Yes, those changes, (for instance if you live more than 40 miles from a VA Health Center) you are supposed to be able to see a local doc and have the VA pay for it. It is far more complicated than that however. My husband is 100% disabled from combat-related injuries, and the VA is supposed to pay 100% of medical and dental bills. The coverage for others is not as comprehensive, but even for him the VA would not approve most requests.
He ultimately decided to get supplemental insurance from USAA (available to any veteran) and now we go to UVA for most things instead of a round-trip of 140 miles to Richmond. He is getting much better care, and has avoided 2 unneeded surgeries. Two VA diagnoses have also been proven to be incorrect.
Also, where would the money come to pay for local doctor visits when the VA is already underfunded? Trump is not going to accomplish this – the money isn’t there. As more wounded return from these republican-started wars, more resources will be needed to rehabilitate them. That is something the VA does very well, and equipment is never a problem.