The Trump administration is making it more difficult for veterans with a rare but deadly cancer to get their health care needs covered by the government. The new policy, involving breast cancer in men, is laid out in a Department of Veterans Affairs memo obtained by ProPublica.
The previously undisclosed document does not cite any evolving science. Rather, it relies on an order that President Donald Trump issued on his first day in office titled: “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”
An agency spokesperson confirmed the change.
“As of Sept. 30, the department no longer presumes service connection for male breast cancer,” press secretary Pete Kasperowicz wrote in a statement to ProPublica. He noted that veterans who’ve previously qualified for coverage can keep it.
But for the roughly 100 male veterans who are newly diagnosed each year, the path will now be significantly harder. They will have to show their cancer was connected to their military service, a burden that has often been hard to meet.
Without VA coverage, experts say, veterans’ care could be delayed or even missed altogether — even as research has shown the rate of breast cancer among men has been increasing and the disease is deadlier than for women. One study also found that breast cancer for men is “notably higher among veterans.”
“Cancer in male veterans should be covered,” said Dr. Anita Aggarwal, a VA oncologist who researched and treated breast cancer for years before retiring recently. “These people have put their lives at risk for us.”
As Aggarwal noted, breast tissue in men and women are similar. “Male breasts don’t produce milk,” Aggarwal said. “But the treatment is the same.” She added that research has linked breast cancer to toxic exposure.
The administration’s new policy rolls back benefits that were created under the Promise to Address Comprehensive Toxics, or PACT, Act, a Biden-era law that ushered in one of the largest expansions of health care and benefits in VA history.
After a long fight by advocates, congressional Democrats and Republicans passed the measure three years ago, making it easier for veterans poisoned by Agent Orange and other toxic substances to get benefits.
Before the law, the VA had frequently been denying the claims. Now, the government would presume many ailments were connected to veterans’ military service, so long as they served in particular areas and had any number of diseases on a VA list.
As a result, more than 200,000 veterans likely exposed to toxic substances during their service have qualified to have their care covered.
The Trump administration’s change means that male veterans who get breast cancer will no longer be able to benefit from that easier path for coverage.
Veterans who have breast cancer said the move left them aghast and puzzled.
Jack Gelman, a 80-year-old former Navy fighter pilot who served in Vietnam, is already facing the fact that his long-dormant breast cancer came back last year. Now he has to grapple with the fact that the government has just made it harder to get his care covered.
“I’m astonished,” Gelman said repeatedly when ProPublica told him about the change. “This is really nickel and diming a very small group of people who should be taken care of.”
Other veterans echoed that. “I don’t care if it’s toenail cancer,” said Kirby Lewis, who was diagnosed with breast cancer about a dozen years ago and is now Stage 4. “If exposure occurs, they should take care of those people.”
Lewis, who served in the Navy for five years during the 1980s, isn’t worried about losing his coverage, which the VA granted him as a result of unrelated heart issues. But he said the administration’s decision risks further stigmatizing men with the disease.
“There’s this machinismo aspect that they don’t want to accept that we have breasts, but we do,” said Lewis, who called the decision “very upsetting.”
A flag, a porthole and color bars are some of the items Lewis has on display at his home from his time in the Navy. Greg Kahn for ProPublica
The PACT Act gives administrations widespread discretion to cover diseases as science develops. Last year, the VA added three cancers, including male breast cancer.
The law states that “reproductive cancer of any type” be covered. Officials added male breast cancer under that category after a working group of experts reviewed the science. The decision noted “the marked similarity of male and female breast cancer.”
The Trump administration’s memo argues that designation is a mistake. “The Biden Administration falsely classified male breasts as reproductive organs,” Kasperowicz said in his statement to ProPublica.
A former official who was involved in the VA’s decision last year said that while there were discussions about how to interpret “reproductive cancer,” the scientific consensus among VA oncologists was clear. “The evidence showed that male and female breast tissue respond similarly to toxic exposures and share nearly identical biological and mutational profiles,” said the former official, who spoke on condition of anonymity, citing concern for his job prospects in government. “Expanding coverage to male breast cancer was the right call.”
Rosie Torres, who advocated for the PACT Act after her husband became sick, said the current administration is putting politics above patriotism and people. “It shouldn’t matter who signed the bill,” Torres said, referring to Biden. “If you don’t like the ‘reproductive’ word, do it under another category. Don’t remove it. These are peoples’ lives.”
Kasperowicz emphasized that veterans can still get coverage, so long as they show a connection between their illness and their service.
“The department grants disability benefits compensation claims for male Veterans with breast cancer on an individual basis and will continue to do so,” he said in his statement. “VA encourages any male Veterans with breast cancer who feel their health may have been impacted by their military service to submit a disability compensation claim.”
The change follows a wider tumult at the VA, where tens of thousands of staffers have left amid plummeting morale and work edicts such as a return to office.
Secretary Doug Collins has long insisted that care will not be affected. “Veterans benefits aren’t getting cut,” Collins said in February. “In fact, we are actually giving and improving services.”
Advocates and Democrats say they’re concerned that the rollback of presumptive coverage for male breast cancer could presage wider cuts. This year, House Republicans passed a bill to cut a fund for veterans covered under the PACT Act, which they’ve criticized as lacking in oversight. The bill has not passed in the Senate.
Meanwhile, Project 2025, the conservative initiative to create a blueprint for the Trump administration, urges officials to roll back benefits, or as the initiative puts it, to “target significant cost savings from revising disability rating awards.”
The Trump administration has so far not done that. ProPublica asked the VA whether there are any plans to change coverage beyond male breast cancer.
The department did not respond.
ProPublica wants to hear from doctors, nurses and other front-line medical providers who recently left positions at a VA hospital or clinic.
