(U.S. Senate) – Ranking Member of the Senate Veterans Affairs Committee Jon Tester today questioned VA Secretary Robert Wilkie about the VA’s implementation of Tester’s bipartisan VA MISSION Act.

The following is Tester’s opening statement, as prepared for delivery:

I’d like to thank Chairmen Roe and Isakson for calling this important hearing today. 

Implementation of the VA MISSION Act will fundamentally transform the delivery of health care to our nation’s veterans.

For more than a year, we all worked carefully to negotiate the text of the bill with the Administration. We were in regular communication with VA on how it would interpret and implement the bill – passing it back and forth for technical assistance and ensuring we were on the same page.

However, since that time, I’ve grown increasingly concerned with the Department’s planned implementation of the new Veterans Community Care Program created in the bill.

Mr. Secretary, VA is moving away from the direction it was headed just six months ago. Make no mistake about that. The most dramatic example has to do with VA designating certain types of care as nearly-automatically eligible for community care.

Six months ago, we all agreed that if veterans faced excessive wait times, driving times, or driving distances to access CERTAIN services at a VA facility, they should be offered referrals to the community. Specifically, we discussed designating access standards for services like routine lab work and x-rays.  But we agreed to give VA the authority to decide exactly which services or categories of care should make veterans automatically eligible to receive care in the community.

Now that we’ve passed the VA MISSION Act, the Department has decided to head in a completely different direction. The VA now indicates it plans to designate access standards that will apply to each and every type of care a veteran might need. 

This would essentially outsource all segments of VA health care to the community based on arbitrary wait times or geographic standards – which we were supposed to be moving away from by ending the Choice Program. And that’s despite the fact that several studies - one as recently as last week - have indicated that the quality of VA care is as good as or better than private sector care.

To make matters even worse – VA officials have offered us only vague, verbal descriptions of the various sets of potential access standards you are considering, Mr. Secretary. It also concerns me that—each time we’ve discussed this issue in the last 2 months—VA officials have given us wildly different estimates of the budgetary resources needed to implement the sets of access standards you are considering.

For example, if the Department chooses to go with the same access standards used by TRICARE PRIME, we’ve been told it could take anywhere from $1 billion for the first year to more than $20 billion over 5 years. Some of the VA estimates indicate that costs will be less than what we’ve spent on Choice, but would make a greater percentage of veterans eligible for community care referrals. That just doesn’t make sense.

So we need to know what you’re doing and how much it is going to cost.  No conflicting or vague answers.  No fuzzy math.  No games. The stakes are too high.

Mr. Secretary, not even six months ago, you came before the Senate Committee and said you would oppose attempts to privatize VA health care. If you move further down this path – gutting the VA health care system for those veterans who want and need to use it – you’ll end up bringing down the whole ship. And you’re going to spend a whole lot of money sending veterans into the community for care that’s less timely and not as high in quality. 

That’s a bad deal for taxpayers.  That’s a bad deal for veterans, who would ultimately bear the brunt of cuts to other services or benefits to cover the increased costs of community care. And that will be a bad deal for veterans. Because, at some point, when you burn through your appropriated funds quicker than expected and come to us because VHA is running out of money again, veterans will be once again in limbo when seeking community care as Congress sorts out VA’s fiscal mess.  

I’m frustrated because this hearing would have been a great opportunity to talk about the great work being done by VA employees across the country every single day. About how their work will be bolstered by additional high-quality health care professionals hired under the new authorities in the MISSION Act. And about how streamlining the various VA community care programs into a new community care network will make care more efficient, timely and seamless for veterans.

Instead, we’re left trying to figure out why the VA decided to take things in a direction other than what Congress intended and veterans have advocated. 

My suspicion is that it’s politics. But I hope I’m wrong. 

And at the end of the day, I really hope that meaningful consultation will take place before final decisions are made. We got this far by working together and by taking our cues from veterans.  And it would be a shame to undermine those efforts and relationships by caving to political forces.  

Thank you.