The healthcare needs of our nation’s veterans have long been a top priority, but recent policy shifts at the Department of Veterans Affairs (VA) have raised concerns about the accessibility and quality of care.
Senator James Lankford (R-OK) and Senator Jerry Moran (R-KS), alongside a bipartisan group of his colleagues, have taken a firm stance, urging the VA to swiftly address these concerning developments and uphold the spirit of the MISSION Act – transformative legislation that expanded veterans’ options for community-based care.
“Congress has never failed to provide VA with the resources required to fulfill its mission,” wrote the Senators. “If you believe that VA lacks the funding to provide the level of access to care that veterans deserve in VA and in the community, it is incumbent on you to reprioritize resources from non-patient care areas and reduce waste, fraud, and abuse, not to unilaterally implement purported cost-savings measures that, even as an unintended consequence, decrease veteran choice and endanger veteran lives.”
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In the aftermath of a nationwide access-to-care crisis a decade ago, the enactment of the MISSION Act in 2018 marked a significant milestone. This legislation empowered veterans to seek care from healthcare providers in their local communities, a vital lifeline for many. Over the years, the VA healthcare system has witnessed a surge in enrollment, utilization, and veteran trust, underscoring the importance of this expanded access.
However, recent policy shifts at the VA have threatened to undermine these hard-won gains. In January 2023, the VA’s Under Secretary for Health, Dr. Shereef Elnahal, commissioned a “Red Team” to assess the trends and drivers of increasing community care spending. The VA leadership, including Secretary Denis McDonough, provided the Red Team with select data and briefings, which ultimately framed community care as a “potential existential threat” to the VA’s direct care system, rather than the critical resource it has become for veterans.
Among the Red Team’s concerning recommendations are suggestions that the VA could save money by reducing community care referrals for veterans seeking emergency, oncology, and mental health care – services that cater to some of the most vulnerable and high-risk individuals. This proposal is not only unconscionable but also directly contradicts the intent of the MISSION Act, which was designed to expand access to care for veterans.
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According to Lankford, the senators have received an influx of reports from veterans, their family members, and VA whistleblowers detailing administrative practices that suggest the VA is already implementing the Red Team’s recommendations. These accounts include incidents where the VA has cancelled community care authorizations for veterans mid-treatment, denied access to critical cancer care, and revoked non-narcotic pain relief treatments in favor of opioid prescriptions – a concerning reversal of the VA’s own Opioid Safety Initiative.
Furthermore, VA whistleblowers have disclosed the establishment of burdensome processes that require VA medical center leaders to closely scrutinize community care referrals, seemingly in an effort to recapture care within the VA’s direct care system. This development is particularly troubling given the VA’s recent strategic hiring pause and plans to reduce its staff by 10,000 employees, which could exacerbate wait times for veterans and further strain an already overburdened workforce.
“Many of the veterans who have shared their complaints with our offices are willing to do whatever it takes to continue accessing care in their communities. This includes paying out of pocket, even if they are on limited incomes. The MISSION Act was designed, in part, to avoid this unacceptable outcome. VA must embrace both the spirit and letter of that transformational piece of legislation to ensure this does not continue. Doing anything less is detrimental to the progress VA has made through the MISSION Act and a personal affront to veterans across the country,” wrote the lawmakers.
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Compounding these issues are concerns raised by veterans and VA staff regarding alleged budget shortfalls that are purportedly limiting access to community care. However, the senators have emphasized that Congress has consistently provided the VA with the necessary resources to fulfill its mission, and VA data indicates that community care is more cost-effective than the VA’s direct care system.
The senators have made it clear that the VA must embrace both the spirit and the letter of the MISSION Act, which was designed to empower veterans with the choice and convenience of community-based care. Anything less, they argue, would be detrimental to the progress made through this transformative legislation and a disservice to veterans across the country.
In light of these concerning developments, Lankford and his fellow senators have called on Secretary McDonough to act swiftly to refute the Red Team’s recommendations and issue clear guidance to all VA staff, reaffirming veterans’ right to seek community care. Failure to do so, they warn, will endanger the lives of vulnerable veterans and undermine the hard-won gains achieved through the MISSION Act.
Lankford and Moran were joined on the letter by Senators Chuck Grassley (R-IA), John Cornyn (R-TX), John Thune (R-SD), Jim Risch (R-ID), John Boozman (R-AR), Marco Rubio (R-FL), Ted Cruz (R-TX), Deb Fischer (R-NE), Steve Daines (R-MT), Mike Rounds (R-SD), Thom Tillis (R-NC), Joni Ernst (R-IA), Dan Sullivan (R-AK), Marsha Blackburn (R-TN), Kevin Cramer (R-ND), Rick Scott (R-FL), Tommy Tuberville (R-AL), and Ted Budd (R-NC).
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