Path Forward on Sweeping Veterans Bill Uncertain Amid Political Fighting

Storm clouds darken the skies above the Capitol in Washington
Storm clouds darken the skies above the Capitol in Washington, Monday, June 12, 2023. (AP Photo/J. Scott Applewhite)

A wide-ranging veterans policy bill that seeks to bolster home caregiver programs, provide more support for homeless veterans and fix the beleaguered electronic health records program appears to be falling victim to election-year politics, veterans service organizations are warning.

Veterans groups and congressional staff were hopeful that the legislation would pass early this summer after the Republicans on the House Veterans Affairs Committee and Democrats and Republicans on the Senate Veterans Affairs Committee announced an agreement on the bill last month.

But opposition from House Democrats and some Republicans has raised doubts about the future of the bill. Veterans groups say the opposition is being fueled by misinformation about what the legislation would do and that the partisan bickering is leaving veterans and their families caught in the middle waiting for desperately needed improvements.

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"This is something that we need now, whether you're Democrat or Republican," said Lara Garey, a fellow with the Elizabeth Dole Foundation who was a caregiver for her husband before he died of amyotrophic lateral sclerosis, or ALS, two years ago. "Caregivers are pushing their mental and physical health to a breaking point because we want to sit around and play politics with legislation that's needed now. Pass it. Pass it now."

One of the key provisions of the bill, formally called the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, would increase the Department of Veterans Affairs' share of covering home nursing care from 65% to 100% of costs, as well as ensure that aging and disabled veterans can get home- and community-based nursing care services through any VA medical center in the country. The change has been a major priority for the Elizabeth Dole Foundation, which supports caregivers for veterans and service members.

    Other major provisions include ones that would set metrics that the VA's troubled Oracle Cerner electronic health records program has to meet and, if it fails to meet those marks, end the program altogether.

    The bill would also revive through 2026 authorities the VA had during the COVID-19 public health emergency that were credited with helping reduce the number of unhoused veterans, including allowing the VA to provide homeless veterans with transportation for medical appointments and increasing the per diem rate the VA can pay to organizations providing short-term transitional housing from 115% of costs to 133%.

    Those provisions have broad support. But two other sections of the bill are garnering controversy.

    One section seeks to ease veterans' ability to get VA-funded health care from non-VA doctors by banning the department from overriding a VA doctor's referral for their patient to get outside care.

    The other section at issue would establish new access standards for veterans to be able to get treatment at residential mental health and substance abuse programs and allow veterans to go to non-VA programs if the wait for a VA program is too long.

    House Democrats are arguing those provisions amount to backdoor privatization efforts.

    "House Republicans have hijacked a historically bipartisan, bicameral process for veterans' packages, to push their main priority of privatizing VA health care," Rep. Mark Takano, D-Calif., the ranking member of the House Veterans Affairs Committee, said in a statement last month announcing his opposition to the bill.

    Major labor unions including the American Federation of Government Employees and AFL-CIO are also lobbying lawmakers against the bill on arguments that it unacceptably expands VA privatization.

    "The legislation includes new benefits and improved processes at VA to better serve veterans, which we support, but contains other provisions that immediately undermine those new benefits and improved processes while harming the VA workforce," the unions wrote in a letter to Congress last month that was obtained by "Without action to remove egregious privatization measures, we are opposed to passage of the legislation."

    Veterans organizations maintain that, while the direction of the community care program and concerns about VA privatization are worthy of debate, Democrats are overstating the bill's scope and that this legislation is not the place to have that broader fight.

    "None of us would be at the table advocating as strongly as we are if this bill was a vast effort to privatize care," Elizabeth Dole Foundation CEO Steve Schwab said of his and other organizations. "I think that what's happened here is folks have gotten into the corners of extreme opinions on headlines that actually aren't accurate. And do I think the politics of an election year matter? I think it matters on everything that's happening in Washington right now. But it used to be the case that those things didn't impact veterans and veteran family members."

    A coalition of veterans groups, including the Elizabeth Dole Foundation, Wounded Warrior Project, Veterans of Foreign Wars and others, is planning a news conference Tuesday afternoon to push for passage of the bill. More than a dozen groups also sent a letter to congressional leadership last month urging them to “put aside politics.”

    On the other side of the political spectrum, some conservative groups such as Concerned Veterans for America are urging Republicans to oppose the bill because they believe the section on residential treatment programs and the legislation as a whole do not go far enough to expand access to non-VA care.

    "The Dole Act as currently drafted is a nonstarter for anyone concerned about caring for our nation's veterans," Russ Duerstine, executive director of Concerned Veterans for America, and Brent Gardner, chief government affairs officer at Americans for Prosperity, said in a joint statement to "Despite the VA's best attempts to steer veterans into wait lines, community care's popularity continues to grow. No elected leader who claims to care about veterans can support a bill that guts community care with a clear conscience."

    Asked about the status of the bill and the prospect of it getting a vote, a House Veterans Affairs Committee staffer told that committee Chairman Mike Bost, R-Ill., is "working with leadership to bring it to the floor as soon as possible" and that the Democratic opposition is the biggest factor in the delay.

    "We are working through that and hopeful that House Democrats will join us in being on the right side of history and agreeing with the 40-plus veterans' groups and stakeholders that are supportive of this good package when it comes to the floor for a vote," the staffer said.

    The bill has been pulled from the House schedule several times in recent weeks, a source familiar with negotiations who requested anonymity to speak candidly told

    The holdup on the bill is also in part because of procedural issues. House leadership was planning to use a fast-track process known as "suspension" in order to pass the bill, the source said. But that procedure requires two-thirds approval for the bill to pass, a benchmark that can't be reached if Democrats oppose the bill.

    While using the regular process would require only a simple majority to pass the bill, it would also require a procedural vote that far-right Republicans have been using to block bills when party leadership does not accede to their demands on amendment votes or other issues.

    With the House seemingly deadlocked, some discussion has started on having the Senate vote on the bill first, the source said. But politics could be an issue there too since Senate Veterans Affairs Committee Chairman Jon Tester, D-Mont., is in a tough re-election battle and Republicans have a history of blocking bills in order to deny him legislative victories he can campaign on.

    "I am eternally an optimist, and so I haven't given up hope that this bill can get across the finish line, and we could do it in the next month," the Dole Foundation's Schwab said. "We're meeting with offices virtually every day to tell them our side and tell them the facts. And my hope is that the pure facts and the pure case for supporting this bill, which are all on the right side, will win the day and that we'll get it done. And if we don't, I will be deeply disappointed that the usual politics of the extreme in D.C. has gotten in the way."

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