Veteran Caregiver Reeducation, Reemployment, and Retirement Act

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Bill ID: 119/hr/2148
Last Updated: March 24, 2026

Sponsored by

Rep. Morelle, Joseph D. [D-NY-25]

ID: M001206

Follow the money

The bill

Veteran Caregiver Reeducation, Reemployment, and Retirement Act

HR. 2148, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Rep. Morelle, Joseph D. [D-NY-25]

Every bill has someone who introduced it. That name is where the paper trail starts.

The money

$67,500 raised

22 itemised contributions to this sponsor, pulled from FEC filings.

The alignment

70% match to Project 2025

This bill's text tracks the "Department of Health and Human Services" section, p. 515-517 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Ordered to be Reported in the Nature of a Substitute (Amended) by Voice Vote.

February 11, 2026

Introduced

📍 Current Status

Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.

🏛️

Committee Review

🗳️

Floor Action

✅

Passed House

🏛️

Senate Review

🎉

Passed Congress

🖊️

Presidential Action

⚖️

Became Law

📚 How does a bill become a law?

1. Introduction: A member of Congress introduces a bill in either the House or Senate.

2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.

3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.

4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.

5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.

6. Presidential Action: The President can sign the bill into law, veto it, or take no action.

7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!

Bill Summary

Another exercise in legislative theater, courtesy of the 119th Congress. Let's dissect this farce, shall we?

**Main Purpose & Objectives:** The Veteran Caregiver Reeducation, Reemployment, and Retirement Act (HR 2148) claims to expand medical, employment, and other benefits for family caregivers of certain veterans. How noble. The real purpose? To create a feel-good narrative while throwing breadcrumbs at the problem.

**Key Provisions & Changes to Existing Law:**

1. Extension of medical care coverage for primary caregivers during a 180-day period after removal from the program. 2. Employment assistance, including reimbursement for certifications and training modules. 3. Expansion of available services, such as retirement planning and bereavement counseling. 4. Studies on returnship programs and incorporating former caregivers into the Department of Veterans Affairs workforce.

**Affected Parties & Stakeholders:**

* Family caregivers of veterans * The Department of Veterans Affairs * The Department of Labor * The Department of Defense

**Potential Impact & Implications:** This bill is a Band-Aid on a bullet wound. It attempts to address the symptoms rather than the root causes of caregiver burnout and inadequate support. By providing limited benefits and studies, Congress can claim they're doing something without actually solving the problem.

The real disease here is bureaucratic inefficiency and lack of resources. This bill doesn't address the systemic issues plaguing the VA or provide meaningful support for caregivers. It's a PR stunt designed to appease voters while maintaining the status quo.

In medical terms, this bill is akin to prescribing a placebo to a patient with a chronic condition. It might make them feel better temporarily, but it won't cure the underlying disease. The politicians behind this bill are either incompetent or deliberately misleading the public. Either way, they're not worth our trust.

Diagnosis: Legislative Theater-itis – a chronic condition characterized by empty promises, half-measures, and a complete disregard for the well-being of those affected. Treatment? A healthy dose of skepticism and a strong stomach to handle the inevitable disappointment.

Related Topics

Military & Veterans Affairs
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

Rep. Morelle, Joseph D. [D-NY-25]

Congress 119 • 2024 Election Cycle

Total Contributions
$67,500
21 donors
PACs
$0
Organizations
$1,500
Committees
$0
Individuals
$66,000

No PAC contributions found

1
CHEROKEE NATION
1 transaction
$1,000
2
GILA RIVER INDIAN COMMUNITY
1 transaction
$500

No committee contributions found

1
SHAMAH, ALAN
2 transactions
$6,600
2
NORTY, LEWIS
1 transaction
$3,300
3
SECUNDA, AMY
1 transaction
$3,300
4
SECUNDA, CYNTHIA
1 transaction
$3,300
5
SECUNDA, MICHELLE
1 transaction
$3,300
6
SECUNDA, THOMAS
1 transaction
$3,300
7
OSTROFF, DIANA
1 transaction
$3,300
8
OSTROFF, RICHARD
1 transaction
$3,300
9
PERLMAN, LEE
1 transaction
$3,300
10
RASKE, JANET
1 transaction
$3,300
11
SANDS, ROB
1 transaction
$3,300
12
SMITH, MICHAEL
1 transaction
$3,300
13
COOPER, MILTON
1 transaction
$3,300
14
COOPER, TODD
1 transaction
$3,300
15
FEINSTEIN, LEONARD
1 transaction
$3,300
16
KHUZAMI, ROB
1 transaction
$3,300
17
STERLING, DAVID
1 transaction
$3,300
18
STERLING, MONA
1 transaction
$3,300
19
SHAMAH, JOSEPH
1 transaction
$3,300

Cosponsors & Their Campaign Finance

This bill has 8 cosponsors. Below are their top campaign contributors.

Rep. Ciscomani, Juan [R-AZ-6]

ID: C001133

Top Contributors

10

1
SALT RIVER PIMA MARICOPA INDIAN COMMUNITY
PACSCOTTSDALE, AZ
$1,000
Jun 14, 2024
2
CHEROKEE NATION
OrganizationTAHLEQUAH, OK
$3,300
Oct 31, 2024
3
EASTERN BAND OF CHEROKEE INDIANS
OrganizationCHEROKEE, NC
$3,300
Nov 5, 2024
4
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Jun 30, 2024
5
DELTA AIRLINES
OrganizationATLANTA, GA
$2,500
Jul 30, 2024
6
THE CHICKASAW NATION
OrganizationADA, OK
$2,000
Oct 8, 2024
7
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$1,834
Jun 30, 2024
8
MS BAND OF CHOCTAW INDIANS
OrganizationCHOCTAW, MS
$1,000
Nov 5, 2024
9
COLORADO RIVER INDIAN TRIBES
OrganizationPARKER, AZ
$1,000
Jun 30, 2023
10
THE CHICKASAW NATION
OrganizationADA, OK
$1,000
Jun 30, 2023

Rep. Pappas, Chris [D-NH-1]

ID: P000614

Top Contributors

10

1
OTOE MISSOURIA TRIBE OF OKLAHOMA
OrganizationRED ROCK, OK
$3,300
Nov 4, 2024
2
THE CHICKSAW NATION
OrganizationADA, OK
$2,300
Oct 7, 2024
3
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,650
Jun 5, 2023
4
BARONA BAND OF MISSION INDIANS
OrganizationLAKESIDE, CA
$1,500
May 19, 2023
5
THE CHICKSAW NATION
OrganizationADA, OK
$1,000
Jun 14, 2024
6
DUDA, JENNIFER
NOT EMPLOYED • NOT EMPLOYED
IndividualMENLO PARK, CA
$3,300
Oct 23, 2024
7
JURVETSON, KARLA
SELF EMPLOYED • PHYSICIAN
IndividualLOS ALTOS, CA
$3,300
Oct 17, 2024
8
SCHUSTER, MARK
WINGATE COMPANIES • CHAIRMAN
IndividualNEWTON CENTRE, MA
$3,300
Oct 22, 2024
9
STOVER, MATTHEW
NOT EMPLOYED • NOT EMPLOYED
IndividualCHESTER, NH
$3,300
Oct 26, 2024
10
WALSH, MARK
AMALGAMATED BANK • BANKER
IndividualBOSTON, MA
$3,300
Oct 23, 2024

Rep. Cherfilus-McCormick, Sheila [D-FL-20]

ID: C001127

Top Contributors

10

1
AMERICAN ISRAEL PUBLIC AFFAIRS COMMITTEE POLITICAL ACTION COMMITTEE
PACWASHINGTON, DC
$500
Nov 4, 2024
2
SEMINOLE TRIBE OF FLORIDA
OrganizationHOLLYWOOD, FL
$3,300
Aug 20, 2024
3
SEMINOLE TRIBE OF FLORIDA
OrganizationHOLLYWOOD, FL
$3,300
Sep 8, 2023
4
FIGGERS, FREDDIE
FIGGERS • INVENTOR
IndividualFORT LAUDERDALE, FL
$6,600
Jun 8, 2023
5
FIGGERS, FREDDIE
IndividualFORT LAUDERDALE, FL
$6,600
Sep 25, 2023
6
MOISE, RUDOLPH
IndividualDAVIE, FL
$3,300
Oct 7, 2024
7
GEORGE, DAVID J.
REFUEL DEPOT LLC • SALES
IndividualLEADWOOD, KS
$3,300
Sep 27, 2024
8
GOLDEN, SYLVIA
NONE • RETIRED
IndividualWEST PALM BEACH, FL
$3,300
Aug 18, 2024
9
GORI, PHILIP
SELF • INVESTOR
IndividualBOCA RATON, FL
$3,300
Sep 16, 2024
10
MUELLER, KYLE
ZUTEK • DIRECTOR OF TECHNICAL SUPPORT SERVICES
IndividualOLATHE, KS
$3,300
Sep 27, 2024

Rep. McGarvey, Morgan [D-KY-3]

ID: M001220

Top Contributors

10

1
EASTERN BAND OF CHEROKEE INDIANS
OrganizationCHEROKEE, NC
$3,300
Oct 26, 2024
2
LA CASITA CENTER
OrganizationLOUISVILLE, KY
$154
Oct 16, 2023
3
CALOBRACE, BRADLEY
SELF • PHYSICIAN
IndividualLOUISVILLE, KY
$6,600
Oct 18, 2024
4
BROWN, CAMPBELL
BROWN-FORMAN • PRESIDENT OLD FORESTER
IndividualLOUISVILLE, KY
$3,300
Oct 30, 2024
5
MEHROTRA, LOPA
NOT EMPLOYED • NOT EMPLOYED
IndividualGLENVIEW, KY
$3,300
Nov 5, 2024
6
MEHROTRA, RISHABH
AVIONTE • CEO
IndividualGLENVIEW, KY
$3,300
Nov 5, 2024
7
HELM, NELSON
RETIRED • RETIRED
IndividualLOUISVILLE, KY
$3,300
Dec 29, 2023
8
ROTH, EVAN
BBR PARTNERS • CO-CEO
IndividualNEW YORK, NY
$3,300
Oct 18, 2023
9
CHRISTENSEN, JOSH
NORTON HEALTHCARE • PHYSICIAN
IndividualLOUISVILLE, KY
$3,300
Dec 3, 2023
10
SISCOVICK, TALIA
NOT EMPLOYED • NOT EMPLOYED
IndividualSTAMFORD, CT
$3,300
Oct 31, 2023

Rep. Carson, André [D-IN-7]

ID: C001072

Top Contributors

10

1
BARONA BAND OF MISSION INDIANS
OrganizationLAKESIDE, CA
$1,500
May 22, 2023
2
INDIANA IMPORT LLC
OrganizationFISHERS, IN
$1,000
Nov 11, 2023
3
MNAYMEH, HALA
RETIRED • RETIRED
IndividualCORAL GABLES, FL
$3,300
Oct 21, 2024
4
DE LA CRUZ, FABIO
WESTON PROPERTY MANAGEMENT • PARTNER
IndividualINDIANAPOLIS, IN
$3,300
Nov 5, 2024
5
KHAN, AZHER M
CALDERON TEXTILES • PRESIDENT
IndividualCARMEL, IN
$3,300
Dec 8, 2023
6
HOGAN, ALAN P.
THE HOGAN GROUP, INC. • CONSULTANT
IndividualINDIANAPOLIS, IN
$3,300
Feb 22, 2023
7
JOHNSON, LACY M.
ICE MILLER • ATTORNEY
IndividualINDIANAPOLIS, IN
$3,300
Mar 16, 2023
8
STACK, ANN M.
RETIRED • RETIRED
IndividualINDIANAPOLIS, IN
$3,300
Feb 22, 2023
9
ABDALLA, MIKE A.
MAGNA PROPERTIES • PRESIDENT
IndividualINDIANAPOLIS, IN
$3,300
Mar 11, 2024
10
MAMOUN, IHSAN
SDI RADIOLOGY • PHYSICIAN
IndividualSEFFNER, FL
$3,300
Jan 23, 2024

Rep. Malliotakis, Nicole [R-NY-11]

ID: M000317

Top Contributors

10

1
M&T BANK
OrganizationMOUNT KISCO, NY
$118
Sep 21, 2024
2
M&T BANK
OrganizationMOUNT KISCO, NY
$101
Sep 21, 2024
3
SIDIROPOULOS, JIM MR.
DELPHI PH • CONTRACTOR
IndividualSTATEN ISLAND, NY
$5,600
Jul 23, 2024
4
BERGER, RICHARD MR.
RETIRED • RETIRED
IndividualHOBOKEN, NJ
$5,000
May 17, 2024
5
LOEB, JOHN L. MR. JR
RETIRED • RETIRED
IndividualPURCHASE, NY
$5,000
Apr 22, 2024
6
BAUMRIND, MARTIN M. MR.
SELF • LANDLORD
IndividualBROOKLYN, NY
$5,000
Sep 16, 2024
7
DUIT, JAMES A
CONTRIBUTION OF CONCEPTION LLC • EXEC
IndividualEDMOND, OK
$3,300
Nov 5, 2024
8
DUIT, PAMELA A
CONTRIBUTION OF CONCEPTION LLC • EXEC
IndividualEDMOND, OK
$3,300
Nov 5, 2024
9
LAUDER, RONALD S.
SELF EMPLOYED • BUSINESSMAN
IndividualNEW YORK, NY
$3,300
Oct 28, 2024
10
BANKE, BARBARA R. MS.
CHAIRMAN • JACKSON FAMILY WINES
IndividualGEYSERVILLE, CA
$3,300
Nov 17, 2023

Rep. Cohen, Steve [D-TN-9]

ID: C001068

Top Contributors

10

1
SEIU COPE (SERVICE EMPLOYEES INTERNATIONAL UNION COMMITTEE ON POLITICAL EDUCATION)
PACWASHINGTON, DC
$3,000
Nov 5, 2024
2
SEIU COPE (SERVICE EMPLOYEES INTERNATIONAL UNION COMMITTEE ON POLITICAL EDUCATION)
PACWASHINGTON, DC
$2,000
Nov 5, 2024
3
KEENEY, MIKE
LEWIS THOMASON • LEWIS THOMASON
IndividualMEMPHIS, TN
$3,300
Feb 6, 2024
4
RITCHEY, JANICE C
IndividualMEMPHIS, TN
$3,300
Jun 30, 2024
5
RITCHEY, KENT
WOLFCHASE TOYOTA • AUTOMOBILE DEALER
IndividualMEMPHIS, TN
$3,300
Jun 30, 2024
6
WALTON, CHRISTY
IndividualBENTONVILLE, AR
$3,300
Jun 30, 2024
7
KEENEY, MICHAEL
LEWIS THOMASON • ATTORNEY
IndividualMEMPHIS, TN
$3,300
May 25, 2023
8
SEGAL, GORDON
RETIRED • RETIRED
IndividualMEMPHIS, TN
$3,300
Apr 10, 2023
9
SMITH, FREDERICK
FEDEX • CEO
IndividualMEMPHIS, TN
$3,300
Jul 31, 2024
10
BEKTAS, MELIH
SELF EMPLOYED • ENGINEER
IndividualNORTH PROVIDENCE, RI
$3,000
Oct 19, 2023

Rep. Horsford, Steven [D-NV-4]

ID: H001066

Top Contributors

10

1
TUNICA- BILOXI TRIBE OF LA
OrganizationMARKSVILLE, LA
$5,000
Jun 9, 2024
2
TUNICA- BILOXI TRIBE OF LA
OrganizationMARKSVILLE, LA
$4,600
Jun 10, 2024
3
OTOE MISSOURIA TRIBE OF OKLAHOMA
OrganizationRED ROCK, OK
$3,300
Nov 1, 2024
4
HABEMATOLEL POMO OF UPPER LAKE TRIBE OF CALIFORNIA
OrganizationUPPER LAKE, CA
$3,300
Dec 27, 2023
5
OTOE MISSOURIA TRIBE OF OKLAHOMA
OrganizationRED ROCK, OK
$3,300
Oct 31, 2023
6
OTOE MISSOURIA TRIBE OF OKLAHOMA
OrganizationRED ROCK, OK
$3,300
Dec 27, 2023
7
TURTLE MOUNTAIN BAND OF CHIPPEWA OF NORTH DAKOTA
OrganizationBELCOURT, ND
$3,300
Oct 31, 2023
8
SAN MANUEL BAND OF MISSION INDIANS
OrganizationLOS ANGELES, CA
$3,300
Jan 5, 2024
9
AGUA CALIENTE BAND OF CAHUILLA INDIANS
OrganizationPALM SPRINGS, CA
$3,300
Apr 21, 2023
10
GBS 2, LLC
OrganizationELGIN, IL
$3,300
May 23, 2023

Donor Network - Rep. Morelle, Joseph D. [D-NY-25]

PACs
Organizations
Individuals
Politicians

Hub layout: Politicians in center, donors arranged by type in rings around them.

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Showing 68 nodes and 37 connections (58 secondary connections hidden)

Total contributions: $105,304

Top Donors - Rep. Morelle, Joseph D. [D-NY-25]

Showing top 21 donors by contribution amount

2 Orgs19 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 4 helped.

  • Section 2(a) extends medical care coverage for caregivers designated as primary providers of personal care services for veterans, including during the 180-day period following removal of designation, which would increase utilization of medical services provided by hospitals and health systems.

  • Section 2(a) extends medical care coverage for caregivers designated as primary providers of personal care services for veterans, including during the 180-day period following removal of designation, which would increase utilization of long-term care services for veterans requiring personal care.

  • Section 3(a)(1)(A) provides reimbursement of fees associated with certifications or relicensure necessary for employment, up to $1,000 lifetime maximum, which would benefit for-profit education providers offering such certifications or relicensure programs.

  • +Labor Unionsconfidence 0.75

    Section 3 expands employment assistance and workforce transition services for caregivers, which could increase demand for union-represented jobs in healthcare, social services, and related sectors where caregivers may seek employment after caregiving ends.

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.

Department of Health and Human Services

Moderate
Vector: 65%
Pages: 515-517AI Enhanced

AI Analysis:

"The bill supports family caregivers of veterans, which aligns with Project 2025's goal of readdressing the National Strategy to Support Family Caregivers, though it focuses on veterans rather than the broader elderly population and does not address the critique of equity-focused policies or telehealth licensure reforms."

Key themes:family caregiver supportcaregiver reemploymentbereavement supportveteran caregiver benefitshealthcare workforce transition

— 483 — Department of Health and Human Services l Readdress the National Strategy to Support Family Caregivers. While in theory the strategy aims to support family members with duties to care for older family members, the plan is overly focused on racial and “LGBTQ+ equity.” The strategy should be examined to establish an efficient plan to support caregivers and their families. There should also be a review of its COVID-19 policies. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) l Congress should allow CMS to use the 340B data that HRSA collects rather than having CMS conduct its own survey, especially in view of the U.S. Supreme Court’s American Hospital Association v. Becerra decision.69 The legislation should also create penalties for those who do not respond to HRSA’s data collection. l Legally define the locus of service as where the provider is located during the telehealth visit rather than where the patient is. With such a definition, states could continue to reserve their powers to establish the standards for licensure and scope of practice. The providers could ensure continuity and consistency of care no matter where their patients might move while maintaining the licenses that make the most sense for them. Americans are far more mobile and technologically advanced today than they were when most health care laws were written. Telehealth has become increasingly important, particularly during the height of the COVID-19 pandemic. It also has great potential in rural and other areas where there are shortages of health care providers. HRSA’s Office for the Advancement of Telehealth includes a program known as the Licensure Portability Grant Program, which bolsters state efforts to reform licensing laws to maximize telehealth flexibility. HRSA does not have the authority through this office to dictate licensure laws; that power has typically been reserved to the states. However, telehealth across state lines, when permitted, is interstate commerce, which can be regulated by the federal government according to the Constitution. l Restore Trump religious and moral exemptions to the contraceptive mandate (also a CMS rule). HHS should rescind, if finalized, the regulation titled “Coverage of Certain Preventive Services Under the Affordable Care Act,” proposed jointly by HHS, Treasury, and Labor.70 This rule proposes to amend Trump-era final rules regarding religious and moral exemptions and accommodations for coverage of certain preventive services under the ACA. Preventive services include contraception, and — 484 — Mandate for Leadership: The Conservative Promise it appears the proposed rule would change the existing regulations for religious and moral exemptions to the ACA’s contraception mandate. There is no need for further rulemaking that curtails existing exemptions and accommodations. l Require HRSA to use rulemaking to update the women’s preventive services mandate. The contraceptive mandate issued under Obamacare has been the source of years of egregious attacks on many Americans’ religious and moral beliefs. The mandate was issued as part of the women’s preventive services guidelines, which were issued without any rulemaking that involved public notice and an opportunity to comment. Instead, HRSA issued and changed the mandate by simply posting changes to its website. HRSA also started off not requiring coverage of fertility awareness–based methods of family planning, then requiring them, and then removing the requirement without notifying the public. A federal judge recently ruled that this failure to undergo notice and comment in issuing the mandate is unlawful. HRSA should be required to repromulgate any women’s preventive services mandates through the notice and comment process that is compliant with the Administrative Procedures Act. Moreover, since the Obama Administration HRSA entered into long- term contracts with the pro-abortion American College of Obstetricians and Gynecologists (ACOG) and related entities to serve as an exclusive adviser with respect to the content of this mandate, HRSA has used this arrangement to ignore comments that members of the public were sometimes able to submit in the process, and ACOG has abused its position to attack HHS’s allowance of religious and moral exemptions to the contraceptive mandate. HHS should rescind these contracts and establish an advisory committee that is compliant with the Federal Advisory Committee Act and has members that are committed to women’s preventive services and are not pro-abortion ideologues. l Expand inclusion of fertility awareness–based methods and supplies to family planning in the women’s preventive services mandate. The ACA requires coverage of and prevents insurance plans from imposing any cost-sharing requirements on women who obtain preventive care and screenings as defined by HRSA. In 2016, HHS included “instruction in fertility awareness-based methods” as part of this requirement. However, in December 2021, HHS removed that language from its list without using the notice-and-comment process or giving any rationale, both of which are mandated by the Administrative Procedures Act. In August

Department of Veterans Affairs

Moderate
Vector: 65%
Pages: 679-681AI Enhanced

AI Analysis:

"The bill aligns with Project 2025's focus on improving the VA Family Caregiver Program by enhancing support services, though it emphasizes caregiver reemployment and bereavement support rather than eligibility consistency or indefinite care for the severely wounded as specified in Section 161."

Key themes:Family Caregiver Programveteran support servicesVA healthcare improvementscaregiver assistanceemployment transition

— 646 — Mandate for Leadership: The Conservative Promise 3. Section 121 (developing and administering an education program that teaches veterans about their health care options available from the Department of Veterans Affairs). 4. Section 152 (returning the Office for Innovation of Care and Payment to the Office of Enterprise Integration with a joint governance process set up with the VHA). 5. Section 161 (overhauling Family Caregiver Program expansion, which has gone poorly, so that it focuses on consistency of eligibility and awareness that the most severely wounded or injured may require the program indefinitely). l Require the VHA to report publicly on all aspects of its operation, including quality, safety, patient experience, timeliness, and cost-effectiveness, using standards similar to those in the Medicare Accountable Care Organization program so that the government may monitor and achieve continuous improvement in the VA system more effectively. l Encourage VA Medical Centers to seek out relevant academic and private- sector input in their communities to improve the overall patient experience. Budget l Conduct an independent audit of the VA similar to the 2018 Department of Defense (DOD) audit to identify IT, management, financial, contracting, and other deficiencies. l Assess the misalignment of VHA facilities and rising infrastructure costs. The VHA operates 172 inpatient medical facilities nationally that are an average of 60 years old. Some of these facilities are underutilized and inadequately staffed. Facilities in certain urban and rural areas are seeing significant declines in the veteran population and strong competition for fresh medical staff. In 2018, Congress authorized an Asset Infrastructure Review (AIR) of national VHA medical markets to provide insight into where the VA health care budget should be responsibly allocated to serve veterans most effectively. However, the Senate Veterans Affairs Committee lacked the political will to act on the White House’s nominations of commission members, and this ultimately led to termination of the AIR process. The next Administration should seek out agile, creative, and politically acceptable operational solutions to this aging infrastructure status quo, — 647 — Department of Veterans Affairs reimagine the health care footprint in some locales, and spur a realignment of capacity through budgetary allocations. Specifically: 1. Embrace the expansion of Community Based Outpatient Clinics (CBOCs) as an avenue to maintain a VA footprint in challenging medical markets without investing further in obsolete and unaffordable VA health care campuses. 2. Explore the potential to pilot facility-sharing partnerships between the VA and strained local health care systems to reduce costs by leveraging limited talent and resources. Personnel l Extend the term of the Under Secretary for Health (USH) to five years. Additionally, authority should be given to reappoint this individual for a second five-year term both to allow for continuity and to protect the USH from political transition. l Establish a Senior Executive Service (SES) position of VHA Care System Chief Information Officer (CIO), selected by and reporting to the chief of the VHA Care System with a dotted line to the VA CIO. l Identify a workflow process to bring wait times in compliance with VA MISSION Act–required time frames wherever possible. 1. Assess the daily clinical appointment load for physicians and clinical staff in medical facilities where wait times for care are well outside of the time frames required by the VA MISSION Act. 2. Require VHA facilities to increase the number of patients seen each day to equal the number seen by DOD medical facilities: approximately 19 patients per provider per day. Currently, VA facilities may be seeing as few as six patients per provider per day. 3. Consider a pilot program to extend weekday appointment hours and offer Saturday appointment options to veterans if a facility continues to demonstrate that it has excess capacity and is experiencing delays in the delivery of care for veterans. 4. Identify clinical services that are consistently in high demand but require cost-prohibitive compensation to recruit and retain talent, and examine exceptions for higher competitive pay.

Department of Health and Human Services

Weak
Vector: 65%
Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on supporting veteran caregivers through medical, employment, and bereavement services, while the Project 2025 HHS section emphasizes healthcare nondiscrimination, reproductive rights, conscience protections, and related civil rights policies. There is minimal thematic overlap, as the bill does not address abortion, gender-affirming care, disability discrimination in healthcare access, or other core HHS priorities outlined in the Project 2025 excerpts."

Key themes:Department of Health and Human Serviceshealthcare accesssupport services

— 501 — Department of Health and Human Services 54. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Office of Civil Rights, and Office of the Secretary, “Special Responsibilities of Medicare Hospitals in Emergency Cases and Discrimination on the Basis of Disability in Critical Health and Human Service Programs or Activities,” draft of Proposed Rule, January 14, 2021, https://www.hhs.gov/sites/default/files/infants-nprm.pdf (accessed March 17, 2023). 55. H.R. 26, Born-Alive Abortion Survivors Protection Act, 118th Congress, introduced January 9, 2023, https:// www.congress.gov/118/bills/hr26/BILLS-118hr26pcs.pdf (accessed March 17, 2023). 56. H.R. 7, No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2023, 118th Congress, introduced January 9, 2023, https://www.congress.gov/118/bills/hr7/BILLS-118hr7ih.pdf (accessed March 17, 2023). 57. S. 401, Conscience Protection Act of 2021, 117th Congress, introduced February 24, 2021, https://www.congress. gov/117/bills/s401/BILLS-117s401is.pdf (accessed March 17, 2023). 58. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, and Office of the Secretary, “Nondiscrimination in Health Programs and Activities,” Notice of Proposed Rulemaking; Notice of Tribal Consultation, Federal Register, Vol. 87, No. 149 (August 4, 2022), pp. 47824–47920, https://www.govinfo. gov/content/pkg/FR-2022-08-04/pdf/2022-16217.pdf (accessed March 17, 2023). 59. Ibid., p. 47916. 60. The regulation was not finalized before the end of the Administration. U.S. Department of Agriculture, Food and Nutrition Services, “Revision of Categorical Eligibility in the Supplemental Nutrition Assistance Program (SNAP),” Proposed Rule, Federal Register, Vol. 84, No. 142 (July 24, 2019), pp. 35570–55581, https:// www.federalregister.gov/documents/2019/07/24/2019-15670/revision-of-categorical-eligibility-in-the- supplemental-nutrition-assistance-program-snap (accessed March 17, 2023). 61. 45 Code of Federal Regulations § 75.300(c) and (d), https://www.ecfr.gov/current/title-45/subtitle-A/ subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.300 (accessed March 17, 2023). 62. H.R. 1750, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https:// www.congress.gov/117/bills/hr1750/BILLS-117hr1750ih.pdf (accessed March 17, 2023), and S. 656, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https://www.congress.gov/117/bills/ s656/BILLS-117s656is.pdf (accessed March 17, 2023). 63. S. 3949, Trafficking Victims Protection Reauthorization Act of 2022, Public Law No. 117-348, 117th Congress, January 25, 2023, https://www.congress.gov/117/plaws/publ348/PLAW-117publ348.pdf (accessed March 17, 2023). 64. Kelsey Y. Santamaria, “Child Migrants at the Border: The Flores Settlement Agreement and Other Legal Developments,” Congressional Research Service In Focus No. IF11799, April 1, 2021, https://crsreports.congress. gov/product/pdf/IF/IF11799 (accessed March 17, 2023). 65. Report, Building a Happy Home: Marriage Education as a Tool to Strengthen Families, Social Capital Project Report No. 1-22, March 2022, p. 17, https://www.jec.senate.gov/public/_cache/files/3d102525-6f0d-48ed- 92f4-d71edd468ad6/building-a-happy-home.pdf (accessed March 17, 2023). The cover of the report reflects that the Social Capital Project is “[a] project of the Joint Economic Committee – Republicans.” 66. See, for example, Alan J. Hawkins, “Are Federally Supported Relationship Education Programs for Lower-Income Individuals and Couples Working? A Review of Evaluation Research,” American Enterprise Institute, September 2019, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 67. H.R. 8404, Respect for Marriage Act, Public Law No. 117-228, 117th Congress, December 13, 2022, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 68. Madison Marino, “Over 1,000 Safety Violations Mar Head Start. Children Deserve Better,” Heritage Foundation Commentary, November 10, 2022, https://www.heritage.org/education/commentary/over-1000-safety- violations-mar-head-start-children-deserve-better. 69. American Hospital Association v. Becerra, 596 U.S. ___ (2022), https://www.supremecourt.gov/ opinions/21pdf/20-1114_09m1.pdf (accessed March 17, 2023). 70. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, “Coverage of Certain Preventive Services Under the Affordable Care Act,” Notice of Proposed Rulemaking, Federal Register, Vol. 88, No. 22 (February 2, 2023), pp. 7236–7281, https://www. govinfo.gov/content/pkg/FR-2023-02-02/pdf/2023-01981.pdf (accessed March 17, 2023). — 502 — Mandate for Leadership: The Conservative Promise 71. 42 U.S. Code § 238n, https://www.law.cornell.edu/uscode/text/42/238n (accessed March 17, 2023). 72. U.S. Department of Health and Human Services, Health Resources and Services Administration, “Early Childhood Health,” last reviewed October 2022, https://mchb.hrsa.gov/programs-impact/focus-areas/early- childhood-health (accessed March 17, 2023). 73. American Pregnancy Association, “Having a Doula—What Are the Benefits?” https://americanpregnancy. org/healthy-pregnancy/labor-and-birth/having-a-doula/#:~:text=Other%20studies%20have%20shown%20 that%20having%20a%20doula,massage%20to%20reduce%20stress%20and%20anxiety%20during%20labor (accessed March 17, 2023). 74. S. 2372, VA MISSION [Maintaining Internal Systems and Strengthening Integrated Outside Networks] Act of 2018, Public Law No. 115-182, 115th Congress, June 6, 2018, https://www.congress.gov/115/plaws/publ182/ PLAW-115publ182.pdf (accessed March 17, 2023). 75. U.S. Department of Health and Human Services, “Securing Updated and Necessary Statutory Evaluations Timely,” Final Rule, Federal Register, Vol. 86, No. 11 (January 19, 2021), pp. 5694–5764, https://www.govinfo. gov/content/pkg/FR-2021-01-19/pdf/2021-00597.pdf (accessed March 22, 2023). 76. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Compliance with Statutory Program Integrity Requirements,” Final Rule, Federal Register, Vol. 84, No. 42 (March 4, 2029), pp. 7714–7791, https://www.govinfo.gov/content/pkg/FR-2019-03-04/pdf/2019-03461.pdf (accessed March 18, 2023). 77. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Ensuring Access to Equitable, Affordable, Client-Centered, Quality Family Planning Services,” Final Rule, Federal Register, Vol. 86, No. 192 (October 7, 2021), pp. 56144–56180, https://www.govinfo.gov/content/ pkg/FR-2021-10-07/pdf/2021-21542.pdf (accessed March 18, 2023). 78. S. 624, Title X Abortion Provider Prohibition Act, 118th Congress, introduced March 2, 2023, https://www. congress.gov/118/bills/s624/BILLS-118s624is.pdf (accessed March 18, 2023). 79. 50 U.S. Code Chapter 55, https://www.law.cornell.edu/uscode/text/50/chapter-55 (accessed March 22, 2023). 80. 18 U.S. Code § 13, https://www.law.cornell.edu/uscode/text/18/13 (accessed March 18, 2023). 81. Bowen v. American Hospital Association, 476 U.S. 610 (1986), https://tile.loc.gov/storage-services/service/ll/ usrep/usrep476/usrep476610/usrep476610.pdf (accessed 22, 2023). 82. U.S. Department of Health and Human Services, Office of the Secretary, “Notification of Interpretation and Enforcement of Section 1557 of the Affordable Care Act and Title IX of the Education Amendments of 1972,” Federal Register, Vol. 86, No. 99 (May 25, 2021), pp. 27984–27985, https://www.govinfo.gov/content/pkg/FR- 2021-05-25/pdf/2021-10477.pdf (accessed March 18, 2023). 83. U.S. Department of Health and Human Services, Office for Civil Rights, “HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy,” March 2, 2022, https://www.hhs.gov/sites/default/files/hhs- ocr-notice-and-guidance-gender-affirming-care.pdf (accessed March 18, 2023). 84. Heckler v. Chaney, 420 U.S. 821 (1985), https://caselaw.findlaw.com/us-supreme-court/470/821.html (accessed March 18, 2022). 85. U.S. Department of Health and Human Services, Office for Civil Rights, “Guidance to Nation’s Retail Pharmacies: Obligations Under Federal Civil Rights Laws to Ensure Access to Comprehensive Reproductive Health Care Services,” content last reviewed July 14, 2022, https://www.hhs.gov/civil-rights/for-individuals/ special-topics/reproductive-healthcare/pharmacies-guidance/index.html (accessed March 18, 2023). 86. H.R. 3103, “Health Insurance and Portability and Accountability Act of 1996, Public Law No. 104-191, 104th Congress, August 21, 1996, https://www.congress.gov/104/plaws/publ191/PLAW-104publ191.pdf (accessed March 18, 2023). 87. U.S. Department of Human Services, “HIPAA Privacy Rule and Disclosures of Information Relating to Reproductive Health Care,” content last reviewed June 29, 2022, (accessed March 18, 2023). See also “Protecting the Privacy and Security of Your Health Information When Using Your Personal Cell Phone or Tablet,” content last reviewed June 29, 2022, https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/ cell-phone-hipaa/index.html (accessed March 18, 2023).

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Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.

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