Representing our Seniors at VA Act of 2026

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Bill ID: 119/hr/785
Last Updated: July 7, 2026

Sponsored by

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

ID: K000399

Follow the money

The bill

Representing our Seniors at VA Act of 2026

HR. 785, 119th Congress — read as touching Long-Term Care & Nursing Homes.

The sponsor

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

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

The money

$141,350 raised

23 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

Placed on the Union Calendar, Calendar No. 498.

April 1, 2026

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 masterpiece of legislative theater, courtesy of the 119th Congress. Let's dissect this farce, shall we?

**Main Purpose & Objectives:** The "Representing our Seniors at VA Act of 2026" (HR 785) claims to aim at improving the representation of seniors in the Department of Veterans Affairs' Geriatrics and Gerontology Advisory Committee. How noble. In reality, it's just a thinly veiled attempt to insert another special interest group into the committee, because what every bureaucratic body needs is more self-serving representatives.

**Key Provisions & Changes to Existing Law:** The bill amends title 38 of the United States Code to include a representative from the National Association of State Veterans Homes on the advisory committee. Oh, and they've also added some token language about including individuals with professional licenses in nursing home administration, because who doesn't love a good dose of bureaucratic redundancy? It's like adding another layer of unnecessary complexity to an already Byzantine system.

**Affected Parties & Stakeholders:** The usual suspects: veterans, their families, and the National Association of State Veterans Homes. But let's be real, the only ones who truly benefit from this bill are the lobbyists and special interest groups who will now have a seat at the table. The rest are just pawns in this game of legislative charades.

**Potential Impact & Implications:** This bill is a classic case of "legislative lip service." It's a Band-Aid on a bullet wound, a token gesture to appease the masses while doing nothing to address the real issues plaguing the VA. The added bureaucracy will only serve to slow down an already glacial process, ensuring that our veterans continue to suffer from inadequate care and support. But hey, at least the politicians can point to this bill and say they're "doing something" for our seniors.

In conclusion, HR 785 is a textbook example of legislative malpractice. It's a cynical attempt to appease special interest groups while ignoring the real problems facing our veterans. The sponsors of this bill should be ashamed of themselves, but let's be real, they're probably too busy counting their campaign contributions to care. Now, if you'll excuse me, I have better things to do than watch this train wreck unfold. Next patient, please!

Related Topics

Military & Veterans AffairsCongressional Rules & Procedures
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

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

Congress 119 • 2024 Election Cycle

Total Contributions
$141,350
21 donors
PACs
$2,000
Organizations
$0
Committees
$0
Individuals
$138,600
1
AIPAC- EARMARKS
1 transaction
$2,000

No organization contributions found

No committee contributions found

1
KEHOE, MICHAEL
1 transaction
$13,200
2
SCHWARTZBERG, ANDREW
2 transactions
$13,200
3
MITCHUM, ELZA
1 transaction
$6,600
4
SILVERMAN, JEFFREY
1 transaction
$6,600
5
PERRY, J DOUGLAS
1 transaction
$6,600
6
WEEKLEY, RICHARD
1 transaction
$6,600
7
GILLIAM, MARVIN
1 transaction
$6,600
8
BOHANNON, DAVID
1 transaction
$6,600
9
FAISON, JAY W.
1 transaction
$6,600
10
KILMER, RONALD L. MR.
1 transaction
$6,600
11
UIHLEIN, RICHARD E.
1 transaction
$6,600
12
YOUNGKIN, GLENN A.
1 transaction
$6,600
13
NERO, TONY
1 transaction
$6,600
14
HOLLAND, LAWIS STANLEY
1 transaction
$6,600
15
COPELAND, TODD A.
1 transaction
$6,600
16
FELTON, NICOLINA
1 transaction
$6,600
17
THURMOND, RICHARD
1 transaction
$6,600
18
KELLY, SUSAN
1 transaction
$6,600
19
GILLIAM, RICHARD
1 transaction
$6,600

Cosponsors & Their Campaign Finance

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

Rep. Cherfilus-McCormick, Sheila [D-FL-20]

ID: C001127

Top Contributors

10

1
AMERICAN ISRAEL PUBLIC AFFAIRS COMMITTEE POLITICAL ACTION COMMITTEE
PACWASHINGTON, DC
$500
Nov 4, 2024
2
SEMINOLE TRIBE OF FLORIDA
OrganizationHOLLYWOOD, FL
$3,300
Aug 20, 2024
3
SEMINOLE TRIBE OF FLORIDA
OrganizationHOLLYWOOD, FL
$3,300
Sep 8, 2023
4
FIGGERS, FREDDIE
FIGGERSINVENTOR
IndividualFORT LAUDERDALE, FL
$6,600
Jun 8, 2023
5
FIGGERS, FREDDIE
IndividualFORT LAUDERDALE, FL
$6,600
Sep 25, 2023
6
MOISE, RUDOLPH
IndividualDAVIE, FL
$3,300
Oct 7, 2024
7
GEORGE, DAVID J.
REFUEL DEPOT LLCSALES
IndividualLEADWOOD, KS
$3,300
Sep 27, 2024
8
GOLDEN, SYLVIA
NONERETIRED
IndividualWEST PALM BEACH, FL
$3,300
Aug 18, 2024
9
GORI, PHILIP
SELFINVESTOR
IndividualBOCA RATON, FL
$3,300
Sep 16, 2024
10
MUELLER, KYLE
ZUTEKDIRECTOR OF TECHNICAL SUPPORT SERVICES
IndividualOLATHE, KS
$3,300
Sep 27, 2024

Rep. Biggs, Sheri [R-SC-3]

ID: B001325

Top Contributors

10

1
BENNETT, HEATHER
IndividualTOWNVILLE, SC
$6,600
Feb 12, 2024
2
COX, HOWARD
RETIREDRETIRED
IndividualSENECA, SC
$6,600
Mar 18, 2024
3
SCOTT, MARILYN
RETIREDRETIRED
IndividualKOSCIUSKO, MS
$6,600
Feb 12, 2024
4
SEYMORE, GARY W
RETIREDRETIRED
IndividualANDERSON, SC
$6,600
Feb 12, 2024
5
MATTEO, CHRIS
UBSFINANCIAL ADVISOR
IndividualHOBOKEN, NJ
$5,000
Mar 6, 2024
6
CASSELS, W.T. JR.
SOUTHEASTERN FRIGHT LINESPRESIDENT
IndividualCOLUMBIA, SC
$3,500
Oct 30, 2024
7
CASSELS, W TOBIN III
SOUTHEASTERN FREIGHT LINESPRESIDENT
IndividualCOLUMBIA, SC
$3,500
Oct 30, 2024
8
ARIAIL, BRANDI C
CROSSWALK HOLDINGS, INC.INVESTOR
IndividualGREENVILLE, SC
$3,500
Mar 22, 2024
9
FLOYD, KAREN KANES
THE PALLADIAN GROUP INCPUBLIC RELATIONS
IndividualSPARTANBURG, SC
$3,500
Jun 18, 2024
10
SIMPSON, DARWIN H
RETIREDRETIRED
IndividualSPARTANBURG, SC
$3,500
Jun 18, 2024

Rep. Suozzi, Thomas R. [D-NY-3]

ID: S001201

Top Contributors

10

1
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$3,300
Aug 3, 2024
2
SCOTTO LLC
OrganizationWOODBURY, NY
$1,650
Aug 30, 2024
3
PATROON OPERATING CO. LLC
OrganizationNEW YORK, NY
$1,000
May 13, 2024
4
THE KLAR ORGANIZATION
OrganizationEAST MEADOW, NY
$1,000
Aug 8, 2024
5
TERIAN, OLIVIA
IndividualNEW YORK, NY
$9,400
May 2, 2024
6
TERIAN, OLIVIA
OLIVIA TERIAN ART & DESIGNBUSINESS OWNER
IndividualNEW YORK, NY
$6,600
Mar 8, 2024
7
MORAN, MARY
NOT EMPLOYEDRETIRED
IndividualGREENWICH, CT
$6,600
Mar 28, 2024
8
MORAN, MARY
IndividualGREENWICH, CT
$6,600
May 2, 2024
9
FAIVUS, HARRY E.
MOUNT SINAIPHYSICIAN
IndividualNEW YORK, NY
$5,000
Oct 31, 2024
10
SOSNICK, AARON
IndividualRENO, NV
$3,392
Jun 25, 2024

Rep. Davis, Donald G. [D-NC-1]

ID: D000230

Top Contributors

10

1
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$3,300
Mar 5, 2024
2
TUNICA-BILOXI TRIBE OF LA
OrganizationMARKSVILLE, LA
$2,000
Dec 31, 2023
3
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,650
Jun 6, 2023
4
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,650
May 13, 2024
5
BARONA BAND OF MISSION INDIANS
OrganizationLAKESIDE, CA
$1,500
May 31, 2023
6
CHEROKEE NATION
OrganizationTAHLEQUAH, OK
$1,000
Dec 28, 2023
7
FISHER, DEBORAH
NOT EMPLOYEDNOT EMPLOYED
IndividualCOEUR D ALENE, ID
$4,000
Jul 29, 2024
8
BLOOM, BRADLEY
BERKSHIRE PARTNERS LLCINVESTMENTS
IndividualWELLESLEY, MA
$3,300
Oct 31, 2024
9
BRAUFMAN, JILL
NOT EMPLOYEDRETIRED
IndividualSURFSIDE, FL
$3,300
Oct 18, 2024
10
CLAPP, STEPHEN
SELF EMPLOYEDRANCHER
IndividualSEQUIM, WA
$3,300
Oct 30, 2024

Rep. Gillen, Laura [D-NY-4]

ID: G000602

Top Contributors

10

1
RALLYE MOTORS
OrganizationROSLYN, NY
$6,000
Jul 18, 2023
2
RALLYE MOTORS
OrganizationROSLYN, NY
$6,000
Jun 5, 2023
3
FEDERATED INDIANS OF GRATON RANCHERIA
OrganizationROHNERT PARK, CA
$1,000
Aug 1, 2024
4
STONE, JAMES M
PLYMOUTH ROCK COMPANY, INC.EXECUTIVE
IndividualBOSTON, MA
$5,000
Oct 16, 2024
5
FAIVUS, HARRY E
SELF-EMPLOYEDOPHTHALMOLOGIST
IndividualNEW YORK, NY
$5,000
Nov 1, 2024
6
STONE, JAMES M
PLYMOUTH ROCK COMPANY, INC.EXECUTIVE
IndividualBOSTON, MA
$5,000
Oct 16, 2024
7
HELFER, RICKI
N/ANOT EMPLOYED
IndividualWASHINGTON, DC
$4,000
Sep 10, 2024
8
ANDEER, KYLE
APPLE INCATTORNEY
IndividualSAN FRANCISCO, CA
$3,300
Mar 27, 2024
9
BINDER, CHARLES
SELF-EMPLOYEDATTORNEY
IndividualNEW YORK, NY
$3,300
Mar 21, 2024
10
BURNSTEIN, CLIFFORD
Q PRIMEMANAGER
IndividualNEW YORK, NY
$3,300
Mar 28, 2024

Rep. LaLota, Nick [R-NY-1]

ID: L000598

Top Contributors

0

No contribution data available

Rep. Fulcher, Russ [R-ID-1]

ID: F000469

Top Contributors

10

1
ROBU, ELI
AJ GENERAL CONTRACTORSCONSTRUCTION
IndividualWORLEY, ID
$3,300
Aug 4, 2024
2
SCOTT, JB
SELF EMPLOYEDREAL ESTATE DEVELOPER
IndividualBOISE, ID
$3,300
Apr 16, 2024
3
VANDERSLOOT, FRANK
MELALEUCACEO
IndividualIDAHO FALLS, ID
$3,300
May 1, 2024
4
TURLINGTON, SCOTT
TAMARACK RESORTHOSPITALITY
IndividualTAMARACK, ID
$3,300
Apr 20, 2024
5
VANDERSLOOT, BELINDA
HOMEMAKERHOMEMAKER
IndividualIDAHO FALLS, ID
$3,300
May 1, 2024
6
BENNETT, BRETT
BENNETT LUMBERPRESIDENT
IndividualMOSCOW, ID
$3,300
Oct 28, 2023
7
WILLIAMS, LARRY
TREE TOP RANCHESOWNER
IndividualBOISE, ID
$3,300
Feb 13, 2024
8
CENTERS, JAKE
RETIREDRETIRED
IndividualMERIDIAN, ID
$3,300
Feb 15, 2024
9
ROOPE, CALEB
THE PACIFIC COMPANIESCEO
IndividualEAGLE, ID
$3,300
Mar 4, 2024
10
ROOPE, CALEB
THE PACIFIC COMPANIESCEO
IndividualEAGLE, ID
$3,300
Mar 4, 2024

Rep. Taylor, David [R-OH-2]

ID: T000490

Top Contributors

10

1
POLITICAL EDUCATION PATTERNS LOCAL 18 OF THE INTERNATIONAL UNION OF OPERATING ENGINEERS
OrganizationCLEVELAND, OH
$5,000
Aug 9, 2024
2
ELITE MOVING & TRANSPORT LLC
OrganizationBATAVIA, OH
$700
Mar 1, 2024
3
WOESTE, BILL
BEECHMONT AUTOMOTIVE GROUPAUTO DEALER
IndividualCINCINNATI, OH
$3,435
Jul 23, 2024
4
SIMS, MICHAEL
RETIREDRETIRED
IndividualCINCINNATI, OH
$3,435
Oct 9, 2024
5
ATIKIAN, SETRAK
SELFINSURANCE
IndividualGALENA, OH
$3,300
Oct 18, 2024
6
MELKUMIAN, VIOLETTA
SELFSELF EMPLOYED
IndividualWESTERVILLE, OH
$3,300
Oct 18, 2024
7
SAFARYAN, ERNA
SELFDENTIST
IndividualGALENA, OH
$3,300
Oct 18, 2024
8
SAFARYAN, SERGEY
SELFAUTO DEALER
IndividualGALENA, OH
$3,300
Oct 18, 2024
9
SAFARYAN, TIGRAN
SELFAUTO DEALER
IndividualCOLUMBUS, OH
$3,300
Oct 18, 2024
10
HOUSER, JOHN
IndividualBATAVIA, OH
$3,300
Dec 13, 2023

Rep. Garbarino, Andrew R. [R-NY-2]

ID: G000597

Top Contributors

10

1
MS BAND OF CHOCTAW INDIANS
OrganizationPEARL, MS
$1,000
Nov 5, 2024
2
THE CHICKASAW NATION
OrganizationADA, OK
$1,000
Jun 20, 2023
3
DUIT, JAMES
CONCEPTION LLCPARTNER
IndividualEDMOND, OK
$3,300
Nov 5, 2024
4
DUIT, PAMELA
CONCEPTION LLCPARTNER
IndividualEDMOND, OK
$3,300
Nov 5, 2024
5
ROCKEFELLER, LISENNE
WINROCK ENTPRESIDENT
IndividualLITTLE ROCK, AR
$3,300
Oct 29, 2024
6
RICKETTS, MARLENE
RETIREDRETIRED
IndividualOMAHA, NE
$3,300
Oct 24, 2024
7
LEACH, HOWARD
SELF EMPLOYEDPRIVATE INVESTOR
IndividualPALM BEACH, FL
$3,300
Oct 22, 2024
8
FEINSTEIN, LEONARD
BED BATH AND BEYONDCHAIRMAN
IndividualJERICHO, NY
$3,300
Oct 31, 2024
9
BANKE, BARBARA R.
JACKSON FAMILY WINESOWNER
IndividualGEYSERVILLE, CA
$3,300
Nov 15, 2023
10
SMITH, HOLLY
SHOOK HARDY BACON LLPATTORNEY
IndividualSAINT LOUIS, MO
$3,300
Dec 22, 2023

Rep. Meng, Grace [D-NY-6]

ID: M001188

Top Contributors

10

1
BARONA BAND OF MISSION INDIANS
OrganizationLAKESIDE, CA
$1,500
May 19, 2023
2
BARONA BAND OF MISSION INDIANS
OrganizationLAKESIDE, CA
$1,500
Jun 30, 2024
3
BENEDICT, DANIEL
SELFINV
IndividualWOODMERE, NY
$3,300
Oct 10, 2024
4
COOPER, TODD
RIPCO REAL ESTATEOWNER
IndividualOYSTER BAY, NY
$3,300
Nov 4, 2024
5
FEINSTEIN, LEONARD
NOT EMPLOYEDNOT EMPLOYED
IndividualSPRINGFIELD, NJ
$3,300
Oct 31, 2024
6
JUNGREIS, AARON S.
ROSEWOOD REALTY GROUPRE BROKER
IndividualLAWRENCE, NY
$3,300
Oct 10, 2024
7
KATZ, ADAM
SELFREAL ESTATE
IndividualFARMINGDALE, NY
$3,300
Oct 17, 2024
8
SHERMAN, I
NOT EMPLOYEDNOT EMPLOYED
IndividualFLUSHING, NY
$3,300
Oct 8, 2024
9
SILVERSTEIN, WILLIAM
BEALREAL ESTATE INVESTOR
IndividualHIGHLAND PARK, IL
$3,300
Oct 15, 2024
10
VASAN, ASHWIN
NEW YORK-PRESBYTERIAN HOSPITALPHYSICIAN
IndividualBROOKLYN, NY
$3,300
Oct 23, 2024

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

PACs
Organizations
Individuals
Politicians

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

Loading...

Showing 61 nodes and 38 connections (45 secondary connections hidden)

Total contributions: $194,150

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

Showing top 21 donors by contribution amount

1 PAC1 Committee19 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 1 helped.

  • Section 2 amends the membership of the Department of Veterans Affairs Geriatrics and Gerontology Advisory Committee to include at least one individual who has served veterans or families of veterans in a State home, which may benefit the long-term care industry by providing them with a representative on the committee.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Rep. Kiggans, Jennifer A. [R-VA-2])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

Moderate65.2%
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

Moderate65.2%
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

Moderate65.2%
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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