Happy Veterans’ Day! Millions of veterans depend on the government to provide health care. But management of the Department of Veterans Affairs (the federal department that houses the VHA) can change depending on who is President and his/her approach to policy.

The Veterans Health Administration (VHA) consists of 150 medical centers, nearly 1400 outpatient clinics, community living centers, Vet Centers and Domiciliaries. The VHA employs approximately 53,000 healthcare practitioners and provides care to approximately 9 million veterans each year. 

In 2014, the VHA was embroiled in scandal when reporting showed veterans died needlessly due to “secret waiting lists,” first discovered at the Phoenix VHA and later, at other sites across the country. Following this scandal, Congress passed and President Obama signed the Access, Choice, and Accountability Act in an attempt to address the lack of accountability and transparency in the program. It’s encouraging that there is often a bipartisan consensus about improving the VA, and of course, Joe Biden was Vice President when this 2014 law passed. 

This law also initiated the “choice” program that allowed veterans who lived too far away (40 miles) from a VHA facility or who faced too long a wait time (30 days) to go to private-sector health providers instead (and use their benefits to pay for private care). The choice program, when first rolled out, faced some problems in implementation. The access measures in the law were also imperfectly executed, as much of the funding went toward hiring non-medical staff within the VA (instead of hiring more doctors to alleviate the long wait times faced by vets).

The Trump Administration sought to fix this and expand the choice program. In fact, the whole philosophy within the Trump VA has been to learn from the private sector and infuse the government department with better incentives, more transparency, and better customer service. This stands in contrast to Joe Biden’s broad approach to healthcare policy, which seeks to make the private sector more like public health programs through standardization and subsidization. 

In 2018, President Trump signed the bipartisan VA Mission Act, which expanded eligibility for the choice program to more than 640,000 additional veterans and eventually replaced the choice program with the “Community Care” program with the goal of making the system easier for veterans to navigate and use. 

For veterans who depend on the VHA for their care, there’s always a lot at stake when it comes to government healthcare policy. Indeed, when the government funds your health care, the government has a great deal of control over your health care. But it is only right for our country to provide health care to those who served; we should make the quality of their care a priority. 

Read more about the Veterans Health Administration in this policy focus from IWF.