On days when the emphysema and the side effects of his traumatic brain injury are not flaring out of control, David Cochran sometimes leaves his house in Vista.
But simple things like traffic can set off his post-traumatic stress, and the U.S. Army veteran quickly returns home, where he doesn’t feel so vulnerable to the possibility of hurting himself — or others.
“I can’t be in crowds,” Cochran said. “I have trouble driving because of the road rage.”
The U.S. Department of Veterans Affairs is the former Army major’s sole health care provider, overseeing his prescription medication regime and offering one-on-one therapy to help him process his experience in Iraq so many years ago.
The VA has served him fairly well since he left the military in 2012, Cochran said.
But his anxiety has reached a slow boil in recent months, as President Donald Trump’s administration slices jobs and services across the federal government, including the VA, where this month the administration announced it plans to cut more than 80,000 jobs.
Now, Cochran and other veterans in San Diego County are worried about how their benefits and services could be impacted by the staffing scale back — and how far the cuts will go. For some, the agency has already targeted specific cuts to health care, announcing last week that it will no longer provide gender-affirming care to transgender veterans.
“I didn’t think it would be this bad,” said Cochran, now 57 and working a private-sector computer job from home. “I didn’t think Trump would brutalize the government like he is. His efforts have surpassed my darkest images.”
The Trump administration said it plans to cut 83,000 jobs from the VA, the agency that provides health care, housing, pensions, education stipends and more to the country’s 15.8 million military veterans, close to 200,000 of whom live in San Diego County.
Veterans also help run the agency, accounting for about 30% of everyone it employs. More still — about 630,000 — work for the federal government at large, making up about the same share of the federal workforce, according to 2023 data from the U.S. Office of Personnel Management.
The VA already cut more than 1,400 jobs in February.
“It really seems like all of the things I was promised as a citizen of this fine country are very quickly either evaporating or intentionally being dismantled and taken apart,” said Ian Mooney, the president of the San Diego chapter of Veterans for Peace.
He served in the U.S. Army from 2007 to 2011 and is now pursuing a doctorate in philosophy from the University of Kentucky.
San Diego’s Veterans for Peace organized a protest on March 14 at the World Beat Center in Balboa Park in response to the Trump administration’s proposed cuts to the VA. Many of the roughly 200 attendees held handmade signs with slogans such as “Hire a Veteran, Fire Musk” and “Keep Promises to Veterans.”
One woman whose husband died in Vietnam at 22 — when she was three months pregnant — said she could have never gone to college herself and gotten a job to support her daughter if it hadn’t been for the VA and the GI Bill.
VA Secretary Doug Collins has said cuts won’t impact veterans or their benefits, maintaining that the move will actually allow more funding to flow to them.
But many local veterans and their families aren’t buying it.
They say cuts to personnel will impact their services — making for longer wait times and hurting communication with the VA employees who are helping them process medical claims and enroll them in programs.
“If the people who were processing the claims are no longer there… What if it takes a year for you to get a determination? What are you supposed to do for that year?” asked Clairemont resident Patricia Hoekman, whose 28-year-old son was discharged from the U.S. Coast Guard last weekend. “If you’re diminishing our access to care, you’re essentially taking it away.”
Her son has been working with a VA employee to process his service-connected disability claim, a process he started months ago. As of Wednesday, he hadn’t heard from them in a few days.
Carlos Perez Gomez, a 42-year-old U.S. Marine Corps veteran who lives in El Cajon, says he’s scared the government will come for veterans’ benefits next.
Gomez is a Silver Star recipient who served in Iraq during 2003 and 2004, including in Fallujah, where he was shot in the face and shoulder during a mission.
He remembers the fear he and his company felt in Iraq. They had to jerry-rig their own vehicle protection, he says, using sandbags and plywood to create a defense against enemy fire. Their uniforms were green camouflage, unfit for Iraq’s beige desert landscape.
The war also shifted the deployment schedule for the Marines, he said, so that some had less training before entering combat zones.
When Gomez left the service in 2006 at the age of 23, he didn’t know anything about post-traumatic stress disorder. But he sought help when he became worried that his aggression could put his young son in danger.
His experiences with the VA’s mental health services haven’t always been great. In 2023, he had to wait 18 months for an in-person one-on-one counseling appointment. But he says this is a sign that the agency needs more resources, not fewer.
“We need to increase the services,” he said, adding that even though he’s experienced hiccups at the VA, “they’re actually helping as best they can.”
The VA has already been understaffed for years.
In a 2024 review on staffing shortages from the VA Office of Inspector General, the Veterans Health Administration (VHA) reported a total of 2,959 severe occupational staffing shortages across its facilities.
Shortages in psychology were the most frequently reported, and have been one of the most reported since 2018. More than 80 percent of facilities reported shortages of medical officers and nurses — a severe shortage that has been reported every year since 2014, according to the review.
Andrea Johnson has worked as a registered nurse at the VA in La Jolla for the past seven years. She said the challenge of treating veterans has never been greater than in the two months since Trump returned to the White House.
“Every day when we go to work, our nurses are really struggling with feeling demoralized,” Johnson said. “Every day is a surprise.”
So far, none of the 900 or so registered nurses, nurse practitioners or other members of the National Nurses United union at the La Jolla hospital has been laid off, Johnson said.
But many of the dietary staff, housekeepers, supply chain managers and lab technicians have been let go or accepted early-retirement offers, she said, forcing nurses to do extra work that takes them away from their primary duties.
“These are all services and people we rely on to assist in the care of veterans,” Johnson said. “We started to feel the effects as far as impacting patient care over the last three or four weeks.”
According to Johnson, no one has died due to the staffing cuts imposed to date — but the level of care already has been affected.
“When there’s a reduction in staff and a reduction in health care providers, that does lead to negative patient outcomes,” she said. “We’re in the business of caring for veterans and getting them back home to their families. We don’t want to be hindered in our ability.”
This week, the VA also went a step further in its reductions, targeting care for transgender veterans.
The VA has never provided gender-affirming surgeries, but it announced on Monday it would be cutting other gender-affirming health care for transgender veterans and veterans with gender dysphoria, including hormone-replacement therapy and voice training therapy.
The move rolls back VHA Directive 1341, which was introduced in 2018 under Trump’s first term and provided “a policy for the respectful delivery of health care” for trans veterans. Information on the policy is no longer available on the VA’s website.
Democratic Rep. Mike Levin, speaking to reporters in Oceanside on Friday, said the move fits with the Trump administration’s attacks on transgender people.
“Anybody who puts on the uniform, who serves our nation voluntarily, who puts their lives at stake in order to defend our freedom and our institutions and our country — we should take care of them,” Levin told The San Diego Union-Tribune after a press conference, during which he advocated for VA staff and programs.
Levin said he wrote to Secretary Collins last month pushing to preserve veterans’ services but hasn’t gotten a response.
Advocates worry a lack of access to care for trans veterans could lead to higher rates of depression and suicide.
“Gender-affirming care has the ability to effectively save lives, and so any threat to take that away is a direct assault to our rights as human beings,” said Pamuela Halliwell, the assistant director of behavioral health services at the San Diego LGBT Community Center.
Halliwell herself was kicked out of the U.S. Navy under the “Don’t Ask, Don’t Tell” policy in 2007 for being transgender — a discharge that stripped her of the right to receive benefits under the VA.
She said that since the election, more community members — including active-duty and retired military personnel — have contacted The Center in fear over how they will access services.
Some trans veterans are considering whether they should seek private health care, says Lindsay Church, the executive director of Minority Veterans of America. But not everyone has that option.
And for all the VA’s shortcomings — Church says they’ve been misgendered and harassed — it’s also the only federal agency equipped to understand veterans’ complex needs when they return home from service, something private care may not have the capacity to provide.
Cochran, the U.S. Army veteran in Vista, says he typically attends therapy and receives other treatment at the VA clinic in Oceanside but visits the La Jolla campus fairly regularly.
His one experience with Community Care, the VA program that lets veterans get treatment from private providers when care isn’t immediately available, did not go well. The clinic botched his paperwork and left him with $1,000 of debt that should have been covered, he said.
Now he worries downsizing the VA will force more veterans into private-sector treatment and chip away at the benefits they earned.
Although he has yet to be directly affected by cuts, Cochran is consumed with worry over the way the Trump administration has slashed services on which millions of people rely.
“The government is a complicated organization,” he said. “You can’t just lop off programs at will. It would be like taking out random body parts and hoping people can just live with it.”
Staff writer Jemma Stephenson contributed to this report.
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