Denis McDonough, who served as Barack Obama's chief of staff throughout the president's second term, has been tapped to lead the Department of Veterans Affairs.
The transition team confirmed Thursday that President-elect Joe Biden has chosen McDonough for VA secretary. If McDonough's nomination is approved by the Senate, he would be only the second non-veteran to serve in the post since the VA became part of the Cabinet in 1989.
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McDonough, a native of Stillwater, Minnesota, served in the White House during a contentious time at the VA -- a period that included a scandal over wait times for medical appointments, the subsequent resignation of then-VA Secretary Eric Shinseki, and passage of legislation that broadened veterans' access to health services provided by private physicians, a policy known as Veterans Choice.
A source familiar with Biden's thinking said that, as Obama's closest adviser, McDonough worked with Shinseki's successor, former VA Secretary Bob McDonald, as well as Congress, to "ensure veterans get the care they need and deserve."
"McDonough has the empathy, the character, the integrity and ethics, and the relentless work ethic the position demands -- all qualities that are important to the president-elect," the team member said. "If confirmed, he will work tirelessly to ensure the VA is accountable to those who have served this nation, their families and caregivers, and survivors."
Prior to serving as chief of staff, McDonough was deputy national security adviser, where he helped "work on behalf of military families and veterans," according to the transition official.
At least one veterans organization was swift to question McDonough's qualifications for running one of the federal government's largest bureaucracies, a health care and benefits organization that employs more than 360,000 people and provides services to roughly 9 million former U.S. service members.
"We are surprised by reports the President-elect Joe Biden intends to nominate Denis McDonough to become the next VA Sec. We were expecting a veteran, maybe a post-9/11 veteran. Maybe a woman veteran. Or maybe a veteran who knows the VA exceptionally well," AMVETS said in a statement.
The choice of McDonough, who has no military background, came as a surprise to the veterans community -- perhaps not a welcome one.
Much of the speculation on possible candidates had focused on the idea that Biden would want to make a statement with the nominee for VA secretary by picking the first post-9/11 veteran to hold the post, or the first woman.
In a statement, Joe Chenelly, national executive director of the AMVETS veterans service organization, said, "We were expecting a veteran, maybe a post-9/11 veteran. Maybe a woman veteran. Or maybe a veteran who knows the VA exceptionally well."
The main union at the VA, the American Federation of Government Employees, which represents more than 200,000 VA workers, had backed the choice of former Rep. Patrick Murphy, D-Penn., an Iraq veteran and former under secretary of the Army.
In a Nov. 17 Twitter post, the AFGE wrote, "It's long past time we had a VA Secretary that understands veterans and those who care for them every day. And there couldn't be anyone better for the job than Patrick Murphy.”
Others in the veterans community had mentioned the possibility that Biden might choose Sen. Tammy Duckworth, D-Ill., a severely wounded Iraq veteran who also was believed to have been on Biden's short list for defense secretary before he nominated retired Army Gen. Lloyd Austin. Another outside possibility for VA secretary was W. Scott Gould, a former Navy captain and deputy secretary at the VA during the Obama administration who is the husband of Michèle Flournoy.
Flournoy, a former policy chief at the DoD and co-founder of the Center for a New American Security think tank, had been considered the front-runner to lead the Pentagon before Austin was introduced by Biden on Wednesday.
Former VA Secretary David Shulkin expressed support for the choice shortly after it was first reported by Politico.
Following the appointment scandal that originated at the VA medical facility in Phoenix, Arizona, McDonough defended the administration's actions and said the department was dealing with a dramatic expansion in terms of the health care system and providing education benefits. Veterans in Phoenix waited months for primary and specialty care while the hospital hid the extent of the delays by maintaining paper appointment schedules.
"We have been working aggressively to ensure that not only is health care expanded, opportunities made more ready to our vets, but that people are held to account, as [Shinseki] is doing in this case. We will continue to do that," McDonough pledged during a 2014 interview with CNN.
The Veterans Choice program was later amended and expanded under the administration of President Donald Trump as the VA Mission Act.
While serving as White House chief of staff, McDonough frequently visited Walter Reed National Military Medical Center and traveled to Iraq and Afghanistan to visit troops.
His wife, Kari, is co-founder and president of Vets Community Connections, a support organization that assists veterans with transition from the military to their communities.
Since the end of the Obama administration, McDonough has worked for the Markle Foundation, focusing on employment and job training for Americans.
-- Staff writers Gina Harkins and Richard Sisk contributed to this report.