(U.S. Senate) — During a Senate Veterans’ Affairs Committee hearing yesterday on VA’s budget request for Fiscal Year 2025, Chairman Jon Tester stressed the importance of ensuring VA continues to build its capacity to deliver more timely health care and benefits to veterans, especially as VA provides a record numbers of toxic-exposed veterans and survivors expanded health care and benefits under the PACT Act.

“With the PACT Act delivering the largest expansion of VA health care and benefits ever, and more folks coming into the system—we have to ensure VA can deliver veterans the timely support they earned and deserve,” said Tester. “…VA’s recent hiring surge allowed the Department to deliver an all-time record number of health care appointments due in part to the PACT Act. VA needs to continue to build on this momentum, and continue to hire and retain quality personnel—especially in critical specialties like mental health and in rural areas.”

In a subsequent Senate Appropriations Subcommittee on Military Construction and Veterans Affairs hearing on VA’s budget this morning, Tester pressed VA Secretary Denis McDonough on VA’s decision to implement a strategic hiring pause at the Veterans Health Administration (VHA), despite recent increases in veterans’ health care enrollment and eligibility.

“Talk to me a little bit about staffing, and the impacts that has on community care, which you say is doing nothing but going up,” Tester said to McDonough.

“It’s a Gordian knot. It’s a really tough question,” responded McDonough. “… [W]e have to get better on productivity and then we have to show every time a veteran has a choice, we make a referral for that veteran to go to the community. We say, ‘Hey, this is where you qualify in the community, you should do that if you want. But we’d like you to stay with us and here are your options.”

Tester replied that veterans cannot make a choice to stay with VA unless it has the staff in place.

Continuing to stress the importance of ensuring VA has the staff to serve veterans amidst record enrollment, Tester continued, “Here’s the point I want to make …if you [reduce staff], don’t forget to look at the hospitals that are short on [physician assistants], on docs, on RNs, on all the above. Because if we don’t do that, you can’t expect community care to even begin to level off. It’s going to continue to go through [the roof]. So hopefully your VISN Directors will take a look and say ‘hey, we’ll put pressure on you to get more docs in here because we need them.’ Otherwise, the community care issues is going to continue to grow and grow and grow.”

During Wednesday’s Senate Veterans Affairs’ Committee hearing, Tester also questioned Secretary McDonough and Veterans Service Organization (VSO) representatives who authored this year’s Independent Budget on VA’s proposed increase in community care spending, underscoring the need to find a balance between community care and direct VA care.

“The testimony you brought forward raises concerns about community care spending, especially compared to spending for direct care,” Tester said to the VSO representatives of the Independent Budget. “Given the memberships of your organizations and the impact that their military service has had on their abilities, physically and mentally, what should we keep in mind as we engage in this conversation about community care versus direct care?”

“Our veterans consistently tell us that they prefer VA health care and that community care can supplement when needed,” replied Kristina Keenan, Deputy Director of National Legislative Service for the Veterans of Foreign Wars. “We hope and we ask that VA continue to focus and focus even more on improving their direct care primarily.”

Tester championed the PACT Act and shepherded its passage through Congress in 2022. As Chairman, he fought tirelessly for years alongside veterans and Veterans Service Organizations in Montana and across the nation to deliver generations of toxic-exposed veterans and survivors their earned care and benefits under the PACT Act. In March, VA also expanded health care eligibility to all veterans who were exposed to toxins and other hazards while serving in the military—expanding health eligibility to millions of toxic-exposed veterans under the PACT Act. Since the PACT Act was signed into law in August 2022, VA has received more than 1.5 million PACT Act-related claims, and nearly 138,000 veterans have enrolled in VA health care under a PACT Act enrollment authority.