Biden and Trump are vying for the veteran vote in the 2024 race. Here’s how their policies on veteran affairs stack up.

But both also have legislative track records from their first terms in office, as well as well-documented accounts of how the Department of Veterans Affairs functioned under their administrations, that could point to how a second term would play out.

Biden shepherded through the PACT Act, which has been described as the biggest expansion of veterans benefits in a generation. Trump’s biggest veterans-related legislation was the Mission Act, which expanded veterans’ ability to seek VA-funded care outside of the VA system.

“Someone who may have benefited from the passage of the Mission Act, for that individual, it’s the most important thing,” said Patrick Murray, legislative director at the Veterans for Foreign Wars. “Someone who may have had a rare cancer that was benefited by the PACT Act, that’s the most important thing to them. So, different veterans who had different illnesses, injuries, disabilities, whatever, may have benefited from either of the bills and, to those veterans, that’s the most important thing.”

Other veterans groups echoed the importance of both bills.

“We fought hard for the passage of the Mission and PACT acts because all veterans deserve the best care possible from VA,” Chanin Nuntavong, the American Legion’s executive director for government affairs, told Military.com in an email. “This means untangling the knots often associated with securing their earned healthcare benefits; expanding the rules to cover all those eligible; and lifting barriers to access, especially to those who live in rural areas.”

The PACT Act was the culmination of a yearslong effort from veterans, family members, and other advocates to get better recognition and care for ailments believed to be caused by exposure to burn pits and other toxins during their military services.

The legislative push got a significant boost when Biden, who has said he believes his son Beau’s fatal brain cancer was caused by burn pit exposure, endorsed it at a State of the Union address, giving it the momentum needed to become law.

By the VA’s own accounting, the law has resulted in more than a million new benefits claims approved and more than 300,000 new enrollments in VA health care.

The implementation has not been without issues. Most significantly, senior VA executives were improperly paid $10.8 million in bonuses that were intended to retain employees with critical skills needed to handle the influx of work from the PACT Act. Veterans have also given one of the most high-profile elements of the PACT Act — toxic exposure screenings — lackluster reviews.

But, overall, veterans organizations have celebrated the PACT Act as a historic achievement.

“Simply put, the bill represents the largest expansion of VA care and benefits for those exposed to harmful substances during their military service in history,” Joe Parsetich, then the national commander for the Disabled American Veterans, said at the time of the passage in 2022.

The Mission Act, meanwhile, was an effort to fix issues with the earlier Choice Act, a 2014 law that was borne out of the VA wait-time scandal. Trump often incorrectly refers to his achievement as “Choice,” even though the earlier bill with the same name was signed by his predecessor, President Barack Obama.

The Mission Act expanded the number of veterans eligible to receive private healthcare funded by the VA and consolidated several different programs for community care into one. Under the law, veterans can seek outside care if they face more than a 30-minute drive for primary care or mental health services or 60 minutes for specialty care, or a 20-day wait for a primary care or mental health appointment and more than 28 days for specialty care.

Republicans have alleged that the VA under the Biden administration has undermined the Mission Act by limiting the number of referrals to community care. VA officials and Democrats, by contrast, have expressed concern about ballooning community care costs since the law’s implementation.

Another major element of the Mission Act, a commission that studied the VA’s infrastructure needs, fizzled out when it recommended closing 17 medical centers and dozens of aging or underused clinics. Lawmakers in both parties who had facilities on the chopping block refused to move forward.

“What was passed was not perfect. Nothing ever is,” the VFW’s Murray said, noting proposed updates to community care pending in Congress right now. Still, the Mission Act “was huge, unprecedented.”

“And then only a few years later, there was an even huger, more unprecedented bill that followed it,” he added of the PACT Act. “So, both, at the time, were huge, were generational things, and then the next one just follows. So, we will see what comes in five to 10 years if there’s another one that we’ll be talking about.”

Outside of legislation, Trump and Biden have divergent records on VA staffing and leadership.

Much like the rest of his administration, Trump’s VA saw significant leadership turmoil.

Trump’s first VA secretary was David Shulkin, a VA undersecretary during the Obama administration who was one of Trump’s last picks for Cabinet secretaries ahead of his inauguration. Shulkin was ousted by Trump a little more than a year into the job after an inspector general report found he took a trip to Europe that involved more sightseeing than official business, used taxpayer funding to have his wife accompany him on the trip, and improperly accepted tickets to a Wimbledon tennis match as a gift.

To replace Shulkin, Trump first nominated current Rep. Ronny Jackson, R-Texas — at the time, a Navy doctor who served as the White House physician and won Trump’s favor by showering him with praise. Jackson, though, was forced to withdraw from consideration after allegations that were later confirmed by an inspector general that he drank on the job, overprescribed medications, and created a hostile work environment.

After Jackson’s bid ended, Robert Wilkie, who had been working at the Pentagon, was nominated and confirmed as VA secretary. He lasted through the end of the Trump administration.

VA policy during the Trump administration was also directed by a trio of business executives with personal ties to Trump and memberships at his Mar-a-Lago club, according to a 2021 investigation by congressional Democrats that concluded the arrangement “violated the law and sought to exert improper influence over government officials to further their own personal interest.”

Biden’s VA has had comparatively steadier leadership. Denis McDonough, who was Obama’s chief of staff, has served as VA secretary since the beginning of the Biden administration.

There has been some turnover lower down on the organizational chart, including Donald Remy stepping down as deputy secretary last year. His replacement, Tanya Bradsher, the first woman to permanently be the VA No. 2, had a somewhat bumpy Senate confirmation over allegations she did not adequately respond to concerns from whistleblowers and Republican lawmakers that an IT system was exposing veterans’ personal information.

There have been some calls from Republicans for officials involved in the PACT Act bonus scandal to resign, including at least one call for McDonough to step down. But the pressure has so far not reached a groundswell resulting in any resignations, with McDonough saying last month he continues to have faith in his leadership team.

Overall, the highest trust scores for the VA under each administration were nearly tied, according to Wisconsin Watch, a nonpartisan investigative news outlet. They were at 80.2% in 2021 under Trump and 80.4% in 2024 under Biden.