Cramer Questions VA Leadership on Healthcare Access Amid Budget Shortfall

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WASHINGTON, D.C. – The U.S. Department of Veterans Affairs (VA) announced a budget shortfall of nearly $15 billion in July, representing the largest budget shortfall the VA has experienced. This includes $2.88 billion relating to compensation, pension, and readjustment benefit payments at the Veterans Benefit Administration (VBA), and another $11.97 billion in medical care accounts at the Veterans Health Administration (VHA).

The Senate Veterans’ Affairs Committee (SVAC) held a hearing today to hear testimony from VA leadership how to address current and future budget challenges.

Shortly after the VA announced its funding shortfall, U.S. Senator Kevin Cramer (R-ND) led his colleagues in sending a letter to SVAC Chairman Jon Tester (D-MT) requesting an oversight hearing on the issue. 

During the hearing, Cramer discussed the importance of the Community Care Program to ensure timely access to healthcare services for veterans in rural states like North Dakota. The “Red Team” Report, commissioned by VA Under Secretary for Health Shereef Elnahal earlier this year, inappropriately attempts to blame rising VHA costs on community care obligations without addressing existing challenges within the VA direct care systems, such as provider capacity and location. The capacity issue, for example, is highlighted directly in the report, which states the top three reasons for a veteran seeking care in the community are drive time (50%), services unavailable at VA (30%), and wait time (5%). 

Cramer asked Elnahal why the department supports proposals seeking to restrict access under the Community Care Program, while knowing their own data shows Veterans want options to receive care at facilities in their own communities, such as local critical access hospitals, through the community care program. 

“So the top three [reasons] are drive time, availability of services, and wait time,” said Cramer. “And to me, that paints a pretty clear picture of evidence that there are not enough VA providers or facilities to treat veterans where they live, or to deliver the type of specialized care that they need. So to me, reports like this highlight more of a commitment to the bureaucratic institution than to the access to care by the veteran. Can you explain why there’s been such a resistance by the VA to [allow] more community care?”

Elnahal agreed with Cramer, stating the Community Care Network is essential to providing timely access to care, especially for rural veterans. He explained the community care account has grown at very high rates over the last year and part of the supplemental funding would support what the budget projects.

“The benefit of the doubt never goes to the veteran in a challenged situation. Perhaps the first thing we could look for are services that already exist in a lot of these communities and make it easier for the veteran to get care there, rather than build a bigger VA bureaucracy, because it should be about access to care across the board,” continued Cramer. “Please let us look first at existing capacity and infrastructure before we build out a bigger bureaucracy.”