There is a lot of unfinished business in VA, requiring knowledgeable leadership. The White House cannot sacrifice that even if direction is needed elsewhere in the battle over the Affordable Care Act.

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Shulkin was drafted from the private sector in 2015 to tackle VA’s access crisis as it was being blamed for killing veterans stuck on secret wait lists, forced to line up for months before being seen. He was appointed undersecretary of VA’s Veterans Health Administration by President Barack Obama and promoted 18 months later to VA secretary after President Trump was elected. With veterans organizations’ enthusiastic support, the Senate confirmed Shulkin 100-0 in February.

During an otherwise chaotic time in Washington, the transition of power has been smooth at VA. Shulkin was already intimately aware of the challenges he faced coming in, having worked closely with his predecessor Bob McDonald. That experience mattered in understanding the VA as well as the relationships with Congress and the veteran communities and organizations within it.

Shulkin elevated his top aides to seamlessly backfill. While other agencies struggled through drastic change, VA benefited from continuity. The result is perhaps the most productive first year among any of President Trump’s Cabinet-level positions.

Now the prospect of VA losing its chief at this critical time is alarming. But significantly compounding the concern is that two of Shulkin’s top lieutenants just quit. Both were driving creation of the new “CARE” plan, which stands for Coordinated Access and Rewarding Experiences, a multibillion-dollar strategy to ensure access for veterans who live far from VA facilities or near VA medical centers that are over capacity or underperforming.

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Poonam Allaigh and Baligh Yehia each abruptly resigned within the past few weeks. Alleigh was VA’s acting undersecretary for health since Shulkin was promoted, and Yehia ran VA’s network of community medical providers. Both joined the organization in 2015, commissioned to fix a broken system.

CARE is the product of more than two years of collaboration by VA, veterans service organizations and other stakeholders. Much of the plan, expected to be released this month, contains a lot of vagueness, outlining policies but leaving the creation and implementation of regulations up to the VA secretary — someone, it is hoped, intimately involved in its creation. We cannot leave formation of these regulations to a person who was not integral in establishing overall strategy.

VA has three major pillars: health care, veterans benefits and cemeteries. Each is vital to the government keeping its promise to veterans and their families, so each is supposed to be led by an undersecretary confirmed by Congress. But President Trump has yet to nominate anyone for VHA or the Veterans Benefits Administration. If the administration does not move wisely, it will create a dangerous leadership void in an agency that the president often says is among his most important.

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There is no doubt the top post at Health and Human Services is vital to every American, given the raging debate over the future of health-care insurance, certainly including veterans. There is little doubt Shulkin is qualified. But the timing is dangerous to the Department of Veterans Affairs and the millions of veterans who depend on it.

As a veteran, I would never leave my compatriots behind. I hope Shulkin feels the same way.

Chenelly is a Marine Corps combat veteran of operations in Afghanistan and Iraq. He is the national executive director of AMVETS, a veterans service organization with more than 250,000 members nationwide. On Twitter: @jchenelly.