President-elect Trump has tapped former Rep. Doug Collins, R-Ga., to lead the Department of Veterans Affairs, who has military experience but has not been discussed as a candidate.

This surprising selection demonstrates Trump’s propensity to choose loyalists, as Collins, although lacking experience on veterans’ issues, staunchly defended Trump throughout his first term and campaigned with him this year. He did not serve on the House Veterans Affairs Committee during his term.

“None of us really know much about him,” Joe Chenelly, executive director of AMVETS, said of his and other veterans service organizations. He added that his group was pleased with the selection of a veteran — Collins served as a chaplain in the Navy and later joined the Air Force Reserve — for the position.

Trump’s approach to VA during his first term sparked some controversy as his administration sought to make it easier to lay off employees from the service and allow veterans to receive care from the private sector at government expense. Congress ultimately passed the MISSION Act of 2018 on a bipartisan basis, following a 2014 law with similar goals, but lawmakers disagreed over its implementation and conservatives accused President Biden of seeking to curb the use of “community care”.

Trump has often boasted about expanding his choice as one of his signature accomplishments during his first term, and Collins appears poised to continue those efforts.

The secretary-designate said on X that he would “fight tirelessly to streamline and reduce regulations within the VA,” perhaps an allusion to reducing barriers to private sector care. Collins recently said Fox News that if veterans “want to go back to their own doctor, so be it.”

The Biden administration, under Secretary of State Denis McDonough, has continued to implement the MISSION Act and spending on community care has increased each year. Still, VA has faced some criticism for not expanding its use further.

Chenelly said AMVETS feared Trump would bring in someone “more extreme” on the issue of privatized care. Among the names considered by the transition team, according to briefings provided to veterans groups, were former Rep. Tulsi Gabbard, D-Hawaii, whom Trump instead chose to lead the office of Director of National Intelligence Robert Wilkie, who previously led VA. under Trump, Darin Selnick, former Trump policy advisor on veterans issues, and Jeff DiLullo, vice president of Phillips North America. Collins doesn’t appear to have much experience in veterans policy, Chenelly said, but he hopes to meet with him before Trump’s inauguration to present AMVETS’ ideas.

John Byrnes, strategic director of Concerned Veterans for America, a right-wing veterans group with deep ties within Republican circles, said Biden and McDonough have undermined the spirit of the MISSION Act and that veterans deserve “a complete choice in health care”.

“Doug Collins has spoken out in favor of fixing VA’s broken healthcare system and ensuring veterans have access to choice,” Byrnes said. “We look forward to working with the next Secretary of Veterans Affairs in the Trump Administration to hold the VA accountable for meeting the needs of our nation’s heroes so that no veteran is left waiting for care.”

After his firing, Trump’s first VA secretary, David Shulkin, suggested he was dismissed for political reasons surrounding his reluctance to further privatize parts of the department. At the time, VA rejected that claim and said the idea that it had any interest in privatizing the department was a myth.

Collins also brought up the long-standing conservative goal of laying off more VA employees. Following his selection, he pledged to “eliminate corruption” from the ministry. Collins also criticized VA under McDonough for following a decision requiring the department rehire employees he improperly terminated.

McDonough last year completed the implementation disciplinary provisions included in the 2017 Whistleblower Accountability and Protection Act signed by Trump, citing his repeated defeats in courts, labor boards and elsewhere. The move marked the second time in the past decade that Congress unsuccessfully attempted to expedite VA shootings. In 2016, the department announced it would no longer use a 2014 law aimed at making it easier to fire senior career executives, after also suffering a series of legal setbacks.

The Trump White House and VA would likely be much more supportive of a measure that House Republicans passed through the House Veterans Affairs Committee last year on a party-line vote. The Restore VA Accountability Act would restore and strengthen many provisions of the 2017 Termination Act. The measure would again remove the requirement for a performance improvement plan and lawmakers have made clear in the new bill that its reforms would supersede any agreement VA negotiated with a union. Sen. Jerry Moran, R-Kan., who is set to take over as chairman of the Senate Veterans Affairs Committee, has introduced a companion bill.

The Biden administration forcefully pushed back on the renewed efforts, saying the legislative proposal was unnecessary and a retread of failed ideas.

Another effort Collins could revive with help from Congress is the process of identifying VA facilities to consolidate or close. The MISSION Act created a commission for this purpose, and the Biden administration has identified hundreds of facilities to close — as well as additional areas for construction of new clinics and medical centers — but a bipartisan group in the Senate boosted the initiative.