New rules at US Department of Veterans Affairs (VA) hospitals now allow doctors and healthcare staff to refuse treatment to veterans who are Democrats or unmarried. The changes were introduced quietly after an executive order signed by US President Donald Trump in January, and they have already taken effect in some facilities.Earlier, VA staff were explicitly prohibited from discriminating based on political affiliation, marital status, or union membership. That language has now been removed from the department’s bylaws.The VA says that “all eligible veterans will always be welcome” and that they are still entitled to treatment. However, under the new rules, individual staff members can now refuse to treat patients based on personal traits that are not specifically protected under federal law.The new rules, accessed by The Guardian, apply not just to doctors but also to psychologists, dentists, and several other healthcare roles. They also permit hiring discrimination against medical staff based on similar personal factors.The executive order was mainly aimed at removing federal protections for transgender individuals. It also banned the use of terms like “transgender” in VA clinics and led to cuts in gender-affirming care. These changes are part of a wider policy shift under the Trump administration.VA health researchers are now facing tighter controls, including a requirement to get political approval before publishing in scientific journals.Veterans advocacy groups warn that the new rule may impact rural veterans and survivors of military sexual trauma the most. According to Tia Christopher, a Navy veteran, some patients could be forced to travel more than 100 miles just to find a doctor willing to treat them. Experts are also concerned by the lack of consultation, as VA doctors were not involved in the changes. The VA has not denied this. Medical organisations, including the American Medical Association, are also pushing back. At a meeting this week, the AMA passed a resolution urging hospitals to preserve doctors’ autonomy and involve them in rule-making.The Department of Veterans Affairs runs the largest integrated hospital system in the United States, with over 170 hospitals and 1,000 clinics. It employs around 26,000 doctors and provides care to nearly 9 million patients each year.