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What’s next for VA reform? Policy Director Juliana Heerschap details what’s on the horizon for veterans’ health care.

VA Doctor talking to Veteran in Camo in Waiting Room

By Concerned Veterans for America

Concerned Veterans for America has released its 2021 policy agenda , and our grassroots army is hard at work sharing our solutions to the nation’s greatest challenges.

This year’s agenda is packed full of ideas for continuing to reform the Department of Veterans Affairs and ensuring veterans receive the care they were promised. We’ve been working toward a better VA system for years  and have made incredible progress so far.

But there is still much work to be done.

We sat down with CVA Policy Director Juliana Heerschap to talk through proposals for VA reform, what’s next for the VA MISSION Act, and what a better future for the VA and veterans looks like.

Q: What does CVA hope to accomplish with its policy proposals this year?

A: This policy agenda is a great way to set our goals and tell Congress and our grassroots activists what we plan on prioritizing. In an ever-changing Washington, D.C., our agenda lets us share who we are and what our mission is. On the VA front, we are keeping our focus on preserving the VA MISSION Act and community care access for veterans, examining the VA benefits system, and getting on a path to more sustainable VA spending to preserve our financial future as a nation.

Q: The VA MISSION Act will be three years old this summer. Why are we still making implementation a priority?

A: The VA MISSION Act established new systems and approaches to care that simply could not be implemented overnight. So the law included a years’ long timeline with steps for fully getting the law and its provisions into place.

Q: What is the next step?

A: The veteran population that today’s VA system is serving is rapidly changing. The way health care is delivered looks different than it did when most of the VA’s health care system was built. The VA MISSION Act includes a provision to create an Asset and Infrastructure Review (AIR) Commission that will study and assess the VA’s infrastructure and find a better path forward to realign the facilities the VA operates. The next step is for the Senate to confirm members to that commission.

On the  delivery side, nearly a year into the COVID-19 pandemic, we know there is a need for health care to be delivered in increasingly unique and innovative ways. The VA should utilize all the tools it has to ensure veterans are not missing appointments and can get care when and where they need it. The community care program is still in its early stages of rollout and Congress should pursue oversight of its rollout, and ensure veterans know they have access options, including telehealth, community care, the VA, or a combination.

Q: Let’s go back to the AIR Commission. What exactly will commissioners be reviewing? And what effect will their report have on veterans?

A: The AIR Commission will be charged with taking findings from market assessments, community input, and the VA’s own data to determine what the VA health care system should look like to serve today’s and tomorrow’s veterans.

The average VA building is over 50 years old. The veteran population is expected to decrease by 40 percent over the next 25 years. Veterans are not living in the same communities they lived in when the VA’s infrastructure was built. Some VA hospitals need additional resources to serve geographic areas where the veteran population is growing. The AIR Commission will look at this kind of data when crafting its recommendations for the VA and Congress. Once their work is complete, veterans will hopefully see positive changes.

Q: The AIR Commission will help the VA modernize on the health care side, but what about other services?

A: A modern VA system will promote economic independence for veterans by refocusing the disability and benefits process on rehabilitation, innovative support systems, and connecting veterans to a successful transition from the military into civilian life.

Q: The transition out of military life is often a barrier. How can Congress and the VA help?

A: Well-intentioned efforts to mandate countless transition programs, countless pilot programs, and an increasingly complex VA disability system have not solved the challenges many veterans face once they take off the uniform. Instead, Congress, the VA, and DOD have created a bureaucratic nightmare.

Before layering on more programs to an already complex system, the VA and Congress should create an assessment commission to examine what is working, what isn’t working, and where the VA should focus its services to provide for veterans with the greatest needs from their service-connected injuries.

Q: Would an audit of services and spending make the VA stronger and serve veterans better?

A: Absolutely. To understand what you can do better, you have to understand the whole of what you are doing in the first place. That goes for both services and spending.

As the VA’s annual budget continues to grow year over year, it should face some difficult questions. Where is the money going? Who is it going to? What are the justifications for significant staffing increases? Are programs effective? Are VA resources targeted to veterans with the greatest need? All of these are valid questions the VA should answer, and a programmatic audit of the VA system is long overdue.

Q: You mention the VA’s budget growing by the year. Is that ballooning budget actually helping veterans get quality health care?

A: While some of that spending has gone to giving veterans’ health care choice and improving access, a lot of it has simply gone toward a ballooning VA workforce, from 270,000 in fiscal 2011 to 405,000 in 2021. The VA MISSION Act was a major step toward improving access and offering more options for veterans. But to contain costs, more should be done to evaluate where resources are being spent and if they are being used effectively.

To learn more about VA reform and other CVA policy priorities, read our full policy agenda.