Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2023

Floor Speech

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Mr. McGOVERN. Mr. Chair, I thank Chairwoman DeLauro for yielding to me.

Mr. Chair, I rise in strong support of this bipartisan en bloc, which would eliminate funding for the VA Asset and Infrastructure Review, or AIR, Commission, and transfer the $5 million to the Healthcare for Homeless Veterans Program.

Let me be clear. The recommendations advanced so far as part of the VA's asset and infrastructure review process will lead to the closure or downsizing of nearly one-third of this country's VA medical facilities and community-based outpatient clinics. I believe that is an unacceptable and, frankly, rotten way to treat veterans, who have put their lives on the line for this country.

This entire process is a backdoor way to cut services for veterans, and I strongly urge my colleagues to support our veterans and vote ``yes'' on this amendment, which has the support of a wide range of veterans advocacy organizations from across the political spectrum.

This bipartisan amendment eliminates funding for a commission that would make it harder for veterans across America to get the care they deserve.

The decision to recommend shutting down these VA healthcare facilities was based on totally flawed and years-old information. There are huge, unacceptable, and inexcusable gaps in the data that was used to determine which facilities to shut down. The VA did not consider cases where hundreds of millions of dollars in new investments were made in facilities that were recommended for closure. It makes absolutely no sense.

Let me give you an example. One of the facilities that would be closed is the Leeds VA Medical Center in Massachusetts. They said that this facility should be closed because it needed nearly $200 million in upgrades. What they didn't say was that we already invested in those upgrades. $200 million in taxpayer money was already invested in this facility, and now they are recommending that it be shut down.

Talk about ripping off the American taxpayer.

The data that they used is from years ago. It is inexcusable. Even the VA admits this. This is the definition of stupid. We might as well throw taxpayer money out the window if these flawed recommendations move forward.

That is not even to mention the impact this commission would have on veterans. I held a listening session to hear how these recommendations would affect many veterans in Massachusetts and across the country. I happen to have a map here, by the way. Here is the map. The yellow is partial closures, and the blue is total closures all across the country.

Again, what we are finding out by objective observers is that all this is based on flawed and outdated information, and they are recommending that they shut these facilities down.

But I am learning here that this would literally force veterans to drive hours and hours across State lines just to get basic care. I talk to people with PTSD who say: I am just not going to get care anymore if I have to drive across the State into another State to get care.

Older veterans who need nursing home care could have to move long distances from their support systems. This process so far is a complete and total slap in the face to these veterans, and we should not spend one penny more on a commission that is going to be used to advance these awful cuts to veterans' services.

If this moves forward, closures and consolidation of VA facilities are mandatory, but recommendations to build new facilities are subject to future appropriations and are not guaranteed. So, this Appropriations Committee will have to decide whether to invest in the new facilities or the consolidation of facilities.

That is why groups like the Disabled American Veterans, Paralyzed Veterans of America, and Veterans of Foreign Wars all support shutting down this commission right now, which is what this amendment would do.

Everyone knows that this process and the commission are broken. Even VA Secretary McDonough acknowledged it to Congress, telling the House Veterans' Affairs Committee that the data is not up to speed in light of the pandemic. I am also grateful that the chairman of the Veterans' Affairs Committee here in the House, Chairman Takano, is supporting my amendment.

I want to be clear that Secretary McDonough has done a great job on advocating for our veterans, and he is working with my team and me to get to the bottom of some of these problems. But this process started because of a bill that Congress passed even before he became Secretary. I have spoken to him, and I know that he, too, does not want to make it harder for veterans to get care. The solution is that Congress needs to pass this amendment.

Even our nonpartisan congressional watchdog, the GAO, recently put out a report on this called ``VA Health Care: Incomplete Information Hinders Usefulness of Market Assessments for VA Facility Realignment.''

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Mr. McGOVERN. Mr. Chair, I include the executive summary in the Record.

[From the United States Government Accountability Office, Feb. 2022] Incomplete Information Hinders Usefulness of Market Assessments for VA Facility Realignment

The Department of Veterans Affairs (VA) conducted assessments of its capacity within 96 markets to deliver health care to veterans through VA providers and, when the Department cannot provide the care needed, through non-VA providers, known as community care. For these assessments, markets are designated geographic areas made up of a set of contiguous counties that contain one or more VA medical centers and associated clinics. For an overview of VA's approach, see the figure.

Text of Overview of Department of Veterans Affairs' Approach to Its Market Assessments:

Compiled data about the market including veteran health care supply and demand,

Identified gaps between supply and demand,

Developed proposals to respond to gaps between supply and demand, and

Issue final proposals.

VA officials described the department's process of developing proposals as iterative in that VA continually reviewed and revised draft proposals throughout the market assessments process. The VA Secretary plans to transmit recommendations to the Asset and Infrastructure Review Commission by March 14, 2022--that is, no later than 6 weeks from the statutory deadline of January 31, 2022. The Commission will then review these recommendations, hold public hearings, and prepare and issue their own recommendations to the President.

GAO identified gaps in the data VA compiled and certified for the market assessments that were relevant to determining both the supply of and demand for non-VA care. For example, VA lacked complete data on the extent to which its contractors maintain an adequate number of non-VA providers to ensure veterans have timely access to community care. VA officials told GAO that they determined supply and demand based on the most recently available data at the time of data compilation--December 2018 to November 2020. In addition, while VA officials told GAO the end-of-assessment analyses included updated data on community care, these data did not address the gaps GAO identified. Without such information, VA lacks a full understanding of the extent to which community care is able to supplement VA facility care to meet veterans' current and future demand.

GAO also found that VA's approach to the market assessments did not include steps to collect information on the quality of VA data compiled from numerous VA data sources or other steps to understand any relevant data limitations. Instead, VA officials leading the market assessments said they relied on VA offices responsible for the databases to ensure the data quality. As a result, VA is unable to communicate to external stakeholders, such as the Asset and Infrastructure Review Commission, all relevant information on the quality of VA data used in market assessments, including any limitations affecting these data and the resulting proposals for realignment.

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Mr. McGOVERN. Mr. Chair, moving forward with funding this fundamentally broken process would be an incredible disservice to our veterans and would jeopardize access to the high-quality, specialized care that they have earned.

This commission is being dismantled as we speak because the recommendations that were made to it were so catastrophically bad. Last month, Senate Veterans' Affairs Committee Chairman Jon Tester led a bipartisan group of 12 Senators to announce that the Senate Veterans' Affairs Committee would not even confirm any more nominees to the commission, effectively ending this process once and for all. Last week, we had an amendment to the NDAA pass to shut this down.

Why are we giving $5 million to a commission that may very well never exist and which is actively seeking to undermine care for our veterans and their families?

Mr. Chair, we all believe in upgrading and updating our VA system, but let's use accurate information. There is no way that anybody here can tell me that the recommendations that are being put forward are based on accurate and updated information. We are talking about our veterans, who are now going through needless anxiety because of all these threats of closures.

Mr. Chair, we need to do better, and I urge my colleagues to vote ``yes'' on this en bloc.

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