The VA has skirted the law for too long. It’s time for some real accountability for VA leadership

For nearly 10 years, veterans have been calling for more choice over their health care at the Department of Veterans Affairs.

Those calls, coupled with scandal after scandal at VA facilities nationwide, drove Congress to pass legislation aimed at putting veterans first at the VA. Specifically, the VA MISSION Act gave more veterans access to community care options through their VA benefits.

Community care is very popular with veterans.

According to the VA’s FY 2024 budget submission, overall satisfaction with Community Care was at 83 percent in 2022. Conversely, the overall rating for VA hospitals was only 69 percent.

The percentage of those surveyed who trust the VA is dropping and is well below the VA’s targets. At the same time, VA enrollment is declining, with a projected drop of more than 100,000 veterans from 2021 to 2025.

The VA has a clear message from veterans about what they want in care: flexibility and choice. But leadership has instead chosen to limit access to community care despite long wait and drive times and to weaponize the budget against the Community Care Program. 

First, the VA is failing to follow the VA MISSION Act’s eligibility requirements for community care.

By law and regulation, if a veteran can’t be seen by the VA within 20 days for primary care and mental health care, or 28 days for specialty care, the veteran is eligible to seek care in the community.

But documents obtained through a Freedom of Information Act lawsuit reveal the VA is using outdated and manipulative scheduling practices to give the appearance that veterans can receive appointments within the wait and drive time standards. Additionally, schedulers will cancel and reschedule appointments without veterans’ consent to “reset” the eligibility clock to deny community care.

Staff are also trained to reduce referrals to community care by dissuading veterans from using the program or misleading them about their eligibility and management of care. Shockingly, the VA has even allowed administrators to overrule doctors on what is in the best medical interest of veterans.

All these practices keep veterans trapped in the VA system.

Second, what the VA can’t kill at the scheduling level, it brazenly targets through budget gimmicks. 

Last year, VA Secretary Denis McDonough testified before Congress that the community care budget was growing, concluding “My hunch is that we should change access standards.” It’s not surprising the VA would suddenly look to limit community care by starving it in the budget.

The FY 2025 advance request budget slashes community care funding by cutting discretionary funding over 34 percent and overall funding by 19 percent from FY 2024.

At the end of the day, this isn’t about numbers or dollars; it’s about veterans’ lives. When they have to wait months for the VA to schedule an appointment, the consequences can be deadly. A veteran cancer patient recently died after the VA delayed a referral for 205 days for needed surgery.

That is unacceptable, but the solution is simple: put veterans first at the VA.

Congress should pass legislation, such as the Veterans True Choice Act, that puts veterans in charge of their care. Legislation should empower veterans with greater access to timely, quality care and close loopholes that have allowed the VA to skirt the VA MISSION Act.

Beyond legislation, Congress should hold VA leadership accountable for their blatant disregard of veterans’ wellbeing and the law. Congress has the power to punish VA leadership until the VA MISSION Act is followed as intended. It should do so by cutting general administration budgets, freezing management bonuses, and launching further investigations into how VA trains its staff and manages community care.

The VA has a solemn responsibility to care for veterans. Accountability for leadership and full health care choice for veterans are the only way the VA will be able to make good on that promise in the future. Since VA won’t take its duty seriously, Congress must step in.

Darin Selnick is a senior advisor for Concerned Veterans for America and an Air Force veteran. He served as veterans affairs adviser on President Donald Trump’s Domestic Policy Council and as a senior advisor to the VA secretary.