A major Veterans Affairs reform has passed the Senate by 92-5 and is on its way to the White House. The $55 billion bill will change how the VA pays for private care, expand a VA caregiver program and start a review of the VA's aging infrastructure. President Trump has said he will sign it — and it's sure to be touted among his biggest legislative achievements.
All three main planks of the VA Mission ACT have been knocking around Capitol Hill for years and have come close to passage several times in just the last 6 months. It took a June deadline of money running out for the current VA Choice program to help push the bill over the finish line.
The most controversial part of the bill revamps the way VA reimburses veterans for private care appointments — replacing the seven different complicated systems currently in use. VA doctors will decide when a vet will benefit from seeing a private doctor because the nearest VA facility is too far away or appointments aren't available.
In most regions, VA care performs as well or better than private care and is less expensive. Critics fear the new system could bleed resources away from VA care, and start a spiral that weakens VA care, pushing more and more vets into the private sector.
Carlos Fuentes with the Veterans of Foreign Wars supports the bill.
"It strikes that balance between improving internal care and relying on the community when necessary," says Fuentes. "We truly believe the VA delivers great care, but the VA can't be everything to everyone."
Dozens of veterans and military service organizations endorsed the bill, promising to closely monitor how it is implemented.
The bill also expands a popular stipend program for family caregivers, currently only available for post-9/11 vets. Now veterans from the Vietnam era and before would be phased in within two years. After another two years vets of all eras could apply.
Finally, the bill initiates a review of the VA's aging and underutilized infrastructure, with the aim of closing down facilities that aren't worth their upkeep. Critics have compared this measure to BRAC - an often politically delicate process of closing down unneeded military bases. But supporters of the bill say VA facilities don't have nearly the same economic impact on the communities around them. Congress and veterans organizations says they will closely monitor any decisions to close down VA buildings.
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