Veterans Health Care Freedom Act

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Bill ID: 119/hr/71
Last Updated: February 15, 2025

Sponsored by

Rep. Biggs, Andy [R-AZ-5]

ID: B001302

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Referred to the Subcommittee on Health.

February 6, 2025

Introduced

Committee Review

📍 Current Status

Next: The bill moves to the floor for full chamber debate and voting.

🗳️

Floor Action

âś…

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 "caring" bill from our esteemed lawmakers, designed to make us all feel warm and fuzzy about the treatment of our nation's veterans. How touching.

**Main Purpose & Objectives**

The Veterans Health Care Freedom Act (HR 71) claims to improve veterans' access to medical care by allowing them to choose their healthcare providers within the Department of Veterans Affairs (VA) system or in the community. The bill's primary objective is to create a pilot program that supposedly enhances flexibility and choice for eligible veterans.

**Key Provisions & Changes to Existing Law**

The bill proposes several changes, including:

* Allowing veterans to receive care at any VA facility, regardless of their location * Permitting non-VA facilities to provide care under certain conditions * Enabling veterans to select primary care providers and specialty care providers within the covered care system * Establishing a pilot program with a minimum of four Veterans Integrated Service Networks (VISNs) in varied geographic areas

The bill also amends existing laws, including sections 1703 and 1703A of title 38, United States Code, to remove certain requirements for accessing care.

**Affected Parties & Stakeholders**

* Eligible veterans participating in the pilot program * The Department of Veterans Affairs (VA) * VA facilities and staff * Non-VA healthcare providers and facilities * Taxpayers (who will foot the bill for this "freedom")

**Potential Impact & Implications**

Now, let's dissect the real motivations behind this bill. It's not about providing better care for veterans; it's about:

1. **Privatization**: This bill is a Trojan horse for privatizing VA healthcare services. By allowing non-VA facilities to provide care, the government can slowly dismantle the VA system and shift the burden to private providers. 2. **Increased costs**: The pilot program will likely lead to increased costs, as veterans may choose more expensive care options outside of the VA system. 3. **Administrative burdens**: The bill creates new administrative tasks for the VA, including establishing systems for coordinating care and providing information to veterans. 4. **Lobbyist influence**: This bill has all the hallmarks of a lobbyist-driven initiative. The language is carefully crafted to benefit specific healthcare providers and facilities, rather than genuinely improving veteran care.

In conclusion, HR 71 is a classic example of legislative theater, designed to make politicians look good while serving the interests of special groups. It's a thinly veiled attempt to privatize VA healthcare services, increase costs, and create more bureaucratic red tape. How very "freedom-loving" of our lawmakers.

Related Topics

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đź’° Campaign Finance Network

Rep. Biggs, Andy [R-AZ-5]

Congress 119 • 2024 Election Cycle

Total Contributions
$116,250
26 donors
PACs
$0
Organizations
$0
Committees
$0
Individuals
$116,250

No PAC contributions found

No organization contributions found

No committee contributions found

1
GRAINGER, DAMON
2 transactions
$6,870
2
MCBRIDE, MICHAEL
2 transactions
$6,870
3
BENNETT, HEATHER
1 transaction
$6,600
4
COX, HOWARD
1 transaction
$6,600
5
SCOTT, MARILYN
1 transaction
$6,600
6
SEYMORE, GARY W
1 transaction
$6,600
7
TAYLOR, MARGARETTA J
2 transactions
$6,600
8
BENSON, LEE
2 transactions
$6,600
9
MATTEO, CHRIS
1 transaction
$5,000
10
CASSELS, W.T. JR.
1 transaction
$3,500
11
CASSELS, W TOBIN III
1 transaction
$3,500
12
ARIAIL, BRANDI C
1 transaction
$3,500
13
FLOYD, KAREN KANES
1 transaction
$3,500
14
SIMPSON, DARWIN H
1 transaction
$3,500
15
JOHNSON, NEIL
1 transaction
$3,435
16
KUMAR, DHAVAL
1 transaction
$3,435
17
LEE, LUCIAN
1 transaction
$3,435
18
RAHM, CHRISTINA
1 transaction
$3,435
19
THOMAS, CLAYTON
1 transaction
$3,435
20
EZELL, SHAWN
1 transaction
$3,435
21
MCCLEVE, LONNIE
1 transaction
$3,300
22
FAUST, ANNE R
1 transaction
$3,300
23
BROPHY, DANIEL
1 transaction
$3,300
24
LONDEN, PRISCILLA
1 transaction
$3,300
25
ALLEN, GWYNDA S
1 transaction
$3,300

Cosponsors & Their Campaign Finance

This bill has 10 cosponsors. Below are their top campaign contributors.

Rep. Crane, Elijah [R-AZ-2]

ID: C001132

Top Contributors

10

1
AK-CHIN INDIAN COMMUNITY
Organization MARICOPA, AZ
$3,300
Mar 31, 2024
2
AK-CHIN INDIAN COMMUNITY
Organization MARICOPA, AZ
$3,300
Sep 16, 2024
3
HALE, STEVEN L. MR.
NORTHWESTERN MUTUAL • WEALTH MANAGEMENT ADVISOR
Individual PEACHTREE CITY, GA
$9,900
Mar 31, 2024
4
JOHNSON, BENJAMIN MR.
Individual GRIFFIN, GA
$9,900
Mar 29, 2024
5
METCALF, MICHAEL MR.
SOUND MANAGEMENT SERVICES LLC • OWNER
Individual WOODSTOCK, GA
$9,900
Mar 29, 2024
6
MILES, PHILLIP MR.
Individual ALPHARETTA, GA
$9,900
Mar 29, 2024
7
SANDWICH, JAMES T.
Individual BROOKS, GA
$9,900
Feb 13, 2024
8
SANDWICH, JAMES T. DR.
FAYETTE AREA DERMATOLOGY • PHYSICIAN
Individual BROOKS, GA
$9,900
Feb 13, 2024
9
HALE, STEVEN L. MR.
NORTHWESTERN MUTUAL • WEALTH MANAGEMENT ADVISOR
Individual PEACHTREE CITY, GA
$9,900
Mar 31, 2024
10
JOHNSON, BENJAMIN MR.
LIBERTY TECHNOLOGY • CEO
Individual GRIFFIN, GA
$9,900
Mar 29, 2024

Rep. Webster, Daniel [R-FL-11]

ID: W000806

Top Contributors

10

1
SILVERMAN, JEFFREY
Individual SURFSIDE, FL
$6,600
Apr 18, 2024
2
BRADLEY, JACQUELINE
RETIRED • RETIRED
Individual KESWICK, VA
$6,600
Apr 15, 2024
3
SILVERMAN, JEFFREY
RETIRED • RETIRED
Individual SURFSIDE, FL
$6,600
Feb 15, 2024
4
FILBURN, MARK
WHITESTONE CONSTRUCTION • PRESIDENT
Individual LONGWOOD, FL
$3,400
Jun 26, 2024
5
FILBURN, MARK
Individual LONGWOOD, FL
$3,400
Sep 4, 2024
6
ASNESS, CLIFF
AQR • EXECUTIVE
Individual NEW YORK, NY
$3,300
Jun 6, 2024
7
ASNESS, LAUREL
MARCUM LLP • EXECUTIVE
Individual NEW YORK, NY
$3,300
Jun 6, 2024
8
BEUCHER, NICK
CEO • TAVISTOCK FINANCIAL CORPORATION
Individual ORLANDO, FL
$3,300
May 28, 2024
9
BRADLEY, JACQUELINE
RETIRED • RETIRED
Individual KESWICK, VA
$3,300
Apr 18, 2024
10
DEVORE, DEBBIE
SEA & SHORELINE • ACCOUNTANT
Individual WINTER GARDEN, FL
$3,300
May 31, 2024

Rep. Salazar, Maria Elvira [R-FL-27]

ID: S000168

Top Contributors

10

1
POARCH BANK OF CREEK INDIANS
Organization ATMORE, AL
$3,300
May 26, 2023
2
POARCH BANK OF CREEK INDIANS
Organization ATMORE, AL
$3,300
Jun 7, 2024
3
MICCOSUKEE TRIBE
Organization MIAMI, FL
$1,000
Dec 19, 2023
4
DIAZ-OLIVER, REMEDIOS MRS.
RETIRED • RETIRED
Individual MIAMI, FL
$6,600
Dec 29, 2023
5
FALIC, JANA
HOMEMAKER • HOMEMAKER
Individual BAL HARBOUR, FL
$6,600
Dec 31, 2023
6
MENDOZA GOMEZ, ROSSY A.
ROSE CAFE • OWNER
Individual CORAL GABLES, FL
$6,600
Dec 29, 2023
7
SILVERMAN, JEFFREY
RETIRED • RETIRED
Individual SURFSIDE, FL
$6,600
Oct 17, 2023
8
WEEKLEY, RICHARD
SELF-EMPLOYED • REAL ESTATE DEVELOPER
Individual HOUSTON, TX
$6,600
Nov 7, 2023
9
BARQUET, ROY
FOLEY & LARDNER LLP • ATTORNEY
Individual MIAMI, FL
$6,600
Dec 6, 2023
10
PETERFFY, THOMAS
INTERACTIVE BROKERS GROUP • CHAIRMAN
Individual PALM BEACH, FL
$6,600
Dec 27, 2023

Rep. Gosar, Paul A. [R-AZ-9]

ID: G000565

Top Contributors

10

1
COLORADO RIVER INDIANS TRIBES
Organization PARKER, AZ
$2,000
Sep 21, 2023
2
COLORADO RIVER INDIANS TRIBES
Organization PARKER, AZ
$1,000
Jun 29, 2024
3
MORONGO BAND OF MISSION INDIANS
Organization BANNING, CA
$1,000
Jul 19, 2023
4
SCHIRMER, SCOTT
M3 COMP • EXECUTIVE
Individual SCOTTSDALE, AZ
$5,000
May 20, 2024
5
SMITH, RYAN
SELF EMPLOYED • ENTREPRENEUR
Individual SCOTTSDALE, AZ
$5,000
May 20, 2024
6
SCHIRMER, SCOTT
Individual SCOTTSDALE, AZ
$5,000
Jun 5, 2024
7
SMITH, RYAN
Individual SCOTTSDALE, AZ
$5,000
Jun 5, 2024
8
TAPIA, DONALD
RETIRED • RETIRED
Individual PARADISE VALLEY, AZ
$5,000
Aug 29, 2024
9
TAPIA, DONALD
Individual PARADISE VALLEY, AZ
$5,000
Sep 9, 2024
10
O'KEEFFE, WILLIAM
SAFTI • PRESIDENT
Individual SAN FRANCISCO, CA
$5,000
Oct 23, 2024

Rep. Luna, Anna Paulina [R-FL-13]

ID: L000596

Top Contributors

10

1
POARCH BAND OF CREEK INDIANS
Organization ATMORE, AL
$3,300
Sep 15, 2023
2
DUKE ENERGY
Organization WASHINGTON, DC
$1,000
Sep 29, 2023
3
MOGHADAM, SHAHAB
APPLIED MATERIALS • PROJECT MANAGER
Individual SARATOGA, CA
$5,800
Aug 15, 2024
4
JACOBS, TERRENCE S
PENNECO • PRESIDENT & CEO
Individual WINDERMERE, FL
$3,300
Jul 22, 2024
5
WALTER, JENNIFER
RETIRED • RETIRED
Individual LEWISVILLE, TX
$3,300
Jul 5, 2024
6
WALTER, DAVID
RETIRED • RETIRED
Individual LEWISVILLE, TX
$3,300
Jul 5, 2024
7
TVEDTEN, TYRONE
SUNCOAST FAMILY MEDICAL • PHYSICIAN
Individual REDINGTON BEACH, FL
$3,300
Jul 23, 2024
8
WALTER, DAVID
RETIRED • RETIRED
Individual LEWISVILLE, TX
$3,300
Jul 5, 2024
9
WALTER, JENNIFER
RETIRED • RETIRED
Individual LEWISVILLE, TX
$3,300
Jul 5, 2024
10
RENO, MATHEW J
RETIRED • RETIRED
Individual GILLETTE, WY
$3,300
Jun 11, 2024

Rep. Brecheen, Josh [R-OK-2]

ID: B001317

Top Contributors

10

1
COMMUNITY BANCSHARES OF MS PAC
Organization FOREST, MS
$1,000
Apr 18, 2023
2
NILKNOC LLC
Organization STIGLER, OK
$300
Apr 8, 2024
3
GREEMAN, WALTER M MRS.
SELF EMPLOYED • RANCHER
Individual TISHOMINGO, OK
$6,600
Oct 24, 2024
4
HINMAN, ROY H
FLAGLER HOSPITAL • FAMILY MEDICINE DOCTOR
Individual ST AUGUSTINE, FL
$6,600
Jan 23, 2024
5
LOMANGINO, ANTHONY
RETIRED • RETIRED
Individual PALM BEACH, FL
$6,600
Feb 27, 2024
6
LOMANGINO, LYNDA
HOMEMAKER • HOMEMAKER
Individual PALM BEACH, FL
$6,600
Feb 27, 2024
7
ASBJORNSON, SCOTT
SELF EMPLOYED • PRIVATE INVESTOR
Individual TULSA, OK
$6,600
Jun 5, 2023
8
JAQUISH, GAIL
JURIX INC • PSYCHOLOGIST
Individual AUSTIN, TX
$6,600
Sep 26, 2023
9
KENNINGER, STEVEN
QMO LLC • INVESTOR
Individual AUSTIN, TX
$6,600
Sep 27, 2023
10
LOMANGINO, ANTHONY
RETIRED • RETIRED
Individual PALM BEACH, FL
$6,600
Jul 24, 2023

Rep. Buchanan, Vern [R-FL-16]

ID: B001260

Top Contributors

10

1
RICHARDS, CHRISTINE
CVP • CUST/BUS TRANS
Individual BARTLETT, TN
$3,300
Oct 28, 2024
2
RICHARDS, DANIEL
DR. CONSULTING • CPA
Individual BARTLETT, TN
$3,300
Oct 28, 2024
3
GARCIA, MARIO
EMSI - TAMPA • PRESIDENT/CEO
Individual TAMPA, FL
$3,300
Nov 28, 2023
4
BENJAMIN, STEPHEN
VALIDUS SENIOR LIVING • CEO
Individual ODESSA, FL
$3,300
Nov 10, 2023
5
GARCIA, IVIS
HOMEMAKER • HOMEMAKER
Individual TAMPA, FL
$3,300
Nov 28, 2023
6
GARCIA, MARIO
EMSI - TAMPA • PRESIDENT/CEO
Individual TAMPA, FL
$3,300
Nov 28, 2023
7
GARCIA, IVIS
HOMEMAKER • HOMEMAKER
Individual TAMPA, FL
$3,300
Nov 28, 2023
8
JOHNSON, TRAVIS
1607 STRATEGIES • FOUNDER
Individual ARLINGTON, VA
$3,300
Dec 6, 2023
9
COPELAND, GERRET
TERREG MANAGEMENT LLC • CEO
Individual SARASOTA, FL
$3,300
Feb 7, 2023
10
COPELAND, KYM
HOMEMAKER • HOMEMAKER
Individual SARASOTA, FL
$3,300
Feb 7, 2023

Rep. Miller, Mary E. [R-IL-15]

ID: M001211

Top Contributors

10

1
WINRED PAC
PAC ARLINGTON, VA
$13,010
Mar 31, 2023
2
SAC & FOX TRIBE OF THE MISSISSIPPI IN IOWA
COM TAMA, IA
$1,000
Aug 11, 2023
3
RENEWABLE ENERGY, CITIZENS FOR
COM MADISON, WI
$500
Aug 20, 2024
4
POLITICAL COMMITTEE, NWF ACTION FUND
PAC WASHINGTON, DC
$500
Sep 18, 2024
5
ADAMS MEMORIALS
Organization CHARLESTON, IL
$1,000
Mar 23, 2023
6
VAHLING VINEYARDS
Organization STEWARDSON, IL
$500
Jan 11, 2024
7
THE CHICKASAW NATION
Organization ADA, OK
$1,000
Jun 20, 2023
8
US MARSHALS SERVICES
Organization NEW YORK, NY
$2,900
Apr 20, 2023
9
HUNTON ANDREWS KURTH LLP
Organization RICHMOND, VA
$1,000
Mar 22, 2023
10
KASPAR, SCOTT
KASPAR LAW COMPANY • LAWYER
Individual ORLAND PARK, IL
$13,200
Mar 22, 2023

Rep. Hageman, Harriet M. [R-WY-At Large]

ID: H001096

Top Contributors

10

1
COW CREEK BAND OF UMPQUA TRIBE OF INDIANS
Organization ROSEBURG, OR
$5,000
Aug 6, 2024
2
PUYALLUP TRIBE OF INDIANS
Organization TACOMA, WA
$3,700
Mar 4, 2024
3
CHEROKEE NATION
Organization TAHLEQUAH, OK
$3,300
Dec 22, 2023
4
PECHANGA BAND OF INDIANS
Organization TEMECULA, CA
$3,300
Dec 22, 2023
5
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
Organization PRIOR LAKE, MN
$3,300
Nov 6, 2023
6
SHINGLE SPRINGS BAND MIWOK INDIANS
Organization SHINGLE SPRINGS, CA
$3,300
Dec 22, 2023
7
MORONGO BAND OF MISSION INDIANS
Organization BANNING, CA
$3,300
Mar 29, 2024
8
HPUL PROJECT OPERATIONS
Organization UPPER LAKE, CA
$3,300
Sep 6, 2024
9
MUCKLESHOOT INDIAN TRIBE
Organization AUBURN, WA
$3,300
Sep 6, 2024
10
AK-CHIN INDIAN COMMUNITY OPERATIONS ACCOUNT
Organization MARICOPA, AZ
$3,300
Sep 13, 2024

Rep. Tiffany, Thomas P. [R-WI-7]

ID: T000165

Top Contributors

10

1
ISLAND CATTLE COMPANY
Organization LONG ISLAND, KS
$2,500
May 29, 2024
2
HANDEK CATTLE INC
Organization MUSHOTACH, KS
$300
May 7, 2024
3
SOLBERG, TRYGVE A
SELF • BUSINESS OWNER
Individual MINOCQUA, WI
$13,200
Sep 30, 2023
4
SHANNON, JEAN L
RETIRED • RETIRED
Individual MILWAUKEE, WI
$13,200
Jul 27, 2023
5
NICKLAUS, GREG
INCREDIBLE BANK • VICE CHAIRMAN
Individual ARBOR VITAE, WI
$13,200
Mar 31, 2024
6
NICKLAUS, GREG
INCREDIBLE BANK • VICE CHAIRMAN
Individual ARBOR VITAE, WI
$13,200
Mar 31, 2024
7
BUHOLZER, RONALD
KLONDIKE CHEESE • PRESIDENT
Individual MONROE, WI
$13,200
Jun 30, 2024
8
MAYER, SCOTT A
QPS EMPLOYMENT GROUP • CHAIRMAN OF THE BOARD
Individual FRANKLIN, WI
$10,000
Feb 29, 2024
9
HILGEMANN, WILLIAM
RETIRED • RETIRED
Individual STRATFORD, WI
$9,900
Jun 30, 2024
10
ZIETLOW, DONALD P
RETIRED • RETIRED
Individual LA CROSSE, WI
$6,666
Jun 28, 2023

Donor Network - Rep. Biggs, Andy [R-AZ-5]

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

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Showing 43 nodes and 45 connections

Total contributions: $174,250

Top Donors - Rep. Biggs, Andy [R-AZ-5]

Showing top 25 donors by contribution amount

26 Individuals

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document. Higher similarity scores indicate stronger thematic connections.

Introduction

High 70.7%
Pages: 679-681

— 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.

Introduction

High 70.7%
Pages: 679-681

— 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,

Introduction

Moderate 69.2%
Pages: 676-678

— 643 — Department of Veterans Affairs with a growth in same-day surgical procedures and outpatient care, so has the VA, and in 2018 Congress added access to private-sector urgent care outlets as one of the VA’s health care benefits. Today, the VA operates 172 inpatient VA Medical Centers (VAMCs), which are an average of 60 years old, and 1,113 Community Based Outpatient Clinics (CBOCs), which are newer facilities designed to meet the needs of veterans closer to home. The VA also manages a Community Care Network (CCN) through contracts with Optum and TriWest, third-party health care administrators responsible for build- ing and maintaining a robust population of community providers to meet the needs of veterans referred for care outside of the VA system. Currently, approximately 6.4 million veterans out of 18 million nationally (and out of the 9.1 million who are enrolled) use the VA for health care; the remainder use employer-sponsored plans, Tricare, Medicare, and Medicaid. The disability benefits system evolved significantly in the years between the Cold War era and the global war on terrorism, a period when the VA enrolled large numbers of veterans from World War II, Korea, and Vietnam who were seeking disability benefits and health care. Disability compensation is the largest VA benefit, but there also are dozens of others, the next largest of which are the GI Bill and the Home Loan Guaranty. These benefits are administered through 56 Regional Benefits Offices (RBOs) and hundreds of satellite sites around the country. The Agent Orange Act of 19914 significantly expanded the scope of disability ben- efits for those who had deployed to Vietnam, and the cost of those benefits began to increase dramatically as the Vietnam generation of veterans aged and began to expe- rience adverse health conditions, some of which were presumed to have been caused by defoliant chemicals used in Southeast Asia. In 2016 and 2017, a burdensome backlog of appeals of denied disability claims from multiple wartime generations—a backlog numbering in the hundreds of thousands—led to a joint effort by the VA, Vet- eran Service Organizations (VSOs), and Congress to pass legislation that streamlined appeal processes. Implemented in 2017, this historic “good governance” success has helped the VA to reduce the number of these appeals dramatically. The Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act of 20225 addressed adverse health outcomes presumed to be the result of veterans’ exposure to airborne toxins during the global war on terrorism and further expanded disability benefits to the most recent gen- eration of veterans. These ambitious authorities, like the 1991 authorities, have the potential to overwhelm the VA’s ability to process new disability claims and adjudicate appeals. Currently, the VA is seeking to hire large numbers of personnel to process these claims while exploring the use of an automated process to accel- erate claims reviews and decisions. The ever-present lag in the hiring and training of new employees could result in major problems with the timely adjudication of benefits well into the next Administration in 2025. — 644 — Mandate for Leadership: The Conservative Promise In sum, the VA for the foreseeable future will experience significant fiscal, human capital, and infrastructure crosswinds and risks. Budgets are at historic highs, and with a workforce now above 400,000, the VA is contending with a lack of new veteran enrollees to offset the declining population of older veterans. Recruitment of medical and benefits personnel has become more challenging. Veterans are migrating from the northern states to the southern and western states for retirement and employment. Meanwhile, VA information technol- ogy (IT) is struggling to keep pace with the evolution of patient care and record keeping. Consequently, VA leaders in the next Administration must be wise and courageous political strategists, experienced managers to run day-to-day oper- ations more effectively, innovators to address the changing veteran landscape, and agile “fixers” to mitigate and repair systemic problems created or ignored by the present leadership team. VETERANS HEALTH ADMINISTRATION (VHA) Needed Reforms l Rescind all departmental clinical policy directives that are contrary to principles of conservative governance starting with abortion services and gender reassignment surgery. Neither aligns with service-connected conditions that would warrant VA’s providing this type of clinical care, and both follow the Left’s pernicious trend of abusing the role of government to further its own agenda. l Focus on the effects of shifting veteran demographics. At least during the next decade, the VA will experience a significant generational shift in its overall patient population. Of the approximately 18 million veterans alive today, roughly 9.1 million are enrolled for VA health care, and 6.4 million of these enrollees use VA health care consistently. These 6.4 million veterans are split almost evenly between those who are over age 65 and those who are under age 65, but the share of VA’s health care dollars is spent predominantly in the over-65 cohort. That share increases significantly as veterans live longer and use the VHA system at a higher rate. VHA enrollments of new users are increasingly at risk of being exceeded by the deaths of current enrollees, primarily because significant numbers of the Vietnam generation are reaching their life expectancy. The generational transition from Vietnam-era veterans to post-9/11 veterans will take several years to complete. The ongoing demographic transition is a catalyst for needed assessments of how the VA can improve the delivery of care to a numerically declining and differently dispersed national population

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Policy matches are calculated using semantic similarity between bill summaries and Project 2025 policy text. A score of 60% or higher indicates meaningful thematic overlap. This does not imply direct causation or intent, but highlights areas where legislation aligns with Project 2025 policy objectives.