Continuing Appropriations and Extensions and Other Matters Act, 2026

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Bill ID: 119/s/2882
Last Updated: June 15, 2026

Sponsored by

Sen. Murray, Patty [D-WA]

ID: M001111

Follow the money

The bill

Continuing Appropriations and Extensions and Other Matters Act, 2026

S. 2882, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Sen. Murray, Patty [D-WA]

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

The money

$83,550 raised

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

The alignment

55% match to Project 2025

This bill's text tracks the "Department of Defense" section, p. 128-130 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Motion by Senator Schumer to reconsider, under the order of 10/9/2025, not having voted on the prevailing side, the vote by which the third cloture motion on the motion to proceed to S. 2882 was not invoked (Record Vote No. 557) entered in Senate.

October 8, 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 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 exercise in legislative theater, where our esteemed lawmakers pretend to be responsible stewards of the public purse while actually perpetuating a never-ending cycle of waste, corruption, and bureaucratic bloat.

Let's dissect this monstrosity, shall we?

**Total Funding Amounts and Budget Allocations:** The bill authorizes "such amounts as may be necessary" for various departments and agencies, which is code for "we have no idea how much money we're actually spending." The lack of specificity is a hallmark of legislative laziness. I'd wager that the actual funding amounts will be determined by backroom deals and earmarks, not by any rational assessment of need or effectiveness.

**Key Programs and Agencies Receiving Funds:** The bill continues to fund various programs and agencies at levels similar to previous years, with some notable exceptions. The Department of Defense, for instance, receives a significant chunk of funding, but with caveats that prevent new production of items not funded in 2025 or prior years. This is likely a result of lobbying efforts by defense contractors who want to maintain their gravy train.

**Notable Increases or Decreases:** There are no significant increases or decreases from previous years, which suggests that our lawmakers are more interested in maintaining the status quo than making meaningful changes. The only notable exception is the provision that prohibits the initiation of new projects or activities without specific appropriations, which is a token attempt to appear fiscally responsible.

**Riders and Policy Provisions:** The bill includes several riders and policy provisions that have nothing to do with funding levels. For example, Section 111 attempts to limit the President's ability to propose changes to program funding, which is a transparent attempt to undermine executive authority. There are also provisions related to entitlements, mandatory payments, and food assistance programs, which are likely included to appease various special interest groups.

**Fiscal Impact and Deficit Implications:** The bill's fiscal impact is predictable: it will contribute to the ever-growing national debt and perpetuate a culture of fiscal irresponsibility. The lack of specificity in funding amounts and the inclusion of riders and policy provisions ensure that this bill will be a budget-buster.

In conclusion, this appropriations bill is a symptom of a deeper disease: the chronic inability of our lawmakers to prioritize responsible governance over partisan politics and special interests. It's a legislative placebo, designed to make voters feel like something is being done while actually perpetuating the same old wasteful practices.

Diagnosis: Terminal case of bureaucratic bloat, with symptoms including fiscal irresponsibility, lack of transparency, and an inability to prioritize meaningful reform. Prognosis: Poor. Treatment: A healthy dose of skepticism and a willingness to challenge the status quo.

Related Topics

Federal Budget & AppropriationsDefense Spending & Procurement
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

Sen. Murray, Patty [D-WA]

Congress 119 • 2024 Election Cycle

Total Contributions
$511,128
381 donors
PACs
$0
Organizations
$33,300
Committees
$0
Individuals
$477,828

No PAC contributions found

1
LOWER ELWHA KLALLAM TRIBE
2 transactions
$6,600
2
SAN PABLO LYTTON TRIBE
2 transactions
$6,600
3
PUYALLUP TRIBE OF INDIANS
3 transactions
$5,800
4
THE CHICKASAW NATION
1 transaction
$3,300
5
AK-CHIN INDIAN COMMUNITY
1 transaction
$2,500
6
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
2 transactions
$2,000
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SISSETON-WAHPETON OYATE
1 transaction
$2,000
8
YAKAMA NATION
1 transaction
$2,000
9
SQUAXIN ISLAND TRIBE
1 transaction
$1,500
10
SKOKOMISH INDIAN TRIBE
1 transaction
$1,000

No committee contributions found

1
ARNOLD, JOHN
2 transactions
$6,600
2
ARNOLD, LAURA
2 transactions
$6,600
3
BALLMER, CONNIE
2 transactions
$6,600
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3 transactions
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MICHAELS, LAURIE F.
2 transactions
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SILBEY, ALEXANDER
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ZECH, MARCIA W.
3 transactions
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CLARKSON, LLAYRON JR
2 transactions
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GRINSTEIN, CAROLYN H
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KISTLER, WILLIAM
3 transactions
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LEVIN, DEBORAH
2 transactions
$5,000
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MARTIN, LYLE C
2 transactions
$5,000
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ORLADY, DAVID
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SILL, MARCIA JOSLYN
3 transactions
$4,500
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SMITH, NANCY F.
3 transactions
$4,300
24
BYERS, MARGARET R
4 transactions
$4,000
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CAREY, JAMES
3 transactions
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BENOLIEL, JOEL
2 transactions
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1 transaction
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3 transactions
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HOLLOWAY, SAMANTHA B
1 transaction
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3 transactions
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COCHRAN, DARRELL
1 transaction
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HANSON, JON L
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1 transaction
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FRANK, JOHN E
1 transaction
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116
GARTH, GRETCHEN
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GATES, MIMI
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GATES, REBECCA
1 transaction
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119
GORDON, CAROL S.
2 transactions
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120
GREER, BRIAN
1 transaction
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121
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1 transaction
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1 transaction
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2 transactions
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1 transaction
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HOSTETLER, DAVID D.
2 transactions
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ISAKI, LUCY P.
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1 transaction
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1 transaction
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1 transaction
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1 transaction
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1 transaction
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1 transaction
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1 transaction
$1,000
148
MORGRIDGE, BARBARA G
2 transactions
$1,000
149
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1 transaction
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1 transaction
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O'NEILL, MAURA
1 transaction
$1,000
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ONEILL, MAURA
1 transaction
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1 transaction
$1,000
155
PARVIN, JEANNE L.
1 transaction
$1,000
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PEROT, MARGOT
1 transaction
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157
PERRICH, DOROTHY M
2 transactions
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158
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1 transaction
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159
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1 transaction
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160
PRUZAN, LUCIA S
1 transaction
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161
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1 transaction
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163
RICKERT, ALLEN
1 transaction
$1,000
164
ROBERTSON, WILLIAM G
1 transaction
$1,000
165
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1 transaction
$1,000
166
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2 transactions
$1,000
167
RUDD, ANNA D.
1 transaction
$1,000
168
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1 transaction
$1,000
169
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1 transaction
$1,000
170
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1 transaction
$1,000
171
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2 transactions
$1,000
172
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1 transaction
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173
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1 transaction
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174
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1 transaction
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175
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1 transaction
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176
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2 transactions
$1,000
177
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1 transaction
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178
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1 transaction
$1,000
179
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1 transaction
$1,000
180
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1 transaction
$1,000
181
VAN BUREN, WILLIAM S
1 transaction
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182
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1 transaction
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2 transactions
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ZEH, JUDITH E.
1 transaction
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1 transaction
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199
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1 transaction
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1 transaction
$500
201
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1 transaction
$500
204
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1 transaction
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205
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1 transaction
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1 transaction
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1 transaction
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1 transaction
$500
209
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1 transaction
$500
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1 transaction
$500
211
BOGARD, REBECCA L
1 transaction
$500
212
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1 transaction
$500
213
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1 transaction
$500
214
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1 transaction
$500
215
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1 transaction
$500
216
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1 transaction
$500
217
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1 transaction
$500
218
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1 transaction
$500
219
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1 transaction
$500
220
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1 transaction
$500
221
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1 transaction
$500
222
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1 transaction
$500
223
CHANG, FLORENCE S
1 transaction
$500
224
CLUBB, MEGAN
1 transaction
$500
225
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1 transaction
$500
226
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1 transaction
$500
227
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1 transaction
$500
228
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1 transaction
$500
229
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1 transaction
$500
230
DEEDER, JOHN
1 transaction
$500
231
DERR, CRAIG
1 transaction
$500
232
DESIMONE, RICHARD L
1 transaction
$500
233
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1 transaction
$500
234
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1 transaction
$500
235
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1 transaction
$500
236
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1 transaction
$500
237
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1 transaction
$500
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1 transaction
$500
239
EGGERTSEN, BEN
1 transaction
$500
240
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1 transaction
$500
241
ENSOR, DAVID
1 transaction
$500
242
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1 transaction
$500
243
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1 transaction
$500
244
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1 transaction
$500
245
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1 transaction
$500
246
FRASIER, GRETCHEN G
1 transaction
$500
247
FRASIER, GRETCHEN G.
1 transaction
$500
248
FUGERE, JOE
1 transaction
$500
249
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1 transaction
$500
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1 transaction
$500
251
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1 transaction
$500
252
GLICKMAN, DANIEL R.
1 transaction
$500
253
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1 transaction
$500
254
GOWN, CAROL J.
1 transaction
$500
255
GRIFFIN, MATT
1 transaction
$500
256
GRUDIN, DANIEL F
1 transaction
$500
257
GUDGEL, DAVID
1 transaction
$500
258
GUSTITIS, LILLIAN S
1 transaction
$500
259
HANDSFIELD, H. HUNTER
1 transaction
$500
260
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1 transaction
$500
261
HARTMANN, JUDITH L.
1 transaction
$500
262
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1 transaction
$500
263
HELDE, KATHRYN
1 transaction
$500
264
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1 transaction
$500
265
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1 transaction
$500
266
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1 transaction
$500
267
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1 transaction
$500
268
HOSLEY, THERESA PAN
1 transaction
$500
269
HUDSON, RICHARD B
1 transaction
$500
270
HUGHES, VALERIE
1 transaction
$500
271
INVEEN, LAURA
1 transaction
$500
272
JOHNSON, THEODORE C
1 transaction
$500
273
JONES, DAVE
1 transaction
$500
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JUSTIN, JIM
1 transaction
$500
275
KELLY, MICHAEL JOSEPH
1 transaction
$500
276
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1 transaction
$500
277
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1 transaction
$500
278
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1 transaction
$500
279
KUHN, HANNAH M.
1 transaction
$500
280
LAMP, CHARLOTTE
1 transaction
$500
281
LANGE, RANDALL W
1 transaction
$500
282
LARSEN, JOHNINE L
1 transaction
$500
283
LAZOWSKA, ED D
1 transaction
$500
284
LEONARD, DANIEL J
1 transaction
$500
285
LEVINGER, JANET
1 transaction
$500
286
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1 transaction
$500
287
LOE, GERI L
1 transaction
$500
288
LUND, BERNEDINE M.
1 transaction
$500
289
LYONS, TOM
1 transaction
$500
290
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1 transaction
$500
291
MANAGEMENT, ACR
1 transaction
$500
292
MARQUARDT, JUD R
1 transaction
$500
293
MARTIN, BEVERLY M
1 transaction
$500
294
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1 transaction
$500
295
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1 transaction
$500
296
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1 transaction
$500
297
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1 transaction
$500
298
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1 transaction
$500
299
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1 transaction
$500
300
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1 transaction
$500
301
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1 transaction
$500
302
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1 transaction
$500
303
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1 transaction
$500
304
MILLAR, ROGER
1 transaction
$500
305
MILLER, BARBARA A
1 transaction
$500
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MOORE, JULIE
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NONNEMAN, ELAINE M
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OBERBILLIG, MOLLY
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OLSEN, LYNN
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OLSON, LEE
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ORIANS, GORDON
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OTOROWSKI, CHRIS
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OVERTON, DAVID E.
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PERRICH, DOROTHY M.
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PETRO, JOHN W.
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PRESTON, BARBARA
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PUTNEY, APRIL
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RABINOWITZ, ANDREA
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READ, ALEXANDRA
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REDMAN, ANNE M
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REED, MELANIE
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RICH, STACY
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RIDDLE, CLARINE
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RIZZOLO, CAROL
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ROBBINS, BONNIE B
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ROBBINS, MICHAEL
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ROBINSON, SETH
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ROTHROCK, LOLLY
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RUGGIERO, FRANK
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SANDOVAL, MICHAEL
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SCHAUER, JAYNE
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SCHRAYER, LIZ
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SHERRIS, JACQUELINE
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SHORETT, ALICE
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SPENCER, RAYMOND
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STECKMAN, MATTHEW
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STEGMAN, TODD
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STEINMAN, JONATHAN
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STERLING, GEORGE
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STESLICKI, JEREMY
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STEWART, GREGORY
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STILLMAN, CHARLES
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SVINTH, MARIAN
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TATELMAN, DAVID W
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THAYER, WILLIAM J.
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THOMAS, DAVID
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THOMPSON, GAYLE
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THOMPSON, JOHN R.
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THORNELL, PAUL
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UTELA, DAVID R
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VOCKLER, LARRY
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WALL, MARILYN J.
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WEISENBACH, JACQUINOT
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WEITKAMP, WILLIAM
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WHITAKER, KEN
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WILEY, ROBERT
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WILLIAMS, LARRY
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WITMAN, MARJORIE
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WOHL, RONALD
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WOLFWILETS, VIVIAN
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Donor Network - Sen. Murray, Patty [D-WA]

PACs
Organizations
Individuals
Politicians

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

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Showing 68 nodes and 30 connections (80 secondary connections hidden)

Total contributions: $83,550

Top Donors - Sen. Murray, Patty [D-WA]

Showing top 24 donors by contribution amount

10 Orgs14 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 23 helped, 1 harmed.

  • Section 2111 extends increased inpatient hospital payment adjustments for certain low-volume hospitals, providing continued funding that benefits hospitals and health systems.

  • +Defense Contractorsconfidence 0.90

    Section 131 allows Department of Defense funds for Shipbuilding and Conversion, Navy to be used for completion of prior year shipbuilding programs (Virginia Class Submarine Programs), and Section 132 extends funding for the E-7 Wedgetail program, both benefiting defense contractors.

  • +Pharmaceuticalsconfidence 0.90

    Section 2102 extends Special Diabetes Programs for Type I Diabetes and for Indians, providing funding for diabetes treatments and medications, which benefits pharmaceutical manufacturers.

  • +Cybersecurityconfidence 0.90

    Sections 2309, 2310, and 2311 extend various cybersecurity programs (National Cybersecurity Protection System, State and Local Cybersecurity Grant Program, Cybersecurity Information Sharing), directly benefiting cybersecurity firms.

  • +Health Insuranceconfidence 0.85

    Section 2115 extends funding for outreach and assistance for low-income programs, including State Health Insurance Assistance Programs, Area Agencies on Aging, Aging and Disability Resource Centers, and coordination efforts, which supports health insurance enrollment and assistance activities.

  • Section 163 maintains Essential Air Service program operations, supporting surface transportation logistics and freight rail/trucking industries that depend on air cargo connections.

+ 18 more industries not shown.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Sen. Murray, Patty [D-WA])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.AI-enhanced analysis provides detailed alignment ratings.

Department of Defense

Weak
Vector: 64%
Pages: 128-130AI Enhanced

AI Analysis:

"The bill maintains FY 2025 funding levels and restricts new production or increases, which contrasts with Project 2025's goals of accelerating procurement, prototyping, and industrial base reforms. There is only a tangential connection through continued defense funding and procurement oversight."

Key themes:Defense fundingProcurement oversightContinuing operationsAcquisition process

— 96 — Mandate for Leadership: The Conservative Promise relevant. This allows the acquisition community to focus on portfolio management and move money around more easily instead of being locked into inflexible, multiyear procurement cycles. 2. The President should examine the recommendations of the congressionally mandated Commission on Planning, Programming, Budgeting, and Execution Reform4 and develop a strategy for implementing those that the Administration considers to be in the best interests of the American people. The commission’s final report is due on September 1, 2023. 3. Develop legislation or other means of providing funding outside the traditional PPBE process for the prototyping and experimentation of emerging technologies that are deemed essential to modernization and future conflict. Consider creating a “fast track” for projects that satisfy the most pressing national security needs. 4. Require the Under Secretary of Defense for Acquisition and Sustainment, the Under Secretary for Research and Engineering, and all service secretaries to conduct “Night Court” and use existing authorities to terminate outdated or underperforming programs so that money can be used for what works and will work. Require the Under Secretaries and service secretaries to brief the Secretary annually on the results. 5. Require the Office of the Secretary of Defense to research and report on the acquisition processes used by America’s adversaries to improve our understanding of how they are often able to innovate and field new technologies on a faster timeline. l Strengthen America’s defense industrial base. 1. Replenish and maintain U.S. stockpiles of ammunition and other equipment that have been depleted as a result of U.S. support to Ukraine. This will strengthen the defense industry supply chain and ensure that adequate inventory exists if it is needed for a future conflict. 2. Collaborate with industry to develop a prioritized list of reforms that the DOD and Congress can enact and implement to incentivize industry to help America’s military innovate and field needed capabilities. — 97 — Department of Defense 3. Strengthen the ability of acquisition authorities to engage in multiyear procurements and block buys. This will improve private-sector rates of return, thereby incentivizing defense contractors to partner with the government. It will also reduce government overhead by reducing the number of procurement competitions. 4. Prioritize the U.S. and allies under the “domestic end product” and “domestic components” requirements of the Build America, Buy America Act.5 Currently, defense companies are required to manufacture defense items for the U.S. government that are 100 percent domestically produced and at least 50 percent composed of domestically produced components. However, there are loopholes that allow companies to manufacture these items overseas. This can create supply chain and other issues, especially in wartime. Manufacturing components and end products domestically and with allies spurs factory development, increases American jobs, and builds resilience in America’s defense industrial base. 5. Review the sectors currently prioritized for onshoring or “friendshoring” of manufacturing (kinetic capabilities, castings and forgings, critical materials, microelectronics, space, and electric vehicle batteries); evaluate them according to the strategic landscape; and expand or reprioritize the list as appropriate. 6. Help small businesses to become medium-size and large vendors, which encourages a more resilient industrial base and fosters competition. Encourage and plan for durable supply chains for small businesses so they also have commercial/private-sector customers and are not solely dependent on defense orders, which can be highly specialized, expensive, and irregular. 7. Increase external engagement among small businesses to inform them of DOD’s needs and how they could work with DOD to meet national security priorities. l Optimize the DOD acquisition community. 1. Create incentives to emphasize speed and agility in decision-making for prototyping and program-of-record starts and terminations. Most bureaucrats would rather follow a checklist and fail than go outside the procedures and win because failure means negative

Department of Defense

Weak
Vector: 62%
Pages: 128-130AI Enhanced

AI Analysis:

"The bill maintains current defense funding levels and restricts new production increases, which does not actively advance Project 2025's goals of expanding and modernizing the nuclear force or reforming defense acquisition. While it sustains operations, it lacks the proactive measures called for in the policy."

Key themes:Department of Defensedefense fundingacquisition restrictions

— 95 — Department of Defense 1. Expand and modernize the U.S. nuclear force so that it has the size, sophistication, and tailoring to deter Russia and China simultaneously. 2. Develop a nuclear arsenal with the size, sophistication, and tailoring— including new capabilities at the theater level—to ensure that there is no circumstance in which America is exposed to serious nuclear coercion. l Increase allied counterterrorist burden-sharing. Transnational terrorism remains a threat to Americans even as we pivot toward Asia. 1. Sustain the military forces needed to deter, prevent, and combat terrorism, but at a sustainable cost in concert with other elements of national power and partner efforts. 2. Prioritize enhancing the capability of allies and partners to take the lead in combating terrorism in their regions. DOD ACQUISITION AND SUSTAINMENT (A&S) The DOD’s ability to acquire and field new and existing technologies is essential to the ability of America’s military personnel to fight and win our nation’s wars. To succeed in this endeavor, we must optimize the systems and personnel that the department uses, but the inflexible bureaucratic structure and risk-adverse culture that have developed over the decades make it difficult to provide the tools that warfighters need at the speed of relevance. The number one problem is the DOD budgeting process (instituted in 1961) that requires acquisition spending to be locked years in advance. Because tech- nologies change so rapidly and requirements can change overnight, this creates situations in which military personnel not only go to war with outdated technol- ogy, but also may be fighting with equipment that is less capable than that of their competitors. America owes its military many things, and the most important is the resources they need to survive on the battlefield and carry out the tasks we ask of them. Needed Reforms l Reform the planning, programming, budgeting, and execution (PPBE) process. 1. Enhance funding and authority for DOD mission-focused innovation organizations and away from program-specific stovepipes that, planned for and designed two or three years earlier, may no longer be — 96 — Mandate for Leadership: The Conservative Promise relevant. This allows the acquisition community to focus on portfolio management and move money around more easily instead of being locked into inflexible, multiyear procurement cycles. 2. The President should examine the recommendations of the congressionally mandated Commission on Planning, Programming, Budgeting, and Execution Reform4 and develop a strategy for implementing those that the Administration considers to be in the best interests of the American people. The commission’s final report is due on September 1, 2023. 3. Develop legislation or other means of providing funding outside the traditional PPBE process for the prototyping and experimentation of emerging technologies that are deemed essential to modernization and future conflict. Consider creating a “fast track” for projects that satisfy the most pressing national security needs. 4. Require the Under Secretary of Defense for Acquisition and Sustainment, the Under Secretary for Research and Engineering, and all service secretaries to conduct “Night Court” and use existing authorities to terminate outdated or underperforming programs so that money can be used for what works and will work. Require the Under Secretaries and service secretaries to brief the Secretary annually on the results. 5. Require the Office of the Secretary of Defense to research and report on the acquisition processes used by America’s adversaries to improve our understanding of how they are often able to innovate and field new technologies on a faster timeline. l Strengthen America’s defense industrial base. 1. Replenish and maintain U.S. stockpiles of ammunition and other equipment that have been depleted as a result of U.S. support to Ukraine. This will strengthen the defense industry supply chain and ensure that adequate inventory exists if it is needed for a future conflict. 2. Collaborate with industry to develop a prioritized list of reforms that the DOD and Congress can enact and implement to incentivize industry to help America’s military innovate and field needed capabilities.

Department of Veterans Affairs

Weak
Vector: 62%
Pages: 679-681AI Enhanced

AI Analysis:

"The bill continues existing VA funding levels but does not include any of the specific VA reform initiatives outlined in Project 2025, such as caregiver program overhaul, infrastructure realignment, or innovation office changes."

Key themes:veterans benefitscontinued fundingmandatory payments

— 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.

Showing 3 of 5 policy matches

About These Correlations

Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.

Full Policy Text

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