Jackson has served three administrations under both parties as the White House physician yet has little management experience on his résumé as he gears up to take over a sprawling agency of 360,000 workers and deal with the vexing challenges of providing health care and benefits to military veterans. Republicans say they know little to nothing about Jackson and are quickly studying up as they prepare for one-on-one meetings with the nominee.
“Certainly, I do have concerns about his experience, as far as managing people,” said Sen. John Boozman (R-Ark.), who sits on the Senate Committee on Veterans’ Affairs, which will vet Jackson’s nomination. “There is some concern about whether he’s been in a position to lead an organization like that.”
Sen. Jerry Moran (R-Kan.), another committee member, also expressed worries about Jackson.
“The VA is a difficult place to manage, regardless of what your background experience is. I want to know more about how he believes that he’s capable of fulfilling those responsibilities, and I have a wide array of questions in regard to his experience and background,” Moran said. “I need to be convinced that he can make a difference at a department in which the culture and the upper echelons of its leadership need to have somebody who can take charge.”
At best, Jackson is getting a tepid reaction from Senate Republicans, many of whom had praised his ousted predecessor, David Shulkin, even if they occasionally clashed with him over policy. Democrats were also vocal supporters of Shulkin, the sole Cabinet holdover from the Obama administration and who was the rare Trump-appointed official who sailed through the Senate with no objections.
A White House spokesman did not return a request for comment Tuesday on the Senate Republicans’ concerns surrounding Jackson’s qualifications. But the White House has defended Jackson’s credentials in the past, and the physician himself laid out his leadership background in an interview with a local newspaper in Texas published over the weekend.
“I’ve been in leadership school for 23 years now. . . . And I’ve been able to rise to the level of an admiral, a flag officer in the Navy. I didn’t just stumble into that,” he told the Lubbock Avalanche-Journal.
He added: “I think I’ve got what it takes, and you know, I don’t buy into that argument at all.”
Democrats are also questioning whether Jackson can handle oversight of the massive bureaucracy, which is second only to the Pentagon in size. And they’re making it clear that Jackson’s nomination will be intertwined with the broader fight about whether veterans should have more access to private doctors at taxpayers’ expense.
Shulkin had worked with senators on a bipartisan compromise that would largely keep VA in control if veterans can obtain private health care, while removing some restrictions. But the White House has pushed for a more aggressive turn toward privatization, which has alarmed Democrats and some veterans groups who worry about outsourcing so much of veterans’ care.
Sen. Patty Murray (D-Wash.) said she wants to hear from Jackson that he is “unequivocally opposed to privatization.”
“This is also a concern across the board, from all sides and from the veterans organizations that want to see a VA that was promised to them,” Murray said. “We don’t want to send the millions of veterans out into a system where the doctors meeting them may not be qualified.”
Compounding the challenges for the Trump administration is that Jackson is just one of a handful of Cabinet vacancies that the Senate is suddenly facing after a recent wave of dismissals and resignations.
Republicans are scrambling to quickly install Mike Pompeo as secretary of state. His nomination to be CIA director was supported by 15 members of the Senate Democratic Caucus last year, but he will face a much more sharply partisan confirmation battle to become the nation’s chief diplomat. Gina Haspel’s nomination to succeed Pompeo at the CIA will be a greater challenge for the administration, with both Democrats and Republicans raising questions about her involvement in the agency’s “enhanced interrogation” program, which critics say is tantamount to torture.
Both nominees are already facing opposition from Sen. Rand Paul (R-Ky.). Pompeo’s confirmation hearing is scheduled for Thursday. Haspel’s paperwork has yet to be submitted to the Senate and a hearing is not on the books. Jackson’s hearing has yet to be scheduled.
Senators are also carefully watching the controversies surrounding Scott Pruitt, the embattled administrator of the Environmental Protection Agency, which would be another challenging vacancy to fill in an election year.
Republican lawmakers are much more eager to focus on touting their legislative accomplishments, such as the recently passed tax law, rather than grueling confirmation battles that will only ignite partisan tensions in the Senate.
“The confirmations, they’re important,” Moran said. “But it is very difficult for us to deal with other issues, any things that are pending, that are important to the country when we’re consumed with confirmations, and confirmations that are ones that we had confirmed within the last year or so. And so it reduces the time in which we have to pursue other important issues for the country.”
“It would be good to have consistency [among the Cabinet secretaries] to develop the relationships on Capitol Hill,” said Sen. Mike Rounds (R-S.D.). “I think today, that is lacking with this administration.”
Senate Republicans and the White House have hammered Democrats, most recently this week, for stalling key administration nominees. But by adding more Cabinet-level picks to the Senate’s to-do list, the administration is only further delaying consideration of those lower-level picks.
The White House keeps a list of nominees that ranks each of them by priority, according to one GOP official familiar with the tally. Once Cabinet-level nominations are moved to the top, it moves other picks down, potentially for months, the official said.
Sen. Jon Tester (Mont.), the top Democrat on the veterans committee, said he urged Jackson to submit his paperwork to the Senate soon so a review of his qualifications can begin.
“I think both the management experience as well as his view on where he wants to take VA is really going to be important,” Tester said. “I’m very concerned about VA right now.”
When asked if he believes Jackson is qualified to run the agency, Sen. Johnny Isakson (R-Ga.), who chairs the veterans committee, said, “I don’t know enough to know anything.”
“I’m a blank slate,” said Isakson, who has spoken on the phone with Jackson. Senate Majority Leader Mitch McConnell (R-Ky.) has yet to comment on Jackson’s nomination.
Sen. Thom Tillis (R-N.C.), a member of the veterans committee, also said he has yet to make a judgment on whether Jackson is qualified. Sen. Dan Sullivan (R-Alaska), a fellow committee member, said he wants to question Jackson about “his experience, or lack thereof, on the management side.”
“That’s the most difficult, frustrating bureaucracy in Washington,” Sullivan said. “I think most people would absolutely agree with that.”