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Floor Speech

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Mr. MORAN. Mr. President, 10 years ago, a wait-time scandal at the VA Medical Center in Phoenix, AZ, led to a nationwide access and accountability crisis for the VA healthcare system. Many of us responded to that, worked to find a solution, and we ultimately passed something called the Choice Act.

Subsequent to that, we made improvements in what we learned from the Choice Act's implementation and usage by veterans and its consequences to the Department of Veterans Affairs, and we enacted the MISSION Act, which was signed into law 6 years ago this month.

The MISSION Act expanded the ability for veterans to seek care in their communities and made VA healthcare more accessible, convenient, and veteran-centric than ever before. The MISSION Act has also contributed to significant increases in enrollment of veterans, utilization and reliance on VA care, and improvements in quality and trust among veterans.

For veterans--particularly those in rural States like yours and mine--the ability to get care closer to home can be life-changing and lifesaving. Unfortunately, recently, VA leaders have been taking alarming actions to limit the choices that the MISSION Act affords veterans in Kansas and across the country.

It is unfathomable that the VA would consider leaving veterans with fewer options--fewer options--to seek the care they need. Yet I have seen a dramatic increase in community care-related casework requests from veterans and VA staff in recent weeks and whistleblowers in their conversations with me, and I know that many of my colleagues have experienced the same thing.

A lot of what I know about what is going on in veterans' lives and how the VA is doing is from the conversations I have with veterans in what we as Senators and Members of Congress call casework--someone who brings us a problem with the hope that we can make a difference and find a solution. Our casework in this area has escalated dramatically.

A number of these casework requests involve--one of them, for example, involves a veteran with cancer. I mentioned this in a hearing in which VA officials were in front of our Veterans' Affairs Committee just in the last couple of weeks. But this veteran with cancer--he and others who have cancer, chronic pain, or mental health concerns are among the most vulnerable, high-risk veterans in the VA's patient population.

In one case, the VA canceled the community care authorization for a veteran in Manhattan, KS, about an hour away from Topeka, where there is a VA hospital. The issue here is, this veteran--one, why did they cancel the care? Two, this veteran had completed 58 of 60 cancer treatments, and the VA canceled the last 2 in his hometown and told him he needed to find chemotherapy at the VA in Topeka, about an hour away. The VA wanted him to drive back and forth to Topeka for his remaining treatments.

The VA, when I told them the facts, saw that something is wrong here and adjusted to allow him to have his treatments--the last 2 of the 60--where he had been receiving the first 58. But it is only one example in which the VA is rolling back the opportunities for veterans who are already receiving care in the community to continue to receive that care.

These kinds of decisions would be alarming and unacceptable to me and many of my colleagues I think at any time, but it is particularly concerning right now--and it is why I am on the Senate floor today highlighting this issue--it is particularly concerning right now given that the VA recently implemented a strategic hiring pause in the VA healthcare system and is actively working to reduce the VA workforce by 10,000 employees.

It defies my understanding, how the VA expects to limit choices for veterans in the community--in other words, forcing them into a VA direct care system--while at the same time working to reduce staff in that direct care system that are actually available to care for those veterans.

Independently, these policy goals are cause for concern. Together, they risk the welfare of veterans and the VA's workforce nationwide.

I would encourage my colleagues to take a look at the casework that their staffs are working on on behalf of veterans in their States and see if they are not experiencing the same thing that I am seeing, which is more and more veterans saying: Senator, Jerry, Senator Moran, can you help me? I have been receiving care in the community. I like the way I am receiving that care. I like my provider. Yet the VA is pulling the rug out from under me.

These actions could cost some veterans their lives and drive other veterans away from VA healthcare benefits that they have earned and deserve. I have had several veterans tell me: I like what I am getting in the community so much, I am going to pay for it out of my own pocket.

Veterans can do better. The VA can do better. The VA must do better.

But I don't think this is just a happenstance. I don't think that the facts or the circumstances I am describing to my colleagues are just something that seems to be happening at the VA. It is a concerted effort by VA leadership to bring community-care veterans back into direct care at the VA.

As my colleagues may recall from the MISSION Act, what the law says is a veteran, in many instances--in most instances--is entitled to care in the community if he or she--the veteran--along with their provider, decide it is in the best interest of the veteran.

That decision is not made by the VA whether a veteran is entitled to care in the community; it is made by the patient--the veteran--and the provider--the doctor, the nurse practitioner, the physician assistant. Yet there is a concerted effort in VA leadership to deny veterans that care and insist that if they are going to receive care, they receive direct care within the VA healthcare system.

I am a fan of the VA healthcare system. I support it. I work hard to make sure that it has the capabilities--their assets, the necessary resources--to do its job. But I also know that there are circumstances, particularly in rural areas or certain kind of specialized treatment, in which it is the right thing to do to allow a veteran, with his or her desire, and his or her provider saying this is in the best interest of my patient to have care provided in the community.

This is a really important issue. The VA struggled to provide care for veterans in the past. Many improvements have been made. We have given veterans a choice. But the VA has no right, no ability, to undermine the choice that a veteran makes. I call on the VA to immediately reverse course.

The VA has, of course, explained to me their rationale, in some ways deny that there is any concerted effort or any policy change; but the circumstances are so evident, so prevalent, that I absolutely believe that the VA's policies, the encouragement of their staff, is to do something contrary to the law.

The VA needs to reverse its course, reaffirm the right of veterans-- those who have served our country. They have the right to seek the care that they need and desire in the community in which they live or where they believe the best absolute care can be provided to them under their current healthcare circumstances.

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