Sending Office: Committee on Veterans’ Affairs
Sent By:
Megan.Bland@mail.house.gov

Messaging on S. 2372 (H.R. 5674), the VA MISSION Act

Ranking Member Tim Walz (D-MN) will be voting No on S. 2372 (H.R. 5674), the VA MISSION Act. The Ranking Member encourages all Democratic members to make their own determination.

The VA MISSION Act is a controversial $47 billion legislative package that does four things:

  1. Overhauls VA private sector healthcare programs
  • The bill replaces the flawed Veterans Choice Program with a permanent community care program that consolidates VA’s various community care initiatives into one program, making it easier for veterans to receive care in the private sector at VA’s expense.
  • The Ranking Member has concerns with how this program will be funded and subsequently implemented by the Trump Administration.
    See Additional Talking Points on the VA MISSION Act found below.
  1. Implements a BRAC-style commission for VA
  • The bill will create an Asset and Infrastructure Review (AIR) board who will create and implement a plan to optimize and modernize VA’s medical care facilities. This is designed as waste reduction measure.
  • The BRAC is designed to offset the cost of community care and the new expansion of caregiver benefits.
  • The BRAC puts all 170 VA medical centers and 1,061 outpatient clinics across the nation in the crosshairs and could lead to hundreds of Veterans Affairs medical facilities across the country being shut down.
    • VA medical facilities in rural and underserved communities will be most at risk.
    • Veterans living in these areas could be left with no other option than to seek their care in the private sector.  
  • The BRAC-style commission is designed to offset the cost of community care and the new expansion of caregiver benefits.
  1. Provides 1 year stopgap funding for the strained Veterans Choice Program
  • If funding for the Veterans Choice Program runs out, millions of veterans currently using the program will be left with few or no other healthcare options. 
  • Will ensure community providers continue to be paid for treatments they provide to veterans.
  1. Expands caregiver benefits to pre-9/11 veterans         
  • The passage of the Caregivers and Veterans Omnibus Health Services Act of 2010 served as an important step forward in ensuring the caregivers of our newest generation of veterans received the resources they needed to provide the best possible care for their
    loved ones.
  • However, these benefits and services were not made available to veterans of all generations.
  • Provisions included in this bill will correct this inequity by extending benefits to caregivers of pre-9/11 veterans.

 

Additional Talking Points on the VA MISSION Act:

The bill is supported by virtually every major VSO, is opposed by prominent labor unions

  • 38 Veterans Service Organizations sent the following
    letter
    to HVAC Chairman Phil Roe (R-TN) and Ranking Member Tim Walz (D-MN) in support of the legislation.

    • This is a sign of nearly unanimous support among veterans organizations in the community.
  • A number of labor unions have come out in strict opposition and are urging members to vote No, including:
    • American Federation of Labor and Congress of Industrial Organizations (AFL-CIO)
    • American Federation of Government Employees (AFGE)
    • American Federation of State, County, and Municipal Employees (AFSCME)
    • National Federation of Federal Employees (NFFE)

While the bipartisan bill will help improve access to care for veterans on a timely basis, it is far from perfect

  • The VA MISSION Act consolidates and simplifies VA’s various care in the community programs, making make it easier for veterans to access the care they need.
  • The community care provisions in this bill are the product of months of back and forth negotiations between Democrats and Republicans in the House and Senate, however, there is still room for improvement.

The bill lacks a sustainable source of funding to ensure veterans’ healthcare is provided and protected in the long term

  • This bill moves funding for the current Veterans Choice Program from mandatory spending to discretionary spending. While this is the right thing to do, the bill fails to address how VA will fund all of its programs once the transfer occurs  
  • Current budget caps do not allow for this level of spending without requiring cuts to existing VA programs, including possible changes in eligibility for the caregivers program, and potentially other federal programs, including construction and maintenance
    on VA hospitals and clinics, medical services provided by VA providers, veterans’ homelessness programs, veterans’ treatment courts, VA research, and veterans’ job training and employment assistance programs. 
  • CBO has estimated the VA Mission Act will cost nearly $47 billion over five years, including $22.5 billion over 5 years just for the new community care program.
  • This increased funding responsibility undermines the Bipartisan Budget Act deal that provided $4 billion for VA infrastructure.
  • House Committee on Veterans’ Affairs Ranking Member Tim Walz (D-MN) offered an amendment in Committee that would have solved this problem by holding the non-defense discretionary budget cap harmless for the transfer of the current Veterans Choice Program
    from mandatory to discretionary and future funding for care provided in the community. This would keep the Bipartisan Budget Act deal in place.
  • Without holding the non-defense discretionary budget cap harmless, the long-term health and stability of VA health care provided in VA hospitals and in the community will be jeopardized.
  • It is unfortunate that this critically important and commonsense amendment, which would have helped future-proof the program for years to come, was not agreed to. 

The VA MISSION Act gives the Trump administration unprecedented power to privatize key VA healthcare services and programs

  • The VA MISSION ACT provides President Trump, his enablers in Congress, and wealthy corporate interests the opportunity they’ve been waiting for to sap money away from an already underfunded VA healthcare system and move that money into the private sector.
  • Large corporations and corporate interests, led by the
    Koch brothers
    , have made VA privatization one of their highest priorities, and their operatives have even received

    high-profile leadership positions in the Trump Administration
    .
  • Our government ought to be committed to strengthening and modernizing VA to improve the veteran experience, not dismantling VA healthcare facilities and sending that money into the private sector.
  • It is wrong to be sending billions of dollars into the private sector when VA’s capacity to provide direct patient care is falling behind.

VA lacks the qualified leadership necessary to implement this program successfully and responsibly

  • Passing a $47 billion community care overhaul without a qualified VA Secretary, VA Under Secretary for Health to lead the Veterans Health Administration, or Deputy Under Secretary for Community Care to manage implementation of this new program would be
    an extraordinary disservice to our veterans and to American tax-payers.
  • It would be wrong to grant such unprecedented authority before a qualified VA Secretary and VA Under Secretary for Health are confirmed.
  • Veterans deserve to know how exactly how this program will be implemented before it is passed.

Rather than streamlining eligibility criteria, the VA MISSION Act creates a complex program

  • Maintains the arbitrary 40-mile, 30-day wait time requirement that veterans continue to complain about.
    • Grandfathers 40-milers and allows the Secretary to establish access standards based on wait times. 
  • The bill creates a secondary set of eligibility criteria for underperforming facilities, and focuses on sending veterans into the community for care instead of addressing the causes for underperformance, which could be lack of providers or significant infrastructure
    needs.
  • The multiple pathways to care in the community in this bill do not always attempt to bring veterans back into VA so their care can be coordinated by their VA health care team.

The bill’s BRAC-style approach to re-aligning VA medical facilities needs more work

  • Providing the VA Secretary with the authority and support he needs to assess and ultimately realign VA’s physical infrastructure should be a top priority of Congress, however, doing so should never interfere with a veteran having access to and receiving
    the highest quality VA-services possible.
  • No one disagrees that VA needs to modernize its own infrastructure and build community partners where it makes the most sense for the veterans and for tax payers.
  • Under this bill, there are not enough checks and balances on those who have an ideological and wrong-footed agenda to privatize the VA.
  • The BRAC puts all 170 VA medical centers and 1,061 outpatient clinics across the nation in the crosshairs and could lead to hundreds of Veterans Affairs medical facilities across the country being shut down.
  • VA medical facilities in rural and underserved communities will be most at risk.
  • Veterans living in these areas could be left with no other option than to seek their care in the private sector.

 

Related Legislative Issues

Selected legislative information: Armed Services, HealthCare, Veterans

Related Bill Information

Bill Type: H.R.
Bill Number: 5674
Special Note: House Bill: HR 5674 Senate Vehicle: S. 2372

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