Three years after the MISSION Act was signed, we still have a long way to go

It has been three years since the 2018 VA MISSION Act was signed into law, and two years since its implementation began. The law, which passed with overwhelming bipartisan support, promised to revolutionize veterans’ health care and the way the Department of Veterans Affairs facilitates delivery.

There has been real success to date. Clear eligibility criteria are now established for veterans to access community care, urgent care services allow rapid access to treatment wherever required, and more resources are now available for family caregivers who provide for the needs of their veterans.

These changes represent some reprieve for those who have suffered weeks or months waiting for appointments, or families that have long been without access to needed resources.

But I am not satisfied with the pace or substance of reforms at the VA over the last three years. Nobody making an objective assessment should be.

Implementation of the community care access standards has been painfully slow and inconsistent. Veterans are still waiting far too long to receive care at a VA facility or to be referred to a private facility under the law’s access standards.

The COVID-19 pandemic exacerbated those issues. In the spring of 2020, instead of allowing veterans to seek care wherever it was available, VA officials paused application of the access standards. In pausing the program, the VA disregarded the law by failing to refer eligible veterans to community providers.

Since the pandemic hit, nearly 20 million VA appointments have been canceled, 7.3 million in just the first six weeks. More than 2 million appointments were not even tracked for follow up.

The pandemic presented complex challenges. But in such circumstances, individuals are best off with choices, flexibility, and the power to be their own advocates when others cannot or will not.

The VA answered instead with tighter control. At the first signs of the pandemic, VA decision makers resorted to their bureaucratic defaults — eliminating options and forcing top-down solutions that prevent veterans from making their own health care decisions.

This “we know best” approach gets more disheartening as the appointment backlog grows.

Yes, some veterans prefer VA care, and they should have every opportunity to select VA as their provider of choice. And some veterans prefer private options. Regardless of what any one veteran prefers, about nine in ten support the freedom to choose for themselves.

Personally, as a service-connected veteran, I’ve come to appreciate care at providers in my community. I find it more personal, more convenient, and much faster.

Of course, it’s not just about access to timely care. President Joe Biden is late in nominating members to a panel, mandated by the VA MISSION Act, meant to study how the VA’s facilities infrastructure contributes to the care of a rapidly changing veteran population. Without the panel and its recommendations, the VA and congressional overseers cannot make informed decisions to optimize and modernize for future generations of veterans.

It’s time for a reality check. The VA MISSION Act has been improperly implemented. The executive branch and VA are not complying with components of the law, the legislature is not providing sufficient oversight, and the veteran community has largely given a pass.

To the VA: Execute the law as it was intended. Serve with transparency and do not betray veterans who trust you have their best interests in mind.

To Congress: Hold VA leaders accountable. Don’t allow political games at the risk of veterans’ lives. Honor the promise made to them when they put on the uniform.

To the veteran community: Be an advocate for your brothers and sisters. We have sustained the status quo too long. Speak up and leave no one behind.

Three years after enactment of the VA MISSION Act, my organization, Concerned Veterans for America, works to complete the mission of improving veterans’ health care. We stand ready to partner with anyone who seeks to do the same.

Nate Anderson is executive director of Concerned Veterans for America and an Army combat veteran.