VA Mission Act of 2018

VA Mission Act of 2018 was a major piece of United States legislation signed into law by President Donald Trump on June 6, 2018. It aimed to consolidate and reform Veterans Affairs community care programs, expand caregiver benefits, and improve the VA's ability to recruit medical staff. The law represented a significant bipartisan effort to overhaul veterans' healthcare following the 2014 wait-time scandal.

Background and legislative history

The impetus for the VA Mission Act of 2018 stemmed from systemic failures exposed by the 2014 scandal at the Phoenix VA Health Care System, which revealed widespread patient wait-time manipulation. This led to the passage of the temporary Veterans Access, Choice, and Accountability Act of 2014, often called the "Choice Act," which was funded by the VA Choice and Quality Employment Act of 2017. As the Choice Act's funding neared expiration, lawmakers sought a permanent solution. Bipartisan legislation was introduced in the House Veterans' Affairs Committee by Chairman Phil Roe and in the Senate by Committee Chairman Johnny Isakson. The bill passed the 115th United States Congress with strong support and was signed at a ceremony attended by Veterans of Foreign Wars and American Legion representatives.

Key provisions

The act's central provision consolidated several existing community care programs, including the Veterans Choice Program, into a single, permanent Veterans Community Care Program. It established new access standards, allowing veterans to seek care from non-VA providers if they face certain drive-time or wait-time thresholds. A major expansion extended the Program of Comprehensive Assistance for Family Caregivers to veterans of all eras, not just those serving after September 11, 2001. It also authorized the Asset and Infrastructure Review process to modernize VHA facilities and granted the Secretary of Veterans Affairs new authorities for recruiting and paying health care professionals, including resolutions for medical residency disputes.

Implementation and impact

Implementation was delegated to the VA, led by then-Secretary David Shulkin and later Robert Wilkie. The new Veterans Community Care Program officially launched in June 2019. The VA Office of Inspector General and the Government Accountability Office have monitored the rollout, noting challenges with the new referral system and electronic health record interoperability. The expansion of caregiver benefits proceeded in phases, with full implementation for pre-9/11 veterans completed in October 2022. The act's provisions also influenced the deployment of the new Cerner EHR system as part of the broader VA modernization effort.

Controversies and criticism

The act faced criticism from some veterans service organizations like Disabled American Veterans, which argued it could lead to the privatization of the VHA by steering too many patients to private sector care. Concerns were raised about the potential for fragmented care and the VA's ability to manage a vast network of community providers. The proposed Asset and Infrastructure Review commission, intended to close or modernize facilities, became highly controversial and was ultimately not established after opposition from groups including the American Federation of Government Employees. Some lawmakers, including Senator Bernie Sanders, expressed worry that funding community care could divert critical resources from VA medical centers.

Support and reception

The legislation received strong bipartisan support from key figures including President Donald Trump, Senator John McCain (for whom the act was partially named), and House Speaker Paul Ryan. It was endorsed by major veterans organizations such as the Veterans of Foreign Wars, The American Legion, and Paralyzed Veterans of America. Proponents argued it increased veteran choice, reduced wait times, and provided long-overdue support to caregivers of veterans from earlier conflicts like the Vietnam War and the Gulf War. The Congressional Budget Office estimated the act would increase direct spending, but supporters contended it was a necessary investment in the future of the VA system. Category:2018 in American law Category:United States federal veterans' legislation Category:115th United States Congress