A plan by the incoming Trump administration to cut government funding could be knee-jerk Department of Veterans Affairs healthcare.

In one oped for the Wall Street Journal this weekElon Musk and Vivek Ramaswamy, whom President-elect Donald Trump tapped to lead the so-called “Department of Government Efficiency,” confirmed they plan to target “unauthorized” federal spending, a category that includes VA medical services.

“DOGE will help end federal overspending by targeting the $500 billion-plus in annual federal spending that is unauthorized by Congress or used in ways Congress never intended,” they wrote, referring specifically to funding for non-profit grants and PBS.

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The pair did not specifically call out the VA. But the kind of spending they have problems with includes about $120 billion for VA medical services, according to a report issued earlier this year by the Congressional Budget Office.

Historically, for a federal agency to operate, Congress passes two different types of legislation: an authorization bill to authorize funding and an appropriations bill to actually distribute the funding.

For example, for the Pentagon, Congress passes the National Defense Authorization Act and a Pentagon appropriations bill each year.

But for most federal agencies, Congress has ignored the authorization bills for years, instead streamlining its work by treating the appropriations bills as self-authorizing.

A 2023 report by the Congressional Research Service The House notes that the distinction between authorizing and appropriations bills “is based on House rules rather than a constitutional or general statutory requirement.”

For VA health care, the last authorization bill was the Veterans Health Care Eligibility Reform Act of 1996, as Congressional Budget Office Report.

The opinion of Musk and Ramaswamy about their plans for DOGE, which is the same name as a cryptocurrency Musk has previously offered, confirmed that they will pursue an idea that Ramaswamy first floated on social media last week.

“We can and should save hundreds of billions each year by defunding government programs that Congress no longer authorizes,” he wrote on X, formerly known as Twitter. “We will challenge any politician who disagrees to defend the other side.”

Asked about the DOGE proposal at a hearing Wednesday, VA Undersecretary for Health Care Shereef Elnahal said he would be “very concerned” about any cuts to the agency and that department lawyers believe it has the legal authority to operate.

Veterans’ demand for care is increasing “actually substationally,” said Elnahal, a Biden administration appointee. “Despite these increases in demand, we’ve seen wait times go down, instead of up, for primary care and mental health. We’ve seen historic results in terms of quality, patient safety, veteran satisfaction and trust. We want to make sure we maintain those results at the same time as we provide accessible, high-quality care to veterinarians.”

Lawmakers in both parties have already pledged to protect the VA.

“If majority Republicans follow Ramaswamy’s wishes, it will mean veterans will no longer be eligible for inpatient services, such as surgeries, urgent care and injuries that may require urgent care, and outpatient services, such as health care visits, immunizations and nutrition and education,” rep . Debbie Wasserman Schultz, D-Fla., the ranking member of the House Appropriations Committee’s VA subcommittee, said at the hearing before asking Elnahal about DOGE.

Later in the hearing, subcommittee chairman John Carter, R-Texas, assured that he “will not stand for anybody who tries to eliminate anything that has to do with our veterans administration.”

Suggesting that unauthorized appropriations be cut is “an amateur comment,” he added.

“We are all here to support the veterans of our country, and there is no one on this committee who is trying to do anything to wipe out our veterans or veterans’ care. And we will be soldiers in the field fighting on your behalf if something like that comes ,” Carter said.

But in their remarks, Musk and Ramaswamy also said they plan to bypass Congress. While a 1974 law called the Impoundment Control Act generally requires a president to spend money appropriated by Congress, the couple noted that Trump opposes that law. Trump’s disregard for that law was part of his first impeachment for withholding congressionally approved aid to Ukraine.

“Mr. Trump has previously suggested that this statute is unconstitutional,” they wrote, “and we believe the current Supreme Court is likely to side with him on this issue.”

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