Veterans’ ACCESS Act of 2025

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Bill ID: 119/hr/740
Last Updated: July 17, 2026

Sponsored by

Rep. Bost, Mike [R-IL-12]

ID: B001295

Follow the money

The bill

Veterans’ ACCESS Act of 2025

HR. 740, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Rep. Bost, Mike [R-IL-12]

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

The money

$104,500 raised

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

The alignment

67% match to Project 2025

This bill's text tracks the "Introduction" section, p. 676-678 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 (Amended) by Voice Vote.

July 22, 2025

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 bill, another exercise in bureaucratic doublespeak and legislative legerdemain. Let's dissect this mess, shall we?

**Main Purpose & Objectives:** The Veterans' ACCESS Act of 2025 claims to "improve the provision of care and services under the Veterans Community Care Program" (VCCP). How noble. In reality, it's a Band-Aid on a bullet wound, designed to appease veterans while maintaining the status quo.

**Key Provisions & Changes to Existing Law:** The bill codifies existing eligibility standards for access to community care from the Department of Veterans Affairs (VA), with minor tweaks. It also requires the Secretary to notify veterans of their eligibility for care under VCCP, consider veteran preferences, and provide telehealth options. Wow, what a revolutionary concept – telling people they're eligible for care!

Section 101 amends existing law by setting arbitrary wait time standards (20 days for primary care, 28 days for specialty care) and driving distance requirements (30 minutes for primary care, 60 minutes for specialty care). Because nothing says "quality care" like a timer and a GPS.

**Affected Parties & Stakeholders:** Veterans, of course, are the supposed beneficiaries. But let's not forget the real stakeholders: VA bureaucrats, healthcare providers, and contractors who'll profit from this expanded program. Lobbyists must be thrilled to have their fingerprints all over this bill.

**Potential Impact & Implications:**

* Veterans might see slightly improved access to care, but only if they're willing to drive an hour or wait a month. * The VA will get more funding for its bloated bureaucracy and inefficient programs. * Healthcare providers and contractors will reap the benefits of increased government spending on community care. * Taxpayers will foot the bill for this expanded program, which might not actually improve outcomes.

Diagnosis: This bill is a classic case of " Legislative Lip Service Syndrome" (LLSS), where politicians pretend to address a problem while maintaining the underlying dysfunction. The real disease? A lack of accountability, inefficiency, and a failure to prioritize veterans' needs over bureaucratic interests. Treatment? A healthy dose of skepticism, followed by a strong prescription for systemic reform.

In conclusion, HR 740 is a half-hearted attempt to placate veterans while perpetuating the same old problems. It's a legislative placebo, designed to make politicians look good without actually fixing anything. Now, if you'll excuse me, I have better things to do than analyze this drivel. Next!

Related Topics

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

💰 Campaign Finance Network

Rep. Bost, Mike [R-IL-12]

Congress 119 • 2024 Election Cycle

Total Contributions
$104,500
19 donors
PACs
$0
Organizations
$12,100
Committees
$0
Individuals
$92,400

No PAC contributions found

1
AK-CHIN INDIAN COMMUNITY
2 transactions
$6,600
2
MIAMI TRIBE OF OKLAHOMA
1 transaction
$2,000
3
CAMPBELL FARMS
1 transaction
$1,500
4
MUSCOGEE CREEK NATION
2 transactions
$1,500
5
WAITE, TOMB & EBERLY LLP
1 transaction
$500

No committee contributions found

1
EMMET, RICHARD
4 transactions
$23,100
2
GILLIAM, RICHARD
2 transactions
$9,900
3
SCHWAB, CHARLES
1 transaction
$6,600
4
STERN, ELIZABETH MAY
1 transaction
$6,600
5
WEEKLEY, RICHARD
1 transaction
$6,600
6
BRADLEY, JACQUELINE
1 transaction
$6,600
7
BUKOWSKY, BRANT N. MR.
2 transactions
$6,600
8
BUKOWSKY, BROCK R. MR.
2 transactions
$6,600
9
BUKOWSKY, JENNIFER
1 transaction
$3,300
10
DONOHO, KIMBERLY K. MRS.
1 transaction
$3,300
11
FLINT, ETHAN
1 transaction
$3,300
12
GREENBLATT, SCOTT
1 transaction
$3,300
13
HOPKINS, JUSTIN MR.
1 transaction
$3,300
14
MCINERNEY, THOMAS E.
1 transaction
$3,300

Cosponsors & Their Campaign Finance

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

Rep. Bergman, Jack [R-MI-1]

ID: B001301

Top Contributors

10

1
MATCH-E-BE-NASH-SHE-WISH BAND OF POTTAWATOMI INDIANS
OrganizationSHELBYVILLE, MI
$3,300
Dec 8, 2023
2
SAGINAW CHIPPEWA INDIAN TRIBE
OrganizationMT. PLEASANT, MI
$3,300
Dec 8, 2023
3
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Jun 17, 2024
4
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Jun 30, 2023
5
PECHANGA BAND OF LUISENO INDIANS
OrganizationTEMECULA, CA
$3,000
Dec 31, 2023
6
SAULT STE MARIE TRIBE OF CHIPPEWA INDIANS
OrganizationSAULT SAINTE MARIE, MI
$2,900
Dec 7, 2023
7
DRESNER, LINDA
DRESNER DESIGNSCEO
IndividualBIRMINGHAM, MI
$6,600
Dec 6, 2023
8
LEVY, EDWARD
WEST BAY BEACH RESORTPRESIDENT
IndividualBIRMINGHAM, MI
$6,600
Dec 6, 2023
9
TAYLOR, MARGARETTA J. MS
NONERETIRED
IndividualNEW YORK, NY
$6,600
Mar 5, 2024
10
GREENBLATT, SCOTT
VETERANS GUARDIAN VA CLAIM CONSULTINGCEO
IndividualPINEHURST, NC
$6,600
Jun 29, 2023

Rep. Hamadeh, Abraham [R-AZ-8]

ID: H001098

Top Contributors

10

1
CLB PARTNERS
OrganizationGILBERT, AZ
$12,000
Jan 28, 2024
2
ADVANTAGE INSURANCE PLLC
OrganizationPHOENIX, AZ
$3,300
May 7, 2024
3
JARDIN RATZKEN PLLC
OrganizationTEMPE, AZ
$1,000
Feb 26, 2024
4
JARDIN RATZKEN PLLC
OrganizationTEMPE, AZ
$1,000
Mar 26, 2024
5
HAMADEH, WASEEM J
HOH INVESTMENT GROUPMANAGING MEMBER
IndividualPHOENIX, AZ
$13,200
Dec 29, 2023
6
MANLEY, DWIGHT
SELF-EMPLOYEDINVESTMENTS
IndividualBREA, CA
$13,200
Dec 13, 2023
7
HAYDEN, STEPHEN
ENTREPRENEURENTREPRENEUR
IndividualELLENSBURG, WA
$13,200
Mar 14, 2024
8
PRICE, KAPU
PATRIOT DISPOSALSELF-EMPLOYED
IndividualPRESCOTT, AZ
$13,200
Feb 29, 2024
9
HAYDEN, STEPHEN
ENTREPRENEURENTREPRENEUR
IndividualELLENSBURG, WA
$13,200
Mar 14, 2024
10
NOWOCIEN, PIOTR
RETIREDRETIRED
IndividualPINECREST, FL
$9,900
Mar 16, 2024

Rep. Miller-Meeks, Mariannette [R-IA-1]

ID: M001215

Top Contributors

10

1
SAC & FOX TRIBE OF THE MISSISSIPPI IN IOWA
COMTAMA, IA
$1,000
Aug 11, 2023
2
RENEWABLE ENERGY, CITIZENS FOR
COMMADISON, WI
$500
Aug 20, 2024
3
POLITICAL COMMITTEE, NWF ACTION FUND
PACWASHINGTON, DC
$500
Sep 18, 2024
4
US MARSHALS SERVICES
OrganizationNEW YORK, NY
$2,900
Apr 20, 2023
5
HUNTON ANDREWS KURTH LLP
OrganizationRICHMOND, VA
$1,000
Mar 22, 2023
6
HOGAN, PATRICK F
RETIREDRETIRED
IndividualDALLAS, TX
$13,200
Mar 15, 2023
7
HOLDEN, RONALD
RETIREDRETIRED
IndividualWILLIAMSBURG, IA
$13,200
Jun 20, 2023
8
VANDEWALLE, LOLA L
SELF-EMPLOYEDENTREPRENEUR
IndividualBLUE GRASS, IA
$13,200
Oct 16, 2023
9
GLEESON, JOHN W
KLINGER COMPANIES, LLCCEO
IndividualSIOUX CITY, IA
$11,600
Feb 15, 2023
10
SMITH, DYAN
HOMEMAKERHOMEMAKER
IndividualNAPLES, FL
$10,000
May 13, 2024

Rep. Barrett, Tom [R-MI-7]

ID: B001321

Top Contributors

10

1
MICHIGAN AGGREGATES ASSOCIATION PAC
OrganizationOKEMOS, MI
$300
Feb 27, 2024
2
DEMKOWICZ, BRIAN MR.
HURON CAPITALINVESTOR
IndividualGROSSE POINTE, MI
$13,200
Jan 8, 2024
3
STADLER, BRIAN
WOLGAST CORPORATIONMANAGER
IndividualSAGINAW, MI
$6,870
Sep 28, 2023
4
UIHLEIN, RICHARD
ULINECHAIRMAN
IndividualLAKE FOREST, IL
$6,870
Sep 26, 2023
5
COURTNEY, JOHN
RETIREDRETIRED
IndividualOKEMOS, MI
$6,870
Dec 8, 2023
6
BAKER, JEFFREY
MUSKEGON CAR CREDITEXECUTIVE
IndividualGRAND RAPIDS, MI
$6,600
Jul 25, 2023
7
BANCROFT, NICHOLAS
AGROLIQUIDCEO
IndividualSAINT JOHNS, MI
$6,600
Sep 19, 2023
8
HAWORTH, MATTHEW
HAWORTH, INC.CHAIRMAN
IndividualHOLLAND, MI
$6,600
Sep 18, 2023
9
HAWORTH, RICHARD
HAWORTH, INC.CHAIRMAN EMERITUS
IndividualSAUGATUCK, MI
$6,600
Sep 18, 2023
10
O'NEIL, WILLIAM
W J O'NEIL COMPANYEXECUTIVE
IndividualCOMMERCE TOWNSHIP, MI
$6,600
Sep 11, 2023

Rep. Kiggans, Jennifer A. [R-VA-2]

ID: K000399

Top Contributors

10

1
AIPAC- EARMARKS
PACWASHINGTON, DC
$2,000
Oct 22, 2024
2
PEAKE FOR SENATE
COMLYNCHBURG, VA
$500
Jan 9, 2024
3
PEAKE FOR SENATE
COMLYNCHBURG, VA
$250
Jan 9, 2024
4
KEHOE, MICHAEL
KINSALE MGMT INCCEO
IndividualRICHMOND, VA
$13,200
Jun 8, 2023
5
MITCHUM, ELZA
C & M INDUSTRIESPRESIDENT
IndividualCHESAPEAKE, VA
$6,600
Oct 18, 2023
6
SILVERMAN, JEFFREY
RETIREDRETIRED
IndividualMIAMI BEACH, FL
$6,600
Oct 17, 2023
7
PERRY, J DOUGLAS
RETIREDRETIRED
IndividualNORFOLK, VA
$6,600
Nov 6, 2023
8
WEEKLEY, RICHARD
SELF EMPLOYEDREAL ESTATE DEVELOPER
IndividualHOUSTON, TX
$6,600
Nov 8, 2023
9
GILLIAM, MARVIN
RETIREDRETIRED
IndividualBRISTOL, VA
$6,600
Mar 30, 2024
10
BOHANNON, DAVID
LONDON BRIDGE TRADING INC.PRESIDENT
IndividualVIRGINIA BEACH, VA
$6,600
May 23, 2024

Del. King-Hinds, Kimberlyn [R-MP-At Large]

ID: K000404

Top Contributors

0

No contribution data available

Rep. Bilirakis, Gus M. [R-FL-12]

ID: B001257

Top Contributors

10

1
COOL MASTER PRO LLC
OrganizationTAMPA, FL
$6,600
Mar 8, 2023
2
ARTECHE, LEON
V-ME MEDIA INC.CFO
IndividualDORAL, FL
$5,000
Jan 18, 2024
3
OF FLORIDA, SEMINOLE TRIBE
EMPLOYEE RECOGNIZED TRIBE
IndividualHOLLYWOOD, FL
$3,300
Aug 2, 2024
4
LAGOS, JAMES H.
LAGOS LAGOS, PLLATTORNEY
IndividualSPRINGFIELD, OH
$3,300
Sep 9, 2024
5
RICE, WILLIAM LLOYD
FALFURRIAS CAPITAL PARTNERS
IndividualMINT HILL, NC
$3,300
Sep 30, 2024
6
WANEK, RON
ASHLEY FURNITURE INDUSTRIES, INCCHAIRMAN OF THE BOARD
IndividualTAMPA, FL
$3,300
Oct 17, 2024
7
WANEK, TODD
ASHLEY FURNITURECEO
IndividualTAMPA, FL
$3,300
Oct 17, 2024
8
WANEK, JOYCE
N/AN/A
IndividualTAMPA, FL
$3,300
Oct 18, 2024
9
WANEK, KAREN
SUPERIOR FRESHOWNER
IndividualTAMPA, FL
$3,300
Oct 17, 2024
10
HEPSCHER, WILLIAM S
RX MANAGE USABUSINESS OWNER
IndividualTAMPA, FL
$3,300
Oct 30, 2024

Rep. Murphy, Gregory F. [R-NC-3]

ID: M001210

Top Contributors

10

1
DOISE, DARYL
OCEANS HEALTHCAREEXEC VP
IndividualDALLAS, TX
$6,700
Apr 1, 2024
2
DOISE, DARYL
IndividualDALLAS, TX
$6,700
Apr 10, 2024
3
KAPOOR, DEEPAK
SOLARIS HEALTHPHYSICIAN EXECUTIVE
IndividualFORT LAUDERDALE, FL
$6,600
Sep 23, 2024
4
KAPOOR, DEEPAK
IndividualFORT LAUDERDALE, FL
$6,600
Sep 30, 2024
5
SCHWARZMAN, STEPHEN
BLACKSTONECEO AND CHAIRMAN
IndividualNEW YORK, NY
$3,300
Oct 21, 2024
6
ARUMUGHAM, PRADEEP
ECUDOCTOR
IndividualKINSTON, NC
$3,300
Dec 11, 2023
7
BOWEN, JOEY M
PRIVATEER TOBACCO CO. INC.TOBACCONIST
IndividualGREENVILLE, NC
$3,300
Nov 15, 2023
8
BOWEN, JOEY M
PRIVATEER TOBACCO CO. INC.TOBACCONIST
IndividualGREENVILLE, NC
$3,300
Nov 15, 2023
9
CLARK, MELISSA A
HOMEMAKERHOMEMAKER
IndividualGREENVILLE, NC
$3,300
Oct 6, 2023
10
CLARK, MELISSA A
HOMEMAKERHOMEMAKER
IndividualGREENVILLE, NC
$3,300
Oct 6, 2023

Rep. Van Orden, Derrick [R-WI-3]

ID: V000135

Top Contributors

10

1
EASTERN BAND OF CHEROKEE INDIANS
OrganizationCHEROKEE, NC
$3,300
Dec 9, 2024
2
HO CHUNK NATION
OrganizationBLACK RIVER FALLS, WI
$3,300
Nov 2, 2024
3
FOREST COUNTY POTAWATOMI COMMUNITY
OrganizationCRANDON, WI
$3,300
Sep 17, 2024
4
AIPAC PAC CONDUIT ACCOUNT
OrganizationWASHINGTON, DC
$500
Oct 23, 2024
5
ALLIANCE OF BANKERS FOR WISCONSIN
OrganizationMADISON, WI
$250
Apr 23, 2024
6
ANDERSON, JOHN R. MR.
ANDERSON ENTERPRISES LLCOWNER
IndividualROCKFORD, IL
$10,000
Dec 19, 2023
7
BROIN, JEFF
POET LLCCEO
IndividualSIOUX FALLS, SD
$6,600
Aug 24, 2023
8
UIHLEIN, RICHARD E. MR.
ULINE INC.CEO
IndividualLAKE BLUFF, IL
$6,600
Feb 28, 2023
9
LEVY, EDWARD C.
EDW. C. LEVY CO.CHAIRMAN
IndividualBIRMINGHAM, MI
$6,600
Mar 28, 2024
10
LEVY, EDWARD C.
IndividualBIRMINGHAM, MI
$6,600
May 6, 2024

Rep. Franklin, Scott [R-FL-18]

ID: F000472

Top Contributors

10

1
SEMINOLE TRIBE OF FLORIDA
OrganizationHOLLYWOOD, FL
$3,300
Aug 23, 2023
2
SEMINOLE TRIBE OF FLORIDA
OrganizationHOLLYWOOD, FL
$3,300
Aug 16, 2024
3
MICCOSUKEE TRIBE
OrganizationMIAMI, FL
$1,000
Jan 30, 2024
4
CASSIDY, ALBERT B MR.
THE CASSIDY ORGANIZATION INC.REAL ESTATE
IndividualWINTER HAVEN, FL
$6,600
May 12, 2023
5
CASSIDY, GENA
IndividualWINTER HAVEN, FL
$6,600
Jun 16, 2023
6
CASSIDY, GLORIA
ENTREPRENEURENTREPRENEUR
IndividualWINTER HAVEN, FL
$6,600
May 12, 2023
7
CASSIDY, STEVEN L
IndividualWINTER HAVEN, FL
$6,600
Jun 16, 2023
8
SILBEY, ALEXANDER
ATS COMMUNICATIONS INCCONSULTANT
IndividualWASHINGTON, DC
$5,000
Mar 29, 2024
9
BRADY, JOSEPH P
RETIREDRETIRED
IndividualST. PETERSBURG, FL
$5,000
Aug 23, 2023
10
RAUCH, GEORGE W III
IndividualBRADENTON, FL
$4,000
Sep 29, 2023

Donor Network - Rep. Bost, Mike [R-IL-12]

PACs
Organizations
Individuals
Politicians

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

Loading...

Showing 67 nodes and 42 connections (65 secondary connections hidden)

Total contributions: $155,820

Top Donors - Rep. Bost, Mike [R-IL-12]

Showing top 19 donors by contribution amount

5 Orgs14 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 9 helped.

  • Section 106 extends the deadline for submitting claims by health care entities and providers under the prompt payment standard from 180 days to one year, which benefits hospitals and health systems by giving them more time to submit claims and receive payment.

  • +Health Insuranceconfidence 0.90

    Section 102 requires the Secretary to notify veterans of eligibility for care under the Veterans Community Care Program, which may increase utilization of community care services, potentially benefiting private health insurers that contract with VA to provide such care.

  • +Medical Devicesconfidence 0.80

    Section 106 extends the deadline for submitting claims by health care entities and providers under the prompt payment standard from 180 days to one year, which benefits medical device manufacturers and suppliers who bill the VA for devices and services.

  • Section 106 extends the deadline for submitting claims by health care entities and providers under the prompt payment standard from 180 days to one year, which benefits long-term care providers who bill the VA for services.

  • +Pharmaceuticalsconfidence 0.80

    Section 105 mandates discussion of telehealth options, which could increase access to prescription medications via telehealth, benefiting pharmaceutical manufacturers through higher medication adherence and sales.

  • +Biotech & Researchconfidence 0.70

    Section 106 extends the deadline for submitting claims by health care entities and providers under the prompt payment standard from 180 days to one year, which benefits biotech firms that provide services or products to the VA and bill for reimbursement.

+ 3 more industries not shown.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Rep. Bost, Mike [R-IL-12])received from donors associated with that industry during the 2022–present cycles. Donations are not proof of intent — they are a record of who funds the people writing the law.

Industries this bill HELPS

Project 2025 Policy Matches

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

Introduction

Moderate66.7%
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

Introduction

Moderate66.7%
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.

Introduction

Moderate66.7%
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,

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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.

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