Long-simmering tensions about privatizing the Department of Veterans Affairs (VA) could erupt into a confirmation battle over President Trump Donald John TrumpOmar fires back at Trump over rally remarks: 'This is my country' Pelosi: Trump hurrying to fill SCOTUS seat so he can repeal ObamaCare Trump mocks Biden appearance, mask use ahead of first debate MORE's pick to lead the department.

Trump’s decision to oust former VA Secretary David Shulkin David Jonathon ShulkinVA inspector general says former top official steered M contract to friend Schumer demands answers in use of unproven coronavirus drug on veterans Former Trump VA secretary says staffer found plans to replace him in department copier MORE late last month and replace him with White House physician Ronny Jackson stoked speculation that the White House wants to allow veterans more access to private-sector health-care providers.

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In an op-ed published in The New York Times just hours after he was removed, Shulkin blamed his ouster on forces within the administration that he said are pushing hard for privatization

“The advocates within the administration for privatizing VA health services ... saw me as an obstacle to privatization who had to be removed,” Shulkin wrote.

Dismantling the department’s health-care system “is a terrible idea,” Shulkin wrote, adding that the private sector “is ill-prepared to handle the number and complexity of patients that would come from closing or downsizing VA hospitals and clinics.”

Groups like the Koch brothers-backed Concerned Veterans for America (CVA) are pushing to loosen current restrictions on veterans receiving private-sector care.

Democrats and veterans’ advocates are concerned that the White House is taking those calls for privatizing the VA system seriously, but the VA denied last week that there is any push to privatize its health system.

“There is no effort underway to privatize VA, and to suggest otherwise is completely false and a red herring designed to distract and avoid honest debate on the real issues surrounding veterans’ health care,” the agency said in a statement.

Democrats and veterans’ advocacy groups have been wary of Republican efforts to privatize the VA since before Trump took office.

In a 2016 campaign rally in Virginia Beach, Trump called the VA corrupt and inefficient.

“Veterans should be guaranteed the right to choose their doctor and clinics, whether at a VA facility or at a private medical center,” Trump said. “We must extend this right to all veterans.”

Senate Democrats and veterans groups have not yet drawn any hard lines against Jackson, partly because they said they don’t know what his positions are.

Verna Jones, the executive director of the American Legion, said she would have to sit down and speak with Jackson before passing judgment on his nomination.

“It seems like people are putting the cart before the horse. Jackson hasn’t had a confirmation and none of us know his views,” Jones said. “To be clear, the Legion opposes privatization. How all this ties into Jackson — we owe it to him to wait and see."

Jackson is an active-duty Navy admiral who has worked as the White House physician for three presidents. Lawmakers have expressed skepticism over whether Jackson, who doesn’t have experience working with the VA or managing a health-care organization, has the qualifications to run the agency.

Senate Democrats on the Veterans’ Affairs Committee said they also don’t know where Jackson stands on privatization. Still, they don’t trust the administration’s motives and are gearing up for a fight.

Sen. Jon Tester Jonathan (Jon) TesterPence seeks to boost Daines in critical Montana Senate race This World Suicide Prevention Day, let's recommit to protecting the lives of our veterans Filibuster fight looms if Democrats retake Senate MORE (D-Mont.), the ranking Democrat on the committee, told The Hill he has only had a brief phone call with Jackson since Trump nominated him for the position.

“There are two areas of concern … one is privatization and the other is management. So that’s what we’re going to focus on,” Tester said.

“Our job is to strengthen the VA in order to provide high-quality care to our veterans, not dismember it,” Sen. Bernie Sanders Bernie SandersButtigieg stands in as Pence for Harris's debate practice Bernie Sanders warns of 'nightmare scenario' if Trump refuses election results Harris joins women's voter mobilization event also featuring Pelosi, Gloria Steinem, Jane Fonda MORE (I-Vt.) said in a statement. “The Senate Committee on Veterans Affairs should not approve any nominee for secretary who supports the privatization of the VA."

Sen. Richard Blumenthal (D-Conn.) told The Hill privatization is a “serious concern” that he hopes to address with Jackson.

A spokeswoman for the VA committee said a hearing would be scheduled as soon as Jackson submits his paperwork and finishes a background check.

Jackson’s nomination could also spotlight legislation that is intended to make it easier for veterans to get care outside the VA system without completely privatizing the system.

The legislation from Tester and Senate Veterans’ Affairs Committee Chairman Johnny Isakson Johnny IsaksonLoeffler paints herself as 'more conservative than Attila the Hun' in new campaign ad Georgia GOP Senate candidates cite abortion in pushing Ginsburg replacement Loeffler: Trump 'has every right' to fill Ginsburg vacancy before election MORE (R-Ga.) has backing from major veterans groups such as the American Legion and Veterans of Foreign Wars.

The bill would overhaul VA Choice, a temporary program that allows veterans to seek care outside the VA network — but only in cases where they have to wait more than 30 days for an appointment or drive more than 40 miles to a facility.

It would eliminate the waiting period and distance requirements and allow veterans to seek community care outside the VA if veterans and their providers agree it’s the best method of treatment.

But the Koch-backed CVA has lobbied hard against it, because they think it doesn’t loosen regulations enough.

Opposition has also come from the left. House Democrats blocked the bill from being included in the omnibus funding bill that passed last month because they think it moves the VA too far toward privatization.

A Senate VA committee aide said Isakson has spoken to Majority Leader Mitch McConnell Addison (Mitch) Mitchell McConnellPelosi: Trump hurrying to fill SCOTUS seat so he can repeal ObamaCare Senate GOP aims to confirm Trump court pick by Oct. 29: report Trump argues full Supreme Court needed to settle potential election disputes MORE (R-Ky.), and hopes to bring the bill to the floor for a stand-alone vote in the next few weeks.