Rep. Mike Bost's, R-Ill., measure would expand extended care options in the private sector and bar VA from considering telehealth availability when calculating community care eligibility. Tom Williams/CQ-Roll Call, Inc via Getty Images
House Republicans set the stage for expanding private care for veterans
President-elect Trump could once again seek to shift veterans away from VA for health care and the top Republican on the issue just laid out a blueprint for doing so.
The top House Republicans for veterans issues is pushing a new measure to codify and expand privatized health care on the taxpayer dime, reigniting a controversial issue that is likely to come back to the fore under President-elect Trump.
The Complete the Mission Act would serve as a followup to the 2018 Mission Act that Trump signed into law, which streamlined and expanded veterans' access to private sector care paid for by the Veterans Affairs Department. Congress passed the Mission Act on a bipartisan basis to follow a 2014 law with similar goals, but lawmakers have since disagreed over its implementation.
The new bill, introduced by House Veterans Affairs Committee Chairman Mike Bost, R-Ill., would ensure existing access standards for private sector “community care” are codified in law. Those rules allow veterans living more than a 30-minute drive on average from the nearest VA facility to access the community care network for services such as primary care, mental health and some extended care. For specialized care, veterans must live more than a one-hour drive from the nearest VA facility. They can also access private care when a close VA facility does not provide the service they are seeking, or when their VA doctor recommends it.
Bost’s measure would expand extended care options in the private sector and bar VA from considering telehealth availability when calculating community care eligibility. It would also require VA to consider veterans’ preference of where to seek treatment. The bill would create a three-year pilot in which patients could enroll in non-VA outpatient mental health or substance use treatment without requiring a VA referral.
The original access standards went into place during Trump’s first term and have remained in effect under President Biden, but congressional Republicans and conservative groups have criticized the current administration for installing what they have described as roadblocks to further community care expansion.
Under Biden and VA Secretary Denis McDonough, private sector care has grown significantly. Annual spending on community care has grown to $24 billion, nearly double what it was in 2020. Of the 9.5 million veterans eligible for VA care in 2023, 2.8 million received private sector care paid for by the department.
Still, Bost said the Biden administration’s implementation of the Mission Act has been “unacceptable.”
“Under the Biden-Harris administration we have seen VA bureaucrats standing in the way of veterans’ community care access,” Bost said. “Every veteran has earned timely options for quality healthcare to meet their needs—no bureaucrat is allowed to stand in the way of that.”
The bill would also require VA to publish wait times for all of its medical facilities. Private sector providers contracting with VA would have more time to submit claims for reimbursement to the department.
The measure is unlikely to become law in the few remaining weeks of the current Congress, but sets the stage for the fight that is likely to come under Trump. His VA secretary-designate, former Rep. Doug Collins, R-Ga., has already hinted that he is interested in expanded community care. Trump has frequently boasted of his expansion of health care choice for veterans as one of his signature accomplishments in his first term.
After his firing, Trump’s first VA secretary, David Shulkin, suggested he was pushed aside for political reasons surrounding his reluctance to further privatize parts of the department. VA at the time rejected the assertion and said it was a myth that it had any interest in privatizing the department.
John Byrnes, strategic director at Concerned Veterans for America, a right-leaning veterans group, praised the bill and said it would guarantee that veterans have the health care choice they deserve.
“Despite the VA MISSION Act being signed into law in 2018 by President Trump, current VA leadership supports bureaucratic barriers to veterans’ access to community care—access that the VA MISSION Act law authorizes,” Byrnes said, adding Bost’s bill would offer a solution.