The recently introduced Take Care of America’s Veterans Act takes long-needed steps to protect veterans’ health care options. A Veterans Affairs Office of Inspector General (VA OIG) report released today shows why this legislation is critical.
Why Community Care Matters
Twelve years ago, the infamous Phoenix wait time scandal became national news, highlighting a broken status quo at the VA. Concerned Veterans for America (CVA) worked with experts and policymakers to transform veterans’ health care from a system that protects bureaucracy to one that empowers veterans.
The result of these efforts, the VA MISSION Act of 2018, gave millions of veterans the choice for the first time to use their health benefits at non VA-run “community care” providers in a variety of situations, such as when wait times or drive times to VA facilities are too long. Today, community care options are more popular than ever, and more than 40% of VA health care treatment is delivered through community providers.
The Threat
Despite the popularity of community care, VA bureaucracy and prior VA agency leadership have tried to undermine the promise of the MISSION Act. Prior Freedom of Information Act (FOIA) suits confirmed that the VA used outdated wait time calculation formulas and improperly trained schedulers to push veterans to appointments at VA facilities, even if veterans asked for community care options.
On June 17, a Congressionally required VA OIG audit confirmed what CVA has told legislators for years—VA schedulers routinely fail to tell veterans about their community care eligibility when scheduling them for appointments. When veterans don’t know the options they have, they can’t exercise them, and are too often forced to drive hours or wait months for care when closer and faster community care alternatives exist.
Inspector General Findings:
In an audit of over 24 million appointments scheduled, the VA OIG found:
- The VA Routinely Fails to Tell Veterans when they are eligible for community care: “For VA appointments completed in the first quarter of FY 2025, the OIG estimates schedulers sent about 38 percent of appointments that were eligible for community care (about 1.8 million of 4.8 million) to VA without evidence that staff first assessed these veterans for community care eligibility.”
- The VA rarely confirms veterans’ preferences for treatment type: “About 58 percent of primary care, mental health care, or specialty care appointments occurring within VA that the OIG identified as eligible for community care (about 1.1 million of about 1.8 million) had no documentation that the veteran had opted out of community care—meaning there was no evidence these veterans knew all their care options before they were scheduled for direct care within VA.”
- The VA often doesn’t even know its own wait times: “Medical facility staff referred about 25 percent of community care consults for mental health care or specialty care—an estimated 340,000 of 1.4 million total consults—to providers outside VA, despite veterans not meeting eligibility requirements….
These issues arose because guidance from VA’s Office of Integrated Veteran Care (IVC) was inconsistent with the MISSION Act and due to scheduling system limitations, which prevented schedulers from seeing appointment availability across all VA medical facilities that were within wait-time and drive-time standards.”
These results confirm what FOIA suits previously found—that the VA regularly disregards community care access standards and rarely tells veterans about their eligibility. In the rarer instances when the VA has mistakenly sent veterans to community care options despite timely VA appointments being available nearby, it shows that the agency does not have enough of a grasp on its own internal wait times to begin with to be the sole option veterans have for their health benefits.
Community care options matter, and stronger laws can ensure the VA honors them.
The Solution: the Take Care of America’s Veterans Act
The Taking Care of America’s Veterans Act (S. 4744/H.R. 9237), endorsed by Americans for Prosperity and Concerned Veterans for America, directly addresses the VA’s failure to fully offer veterans community care choices.
The bill codifies existing community care access standards for 8 years. These standards have been set regulatorily since 2019, putting them into law provides much-needed certainty for veterans. After 8 years, the bill requires Congress to pass a joint resolution to further alter them. The OIG and prior FOIA suits both highlighted how VA guidance on community care scheduling contradicted access standards. Making community care eligibility law gives Congress a much-needed oversight tool to ensure VA compliance.
The bill also directly addresses the VA’s OIG-documented outreach failures by requiring the agency to tell veterans about their community care eligibility within five days of an appointment request. The VA would also be required to tell veterans about the status of their community care referrals and how to appeal if they are denied.
Millions of veterans currently benefit from having community care options alongside the choice to seek treatment at a traditional VA facility. As the VA OIG report shows, however, too often veterans’ health care choices are only exist as policies on paper rather than options in practice. The Take Care of America’s Veterans Act ensures that veterans are empowered to choose the care that best meets their needs in practice, not just in theory.
Tyler Koteskey is Policy Director at Concerned Veterans for America
