Senate sends long-awaited VA community care overhaul to the president’s desk

The Senate on Wednesday cleared highly anticipated legislation that will overhaul community care programs at the Veterans Affairs Department.

The Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act easily passed the Senate with a 92-5 vote.

With the Senate’s passage, lawmakers are finally moving forward on a long-awaited solution to the current Veterans Choice Program, which members had been seeking practically since the program’s beginning in 2014.

The Senate voted earlier this week to limit debate on the bill so lawmakers could send the legislation to the president’s desk in time to avoid another funding shortfall within the Veterans Choice Program. VA has said it will run out of funding for the Choice program by the end of the month without a legislative solution, and Congress wanted to send a bill to the president’s desk by Memorial Day.

The House already passed the bill earlier this month.

The MISSION Act authorizes an additional $5.2 billion to continue the current VA Choice Program for the next year while the department implements the provisions in the new legislation.

In addition, the MISSION ACT:

  • Streamlines VA’s seven disparate community care programs into one,
  • Moves the VA health care program from mandatory funding to discretionary funding,
  • Expands the VA Caregiver Program to veterans and their families of all eras,
  • Creates a new process for reviewing VA’s assets and disposing of under-utilized, outdated or vacant facilities,
  • Creates an education program for veterans about their health care options and a training program for VA employees and contractors to better understand how to administer non-VA health programs,
  • Establishes a scholarship program and a specialty education loan repayment program to better recruit VA doctors, dentists and other health professionals, and
  • Requires VA make information public about its vacancies, separation actions, new hires and other personnel actions.

The MISSION Act has support from more than 38 veterans services organizations, who had expressed concern that Congress and the Trump administration wanted to move the department in a direction that privatized more veterans’ health care.

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But most VSOs are satisfied with the new legislation. Under the MISSION Act, VA will continue to coordinate and direct veterans’ care. The legislation requires veterans receive access to community care if VA doesn’t offer the services they need, if the department doesn’t offer a full-service medical facility in a veteran’s state, if a veteran was eligible to receive community care under the 40-mile rule in the existing Choice program or if the agency can’t provide care within designated access or quality standards.

Federal unions, however, have said the MISSION Act raises their concerns about the prospect of VA privatization.

The MISSION Act was the product of 15 months of work among House Veterans Affairs Committee Chairman Phil Roe (R-Tenn.) and Senate VA Committee Chairman Johnny Isakson (R-Ga.) and Ranking Member Jon Tester (D-Mont.).

The bill passed with wide bipartisan support on Wednesday, but some senators said they were concerned how VA would pay for it.

“I do have one concern with the bill,” Sen. Mike Enzi (R-Wyo.), who did vote for the legislation, said from the Senate floor. “It’s not paid for. I believe we must acknowledge that borrowing more money to pay for this program isn’t an ideal way to honor our veterans.”

Still, a majority of members see the bill’s passage as a legislative victory.

Roe thanked Isakson and Tester for devoting more than a year to the topic and thanked Senate Majority Leader Mitch McConnell (R-Ky.) for bringing the MISSION Act to the floor quickly.

“Now, the committee’s focus will be on implementation of the VA MISSION Act and the department’s transition to a new electronic health record so the men and women who served our nation can finally have timely access to state of the art health care,” Roe said in a statement.

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