Senators Spike a Plan to Close Hundreds of VA Facilities and Displace Thousands of Workers

A bipartisan group of senators announced this week they would not support the slate of nominees nominated to serve on the statutorily created commission to overhaul the Veteran Affairs Department’s physical footprint, effectively killing a years-long effort to close some of the agency’s medical facilities and potentially open new ones. 

Six Democrats and four Republicans, including Sen. Jon Tester, D-Mt., who chairs the Senate Veterans Affairs Committee, said the process for the VA Asset and Infrastructure Review Commission was broken and therefore they would not allow the nominees to proceed. Congress created the AIR Commission in the President Trump-signed 2018 Mission Act to identify which facilities in VA’s network were underutilized and should be closed, as well as areas where the department should grow its reach. While VA has worked for years to gather data and estimates on current and future usage and has released a detailed list with thousands of recommendations, the senators said their announcement “signifies the end of the AIR Commission.” 

“As senators, we share a commitment to expanding and strengthening modern VA infrastructure in a way that upholds our obligations to America’s veterans,” the group said in a joint statement. "We believe the recommendations put forth to the AIR Commission are not reflective of that goal, and would put veterans in both rural and urban areas at a disadvantage, which is why we are announcing that this process does not have our support and will not move forward.”

In its recommendations to the not-yet-formed commission earlier this year, VA proposed closing more than 30 medical centers and shuttering 172, or about 21%, of its more than 800 outpatient clinics. It suggested partly offsetting those closures by building new hospitals, increasing its medical speciality clinics by 56% and boosting reliance on private sector providers. The administration was months late in nominating the commission members and Senate Republicans only just put forward the name for the ninth nominee last week. VA also missed its deadline to submit its recommendations and released them six weeks late. 

If it had been stood up, the commission would have reviewed that plan, conducted its own hearings and investigations, made its own proposals and sent them to the White House by early 2023. President Biden could then have rejected the plan or signed off on it and sent it to Congress. Similar to previous Base Realignment and Closure efforts at the Defense Department, Congress would have had to accept all of the recommendations or none of them. Lawmakers would have to proactively vote down the proposals to void them, however, as inaction would have allowed them to take effect.

The recommendations drew criticisms from lawmakers in both parties and a wide swath of stakeholders, who said VA was relying too heavily on the private sector, not considering the needs of veterans in remote areas and using pre-pandemic data that was no longer relevant. VA Secretary Denis McDonough had said he hoped the commission would review his team’s work and make changes, and vowed to provide updated data that reflected changes to veterans’ needs in the post-COVID-19 world. 

VA employees in particular voiced opposition to the recommendations, saying the plan would force them out of work and have significant consequences for their patients. VA would displace or relocate more than 50,000 jobs under its proposals, according to an estimate by the American Federation of Government Employees. The union represents most VA workers and has held rallies and lobbied against the department’s proposals since they were released. The department countered that after it built new facilities and added other services, it would come out with a net of more staff. AFGE President Everett Kelley said the announcement from the senators was a “major victory for veterans” and VA employees. 

“This closure commission was a bad idea from the start,” Kelley said. “Automatic, mass closures of VA facilities would deny veterans the comprehensive, quality care that our nation owes to those who have defended our country.”

Advocates for the commission have said it would have allowed VA to refocus its resources where they are actually needed and helped replace aging buildings that can no longer serve the requirements of modern medicine. Veterans’ locations and needs have shifted in the decades since many of VA’s facilities were first built, proponents of change have said, and the commission would have provided an avenue for VA to build new facilities or replace dilapidated ones. Congress is on the verge of passing a bill that would give the department $1 billion to procure 31 leases for new medical facilities, but some stakeholders have called for far greater investments. 

The senators pledged to continue fighting for more VA resources and said the commission is no longer necessary to achieve its goals. When something like the AIR Commission was first floated, a debate over the long-term role of government health care facilities was much more active. While the role of the private sector in veteran care has expanded, calls for large-scale privatization have largely ebbed and VA’s budget has continued to soar to unprecedented highs. 

“The commission is not necessary for our continued push to invest in VA health infrastructure, and together we remain dedicated to providing the department with the resources and tools it needs to continue delivering quality care and earned services to veterans in 21st century facilities,” the senators said, “now and into the future.”