Restore VA Accountability Act of 2025

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Bill ID: 119/s/124
Last Updated: April 14, 2026

Sponsored by

Sen. Moran, Jerry [R-KS]

ID: M000934

Follow the money

The bill

Restore VA Accountability Act of 2025

S. 124, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Sen. Moran, Jerry [R-KS]

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

The money

$81,200 raised

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

The alignment

65% match to Project 2025

This bill's text tracks the "Introduction" section, p. 679-681 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Committee on Veterans' Affairs. Hearings held.

March 10, 2025

Introduced

Committee Review

📍 Current Status

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

🗳️

Floor Action

Passed Senate

🏛️

House 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 bill, another exercise in futility. The "Restore VA Accountability Act of 2025" - because what the Department of Veterans Affairs really needed was more bureaucratic red tape and a healthy dose of congressional grandstanding.

**Main Purpose & Objectives**

The main purpose of this bill is to provide disciplinary procedures for supervisors and managers at the Department of Veterans Affairs, allegedly to "restore accountability." In reality, it's just another attempt by Congress to appear as though they're doing something about the VA's chronic problems. The objectives are twofold: (1) to create a new process for disciplining VA employees, and (2) to give the Secretary more power to remove or demote underperforming staff.

**Key Provisions & Changes to Existing Law**

The bill amends Title 38 of the United States Code by adding a new section that outlines the procedures for removing, demoting, or suspending supervisors and managers. The key provisions include:

* A new disciplinary process that allows the Secretary to remove or demote employees based on performance or misconduct * A shortened timeline for notice, response, and final decision (15 business days) * A grievance process that must be completed within 21 days * Judicial review of decisions, but only if they are deemed "arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with a provision of law"

**Affected Parties & Stakeholders**

The affected parties include:

* Supervisors and managers at the Department of Veterans Affairs * VA employees who may be subject to disciplinary action * The Secretary of the Department of Veterans Affairs * Congressional committees responsible for overseeing the VA

**Potential Impact & Implications**

This bill is a classic case of treating the symptoms rather than the disease. The real problems plaguing the VA - inefficiency, bureaucratic red tape, and lack of accountability - will not be solved by creating more procedures and giving the Secretary more power.

In reality, this bill may:

* Create more administrative burdens for the VA, diverting resources away from actual patient care * Lead to a culture of fear among VA employees, where they are reluctant to speak out or report problems due to fear of retaliation * Fail to address the underlying issues that lead to poor performance and misconduct in the first place

In short, this bill is a Band-Aid on a bullet wound. It's a feel-good measure designed to make Congress look like they're doing something about the VA's problems, rather than actually addressing the root causes of those problems.

Diagnosis: Legislative Theater-itis - a chronic condition characterized by grandstanding, bureaucratic busywork, and a complete lack of understanding of the underlying issues. Treatment: a healthy dose of skepticism, a strong stomach for bureaucratic nonsense, and a willingness to call out politicians on their empty promises.

Related Topics

Congressional Rules & ProceduresExecutive Branch OversightGovernment Operations & Accountability
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

Sen. Moran, Jerry [R-KS]

Congress 119 • 2024 Election Cycle

Total Contributions
$81,200
17 donors
PACs
$0
Organizations
$0
Committees
$0
Individuals
$81,200

No PAC contributions found

No organization contributions found

No committee contributions found

1
BORCK, LEON H.
1 transaction
$6,600
2
MANDELBLATT, DANIELLE
1 transaction
$6,600
3
MANDELBLATT, ERIC
1 transaction
$6,600
4
BORCK, JACKIE
2 transactions
$6,600
5
DWYER, JOHN W
2 transactions
$6,600
6
DWYER, NANCY E
2 transactions
$6,600
7
CATZ, SAFRA
1 transaction
$5,000
8
MISSION INDIANS, MORONGO BAND OF
1 transaction
$5,000
9
WILLIS, THOMAS M
1 transaction
$5,000
10
WEILERT, STANLEY R
1 transaction
$3,500
11
THOMAS, ROBERT
1 transaction
$3,300
12
LEPRINO, TERRY L
1 transaction
$3,300
13
POTAWATOMI NATION, PRAIRIE BAND
1 transaction
$3,300
14
BUKOWSKY, BROCK
1 transaction
$3,300
15
OF CREEK INDIANS, POARCH BAND
1 transaction
$3,300
16
BRIGHT, JOHN
1 transaction
$3,300
17
HEMMER, THOMAS
1 transaction
$3,300

Cosponsors & Their Campaign Finance

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

Sen. Tuberville, Tommy [R-AL]

ID: T000278

Top Contributors

10

1
BROAD METRO LLC
OrganizationOLD WESTBURY, NY
$3,300
Apr 18, 2023
2
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Apr 28, 2023
3
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$2,900
Feb 20, 2023
4
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$2,900
Apr 28, 2023
5
SUMMERLIN FARMS
OrganizationMOULTRIE, GA
$1,000
Oct 8, 2023
6
KENT HANCE BUSINESS
OrganizationLUBBOCK, TX
$1,000
Aug 17, 2023
7
SUMMERLIN FARMS
OrganizationMOULTRIE, GA
$1,000
Sep 8, 2023
8
KENT HANCE BUSINESS
OrganizationLUBBOCK, TX
$1,000
Sep 16, 2023
9
BEACH ICE LLC
OrganizationMOULTRIE, GA
$500
Oct 8, 2023
10
LEELAND VENTURES LLC
OrganizationHAMPTON COVE, AL
$500
Dec 4, 2023

Sen. Cassidy, Bill [R-LA]

ID: C001075

Top Contributors

10

1
YAWITZ, JESS B. MR.
RETIREDRETIRED
IndividualSAINT LOUIS, MO
$14,000
Jun 11, 2024
2
MANDELBLATT, DANIELLE
DMM PROPRIETA MANAGEMENTMANAGER
IndividualASPEN, CO
$9,900
Nov 2, 2023
3
MANDELBLATT, ERIC
SOROBAN CAPITAL PARTNERS LPMANAGING PARTNER
IndividualASPEN, CO
$9,900
Nov 2, 2023
4
JAYASINGHE, SAMAN K. DR.
SELF-EMPLOYEDPHYSICIAN
IndividualBATON ROUGE, LA
$9,900
Jun 13, 2024
5
KARP, ALEXANDER C.
PALANTIR TECHNOLOGIESCEO
IndividualBEDFORD, NH
$9,900
Apr 16, 2024
6
OBERNDORF, SUSAN
HOMEMAKERHOMEMAKER
IndividualSAN FRANCISCO, CA
$9,900
Jun 5, 2024
7
OBERNDORF, WILLIAM
OBERNDORF ENTERPRISESOWNER
IndividualSAN FRANCISCO, CA
$9,900
Jun 5, 2024
8
YAWITZ, ALICE G.
RETIREDRETIRED
IndividualST. LOUIS, MO
$9,900
Jun 18, 2024
9
GRIGSBY, BOBBI F. MRS.
HOMEMAKERHOMEMAKER
IndividualBATON ROUGE, LA
$6,600
Dec 23, 2024
10
GRIGSBY, L. LANE MR.
CAJUN INDUSTRIES LLCCHAIRMAN EMERITUS
IndividualBATON ROUGE, LA
$6,600
Dec 23, 2024

Sen. Banks, Jim [R-IN]

ID: B001299

Top Contributors

10

1
STOCKAMP FOUNDATION
OrganizationCOLUMBIA CITY, IN
$100
Feb 26, 2024
2
NEAL, ROLLIE
RETIREDRETIRED
IndividualCLARKSBURG, WV
$13,068
Mar 12, 2023
3
NEAL, ROLLIE
IndividualCLARKSBURG, WV
$13,068
Mar 21, 2023
4
SALAMONE, CHRISTOPHER J
IndividualFAIRPORT, NY
$12,000
Feb 8, 2024
5
BARKLEY, JOSH
BARKLEY BUILDERS INCGENERAL CONTRACTOR
IndividualOSSIAN, IN
$6,700
Apr 3, 2023
6
THRIFT, PAUL
THOMPSON THRIFTCEO
IndividualTERRE HAUTE, IN
$6,700
Feb 28, 2023
7
MUSELMAN, ROGER C.
DRG HOLDINGS, LLCCHAIRMAN
IndividualBERNE, IN
$6,700
Mar 28, 2023
8
WALTERS, KENNETH
JAYCOPRESIDENT AND CEO
IndividualGRANGER, IN
$6,700
Sep 1, 2023
9
DUMEZICH, DANA A.
RETIREDRETIRED
IndividualMARCO ISLAND, FL
$6,600
Jun 15, 2023
10
RAMSEY, JASON
IndividualBREVARD, NC
$6,600
May 8, 2023

Sen. Blackburn, Marsha [R-TN]

ID: B001243

Top Contributors

10

1
FRIENDS OF COMMUNITY ONCOLOGY PAC
PACVIRGINIA BEACH, VA
$5,000
Apr 12, 2023
2
THE COGGIN GROUP
OrganizationMURFREESBORO, TN
$2,900
Mar 9, 2023
3
THE COGGIN GROUP
OrganizationMURFREESBORO, TN
$2,500
Mar 9, 2023
4
DOSS BROTHERS FARM
OrganizationLAWRENCEBURG, TN
$1,000
Apr 17, 2024
5
DOSS BROTHERS FARM
OrganizationLAWRENCEBURG, TN
$1,000
Mar 18, 2024
6
BL PARTNERS GROUP LLC
OrganizationARLINGTON, VA
$500
Mar 17, 2023
7
KING, RODNEY W.
SELF-EMPLOYEDATTORNEY
IndividualGERMANTOWN, TN
$13,200
Apr 4, 2024
8
BEAN, BILL G.
HANNING & BEAN ENTERPRISES INC.REAL ESTATE INVESTOR
IndividualCOLUMBIA CITY, IN
$10,000
May 1, 2024
9
SMITH, THOMAS
PRESCOTT INVESTORS INC.INVESTOR
IndividualBOCA RATON, FL
$10,000
May 13, 2024
10
GAMBLE, KATHRYN
UNAKA COBUSINESS EXECUTIVE
IndividualDALLAS, TX
$9,900
Jul 15, 2024

Sen. Boozman, John [R-AR]

ID: B001236

Top Contributors

10

1
CHEROKEE NATION
OrganizationTAHLEQUAH, OK
$3,300
Oct 3, 2024
2
SHAKOPEE MDEKEWAKANTON COMMUNITY
OrganizationPRIOR LAKE, MN
$3,300
Nov 7, 2023
3
SHAKOPEE MDEKEWAKANTON COMMUNITY
OrganizationPRIOR LAKE, MN
$3,300
Jun 27, 2024
4
BJERKE, TYLER
HERITAGE INSURANCE SERVICESSALES
IndividualFARGO, ND
$5,000
Mar 22, 2023
5
LEPRINO, TERRY
LEPRINO FARMSBOARD DIRECTOR
IndividualDENVER, CO
$3,300
Dec 6, 2024
6
POWELL, JESSE
PAYWARD INC.CEO
IndividualSAN FRANCISCO, CA
$3,300
Nov 5, 2024
7
POWELL, JESSE
PAYWARD INC.CEO
IndividualSAN FRANCISCO, CA
$3,300
Nov 5, 2024
8
STEPHENS, WARREN MR.
STEPHENS INCPRESIDENT
IndividualLITTLE ROCK, AR
$3,300
Jul 7, 2023
9
STEPHENS, WARREN MR.
STEPHENS INCPRESIDENT
IndividualLITTLE ROCK, AR
$3,300
Jul 7, 2023
10
WALTON, ALICE L.. MS.
SELF-EMPLOYEDPHILANTHROPIST
IndividualBENTONVILLE, AR
$3,300
Aug 11, 2023

Sen. Sheehy, Tim [R-MT]

ID: S001232

Top Contributors

10

1
CLUB FOR GROWTH PAC
PACWASHINGTON, DC
$7,720
Jun 27, 2024
2
CLUB FOR GROWTH PAC
PACWASHINGTON, DC
$7,720
Jun 27, 2024
3
CLUB FOR GROWTH PAC
PACWASHINGTON, DC
$7,720
Jun 27, 2024
4
CLUB FOR GROWTH PAC
PACWASHINGTON, DC
$7,720
Jun 27, 2024
5
CLUB FOR GROWTH PAC
PACWASHINGTON, DC
$7,720
Jun 27, 2024
6
SENATE CONSERVATIVES FUND
PACWASHINGTON, DC
$7,609
Jun 21, 2024
7
SENATE CONSERVATIVES FUND
PACWASHINGTON, DC
$7,609
Jun 21, 2024
8
SENATE CONSERVATIVES FUND
PACWASHINGTON, DC
$7,609
Jun 21, 2024
9
REPUBLICAN JEWISH COALITION-POLITICAL ACTION COMMITTEE (RJC-PAC)
PACWASHINGTON, DC
$7,000
Jun 25, 2024
10
REPUBLICAN JEWISH COALITION-POLITICAL ACTION COMMITTEE (RJC-PAC)
PACWASHINGTON, DC
$7,000
Jun 25, 2024

Sen. Cramer, Kevin [R-ND]

ID: C001096

Top Contributors

10

1
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Sep 29, 2023
2
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Jun 14, 2024
3
SISSETON-WAHPETON OYATE
OrganizationAGENCY VILLAGE, SD
$2,500
Jun 21, 2024
4
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,000
Jun 18, 2024
5
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$600
Jun 6, 2023
6
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$400
Jun 6, 2023
7
WALSH, RICHARD
IndividualLAKE WORTH BEACH, FL
$6,700
Oct 16, 2024
8
JORDAN, BORIS
CURALEAFEXECUTIVE CHAIRMAN OF THE BOARD
IndividualBOCA RATON, FL
$6,600
Sep 15, 2023
9
SMITH, BRAD
MICROSOFT CORPORATIONATTORNEY
IndividualBELLEVUE, WA
$6,600
Sep 29, 2023
10
KAPLAN, DAVID
ARES MANAGEMENTCO-FOUNDER
IndividualLOS ANGELES, CA
$6,600
Oct 11, 2023

Sen. Tillis, Thomas [R-NC]

ID: T000476

Top Contributors

10

1
SASTRY, ASHWANI
SUNRISE VASCULARPHYSICIAN
IndividualORLANDO, FL
$3,400
Dec 12, 2024
2
AGARWAL, SAJJAN K
GREENHAWK CORPORATIONCEO
IndividualCARY, NC
$3,300
Dec 11, 2024
3
ALLYN, JILL
BRIGHTHOUSE FINANCIALINVESTMENTS
IndividualESTERO, FL
$3,300
Oct 17, 2024
4
BARATTA, JOSEPH PATRICK
BLACKSTONEFINANCE EXECUTIVE
IndividualNEW YORK, NY
$3,300
Dec 18, 2024
5
BARATTA, JOSEPH PATRICK
BLACKSTONEFINANCE EXECUTIVE
IndividualNEW YORK, NY
$3,300
Dec 18, 2024
6
BIELEN, RICHARD J
PROTECTIVE LIFE CORPORATIONPRESIDENT & CEO
IndividualMOUNTAIN BRK, AL
$3,300
Oct 29, 2024
7
BLITZER, DAVID S
BLACKSTONECHAIRMAN
IndividualNEW YORK, NY
$3,300
Dec 12, 2024
8
BLITZER, DAVID S
BLACKSTONECHAIRMAN
IndividualNEW YORK, NY
$3,300
Dec 12, 2024
9
BRAND, MARTIN
BLACKSTONEFINANCE
IndividualNEW YORK, NY
$3,300
Dec 20, 2024
10
CAMERON, WILLIAM H
CAMERON MANAGMENTPRESIDENT
IndividualWILMINGTON, NC
$3,300
Oct 28, 2024

Sen. Ricketts, Pete [R-NE]

ID: R000618

Top Contributors

10

1
SPIKE OCOTILLO LLC
OrganizationCHANDLER, AZ
$2,500
Mar 4, 2024
2
HUNTON ANDREWS KURTH LLP
OrganizationRICHMOND, VA
$1,000
Mar 28, 2024
3
KING & SPALDING LLP
OrganizationATLANTA, GA
$1,000
Mar 29, 2024
4
GREENBERG TRAURIG
OrganizationALBANY, NY
$1,000
Apr 23, 2024
5
H.A. TRUE, III
OrganizationCASPER, WY
$1,000
Aug 22, 2024
6
DELTA AIRLINES
OrganizationATLANTA, GA
$234
Apr 17, 2023
7
VANDERSLOOT, BELINDA
SELFHOMEMAKER
IndividualIDAHO FALLS, ID
$6,600
Mar 4, 2024
8
VANDERSLOOT, FRANK
MELALEUCAOWNER
IndividualIDAHO FALLS, ID
$6,600
Mar 4, 2024
9
MANDELBLATT, DANIELLE
RETIRED
IndividualASPEN, CO
$6,600
Jun 7, 2024
10
MANDELBLATT, ERIC
SOROBAN CAPITAL PARTNERS LPMANAGING PARTNER
IndividualASPEN, CO
$6,600
Jun 7, 2024

Sen. Scott, Rick [R-FL]

ID: S001217

Top Contributors

0

No contribution data available

Donor Network - Sen. Moran, Jerry [R-KS]

PACs
Organizations
Individuals
Politicians

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

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Showing 61 nodes and 35 connections (46 secondary connections hidden)

Total contributions: $171,036

Top Donors - Sen. Moran, Jerry [R-KS]

Showing top 17 donors by contribution amount

17 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 2 harmed.

  • Section 2 and Section 4 modify disciplinary procedures for employees of the Department of Veterans Affairs, which may lead to increased scrutiny and potential removals of supervisors and managers, potentially affecting hospitals and health systems within the VA system.

  • Labor Unionsconfidence 0.70

    Section 4(h) states that the procedures in this section shall supersede any collective bargaining agreement to the extent that such agreement is inconsistent with such procedures, potentially limiting labor union influence

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.

Introduction

Moderate65.4%
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

Moderate65.4%
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

Moderate62.0%
Pages: 676-678

— 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 — 645 — Department of Veterans Affairs of veterans—a population that is more active, reaching middle age or retirement age, and migrating for lifestyle and career reasons. At the center of the VHA’s evolution during this generational transition is an ongoing tension, some of it politically contrived, between Direct Care for Veterans provided from inside the VHA system and Community Care for Veterans who are referred to private providers participating in the VHA’s two Community Care Networks (CCNs). In recent years, the budget for Community Care has grown as demand from veterans has risen sharply, sometimes outpacing the budgets for Community Care at individual VAMCs. The Trump Administration made Community Care part of its “Veteran- centric” approach to ensure that veterans would be able to participate more fully in their health care decisions and have options if or when the VHA was unable to meet their needs. The Biden Administration has watered down that effort, has sought various procedural ways to slow the rate of referrals to private doctors, and at some facilities is reportedly manipulating the Community Care access standards required by the VA MISSION Act of 2018. If the makeup of Congress is favorable in 2025, the next Administration should rapidly and explicitly codify VA MISSION Act access standards in legislation to prevent the VA from avoiding or watering down the requirements in the future. First and foremost, a veterans bill of rights is needed so that veterans and VA staff know exactly what benefits veterans are entitled to receive, with a clear process for the adjudication of disputes, and so that staff ensure that all veterans are informed of their eligibility for Community Care. Currently, veterans are not routinely and consistently told that they are eligible for Community Care unless they request information or are given a referral. l To strengthen Community Care, the next Administration should create new Secretarial directives to implement the VA MISSION Act properly. Sections for consideration and areas for reform include the following: 1. Sections 101 and 103 (Community Care eligibility for access standards and the best medical interest of the veteran). 2. Section 104 (Community Care access standards and standards for quality of care).

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