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While controversy swirls around last week’s mass firing of 1,000 Department of Veterans Affairs’ employees, a far greater threat to veterans’ health care is going completely unnoticed. Powerful leaders in Congress have quietly unveiled their plan to gut VA-delivered care, wrapped in the misleadingly titled “Veterans’ ACCESS Act.” If veterans don’t act fast, they will lose the VA health care system they know and depend on.
The bill appears innocuous enough, with aspirations of accountability. But don’t be fooled. Hidden in its depths like a ticking time bomb is a provision intended to dismantle the integrated VA health care system faster than you can say “privatization.”
Here’s their Trojan horse sneak attack: In response to struggles with addiction and mental health challenges many veterans face, the bill would allow unfettered access to outpatient private treatment without any VA authorization or referral. No questions asked. No guardrails whatsoever. The VA would simply pay the bills from its limited coffer. That’s phase one.
Then, after three years, this arrangement is intended to encompass all medical care, fundamentally transforming the VA’s primary role from a health care provider to an insurance company writing checks.
Follow the money, which will hemorrhage from the VA to the private sector. The likely outcome is that the VA will close its inpatient services and instead become a sprawling assortment of outpatient clinics. If that sounds familiar, it is the plan laid out in the Project 2025 playbook. Veterans are being hoodwinked that the VA facilities they rely on won’t be impacted. Don’t buy it for a second.
Think this forecast is an exaggeration? Think again. Independent health care experts warned last year that the survival of the VA system is in peril if runaway community care spending (the term for private health care funded by the VA) — which has been growing 15-20% annually — doesn’t slow way down. This bill hits the gas pedal.
If the VA turns into an insurance agency and cuts direct care, veterans will be cast out to locations where there are long-standing shortages in primary, mental health, inpatient and emergency care providers. Half of U.S. counties, and 80% of rural counties, lack even a single psychiatrist. Nearly 200 rural hospitals have shuttered, and over 700 more — one-third of all rural hospitals in the country — are on the brink of collapse. In this health care desert, who exactly will treat our veterans?
Plus, completely absent from the ACCESS Act is any recognition that the VA desperately needs to expand, not shrink, its workforce. The staffing shortage, which was concerning before the new administration took office due to an influx of nearly 400,000 newly enrolled PACT Act-eligible veterans, has become increasingly urgent. Without a substantial addition of health care personnel, the VA will need to curtail services that veterans depend on.
Want to know what else could follow the explosion in community care costs? Congress is in no mood to massively increase VA’s budget, so would have little choice but to reduce who’s eligible for care. That’s exactly the blueprint spelled out by the Project 2025 Heritage Foundation — eliminate health care benefits for whole cohorts of veterans.
Many veterans deeply appreciate the convenience of being referred to community care close to home. But here’s the kicker: They aren’t being told anything about the shattering impact of this plan to convert the VA into what’s essentially an insurance company. If they knew, they would never stand for it.
Recent statements by the Veterans of Foreign Wars, Disabled American Veterans and the American Legion showed overwhelming member support for ensuring the VA remains the primary health care provider and coordinator of care for veterans. A prior VFW report involving 10,000 members found that 92% explicitly prefer that the VA be “fixed, not dismantled.”
Placing ideology ahead of veterans’ welfare is a betrayal. Veterans have earned the right, through service and sacrifice, to the finely tuned integrated network of expert providers who’ve treated millions of physical and psychological veteran-specific injuries. It’s a system where groundbreaking research into PTSD, traumatic brain injury, and burn pit exposure has helped countless former service members, where you can see your health care team, in one place, on one day, under one roof.
Veterans, speak up now before it is too late. Contact your members of Congress and tell them what you think about a bill that will gut your VA health care system.
— Russell B. Lemle is a senior policy analyst at the Veterans Healthcare Policy Institute. His recent Military.com article addressed “Congress Needs to Support the VA and Firearms Industry’s Partnership to Prevent Veterans’ Suicides.”