In the Trump administration’s quest to Make Discrimination Legal Again, the Department of Veterans Affairs last month removed language from its hospitals’ guidelines and bylaws that prohibited doctors and other medical providers from discriminating against patients based on political beliefs or marital status. Protections against discrimination or retaliation against medical staff based on their marital status, political party affiliation or union activity were also removed from the guidelines.

The VA is the nation’s largest integrated health care system, with 170 hospitals and more than 1,000 clinics. It serves about 9 million veterans every year. According to the VA’s own numbers, over 105,000 of those veterans are in Maine. About 7.5% of our state’s population qualifies as veterans.

Speaking to The Guardian, which broke the story, VA representatives insisted that nobody has been or will be discriminated against. The quote was “Under no circumstances whatsoever would VA ever allow any employee to refuse to provide appropriate care to any eligible veteran.” If that’s the case, and nobody was going to do any discriminating, why remove the guidelines? What’s the point?

There’s a quote often misattributed to political scientist Francis Milhoit, but it was actually said by a different guy named Frank Milhoit, leaving a comment on a blog post in 2018. I keep coming back to this quote, as it is proven more and more accurate every day these days. It is: “Conservatism consists of exactly one proposition, to wit: There must be in-groups whom the law protects but does not bind, alongside out-groups whom the law binds but does not protect.”

Of course, the in-group and out-groups are rarely explicitly codified in law. It’s all based on the behaviors of people in charge. Since President Trump took office, the VA has also eliminated the office in the Veterans Administration in charge of researching disparity in benefits between veterans of different races. Reports from the VA itself have found that, among other terrible facts, Black and Native American veterans received significantly lower quality health care than non-Hispanic white veterans.

Reports from the Government Accountability Office have found that white veterans’ disability claims get approved at much higher rates than those of Black veterans. But according to the VA press secretary, the VA “treats all veterans and beneficiaries fairly and equally, so [that office] is no longer needed.” And of course as we all know, saying everyone is treated fairly and equally means everything is hunky dory. No need to look into those claim rates any further.

You can see who’s in the out-groups and in-group based on action.

A few months ago, the VA banned the display of all flags except the American flag, state flags, military service flags, U.S. agency flags and the POW/MIA flag. On the surface, this seems like a generic, universal policy. But the order from Veterans Affairs Secretary Doug Collins specifically removed past VA directives allowing the display of the LGBTQ Pride flag during Pride Month.

Collins said the VA will have “a singular focus: serving the needs of veterans, their families, caregivers and survivors.” This implies that LGBTQ people aren’t veterans, their families, their caregivers, or survivors, and that their needs do not matter. Technically, these new hospital bylaws could allow a Democratic doctor to refuse to treat a Trump supporter, or a nurse practitioner who doesn’t believe in marriage could refuse to treat a married woman.

Let’s be real, that’s never going to happen. One, liberals and progressives are not nearly as vicious and cruel as conservatives, and have much more of a live-and-let-live attitude. (When was the last time a gay baker sued the Supreme Court to be allowed to refuse service to straight people?) And two, because that’s simply not how this government functions. This government does not treat Americans equally, not even ones who signed up to sacrifice their health and life for this country.

If a liberal doctor refused to treat a conservative veteran, that doctor would be on a plane to El Salvador faster than you can say “Hippocratic oath.” Of course, I’d like to believe that no medical professional would ever discriminate or refuse to treat a patient. But those bylaws against discrimination were placed there for a reason. Anything that makes it more difficult to access health care is going to affect people in rural areas more than urban areas, simply because there are fewer alternative doctors in rural areas.

Additionally, a lot of veterans only get services through the VA and don’t have any other options they can afford (even assuming there are options in driving distance). If all of a sudden your doctor won’t prescribe you birth control because you aren’t married (what is this, 1960?) or stops returning your calls because he saw you canvassing for a political opponent, what will vets do?

Health care in general is getting more and more difficult to afford, and the VA has been underfunded for years. Private interests circle it like sharks, waiting to smell blood in the water. Anything that causes a drop in patients and services is likely to be pointed to as proof that the Veterans Administration should be turned into yet another for-profit hospital chain.

Editor’s note: The Guardian updated its original reporting on the hospital guidelines to reflect the response of the Department of Veterans Affairs, which cited both federal law and a “2013 policy directive that it says will continue to protect patients from discrimination despite the redactions.”