans are over 65, making access to geriatric care, chronic disease management and home-based support services a growing necessity. The VA has been a national leader in research and treatment for aging veterans, developing specialized programs for dementia, mobility issues and end-of-life care.

Staff reductions will only make it harder for elderly veterans in Hawai‘i to receive the support they need. Neighbor island veterans will face longer delays for home health visits, while those who require long-term care will struggle to find openings in VA-supported nursing facilities.

A Rising Demand For Care, Met With Cuts

The proposed cuts come at a time when demand for VA health care is rising sharply. The PACT Act, championed by the late Hawai‘i congressman Mark Takai, expanded eligibility for veterans exposed to toxic substances during military service.

In the past year alone, more than 400,000 veterans have enrolled in VA health care, seeking long-overdue treatment for illnesses linked to Agent Orange, burn pits and other hazardous exposures. In Hawai‘i, this expansion has allowed veterans to access specialized care that was previously out of reach.

The Impact On Mental Health Services

Veteran suicide remains a national crisis. An average of 17.6 veterans die by suicide every day. In Hawai‘i, 20 veterans killed themselves in 2022 alone. The Veterans Crisis Line, which receives more than 60,000 calls per month, has been a crucial resource, providing immediate intervention for veterans in distress.

Since its creation two years ago, the service has answered over 2 million crisis calls and texts. Cutting mental health positions now, when demand remains high, is reckless and will put veterans at even greater risk.

The Loss Of VA-Led Medical Research

The VA is not just a health care provider — it is also one of the country’s leading centers for medical research. This work benefits both veterans and the general public. VA researchers developed the first FDA-approved shingles vaccine, advanced treatments for PTSD and traumatic brain injuries, and made breakthroughs in prosthetic technology.

Now, 350 VA research positions are slated for elimination, threatening studies on cancer, pain management and neurological disorders. These cuts will not only undermine care for veterans but will also slow progress in medical science.

A Workforce Already Stretched Thin

The Trump administration justifies these cuts as a cost-saving measure, but the VA is already struggling with severe staffing shortages. The department has thousands of job vacancies, particularly in nursing, medical technology and mental health services. Eighty-two percent of VA facilities reported significant nursing shortages last year, and Hawai‘i has struggled to recruit and retain VA medical professionals due to our high cost of living.

A Broken Promise To Those Who Served

The VA was built on the simple principle that those who served their country should receive the care they were promised. Slashing the VA workforce is not about eliminating waste. It is a failure to uphold that obligation.

Hawai‘i’s veterans have already given enough. They should not have to fight for the medical care they earned.