Veterans Affairs, a Trump Signature Issue, Is Facing Turmoil Again

“The general sense is outrage,” said Kristen L. Rouse, the founder of the NYC Veterans Alliance, who like many female veterans has received an outpouring of emails and calls from other female veterans who said they had experiences similar to Ms. Goldstein’s.

Christina Mandreucci, a spokeswoman for the department, said that “Secretary Wilkie acknowledges that describing the allegations as ‘unsubstantiated’ was a poor choice of words, and he withdraws that word.”

At the same time, the department is focused on the rollout of a broad expansion of health care from private physicians, many of whom are reluctant to do business with the agency because of its history of slow payments. Health care provider networks are scrambling to build capacity without really knowing how many patients they will need to serve in the 36 states where the program will begin in May.

“I’ve heard from a number of South Dakota providers, who contract with the V.A. to deliver health care services to veterans, who are owed millions of dollars in overdue claims,” Senator Mike Rounds, Republican of South Dakota, said at a recent hearing. “Because of this, they are now in the terrible position of possibly having to turn away veterans seeking care.”

A week ago, the deputy veterans affairs secretary, James Byrne, was asked to remain behind after a morning meeting. Mr. Wilkie then told Mr. Byrne that he had “lost confidence” in his No. 2 and that he needed to resign.

“For two and a half years I had the privilege of working with dedicated professionals at the V.A. providing care benefits and services to deserving veterans,” Mr. Byrne said.

No further explanation has been publicly offered by department officials for his dismissal.

“The second-highest person in the second-biggest agency in the federal government got fired, and no one knows why,” said Kristofer Goldsmith, the chief investigator for Vietnam Veterans of America. “It is mind-blowing.”