WATERLOO, Iowa — John-Paul Sager appreciates the care he has obtained at Division of Veterans Affairs hospitals and clinics, however he thinks it must be simpler for veterans like him to make use of their advantages elsewhere.
Sager, a Marine Corps and Military veteran, makes use of his VA protection for non-VA remedy of again accidents stemming from his navy service. However he mentioned he typically should make a number of cellphone calls to acquire approval to see an area chiropractor. “It seems like it takes entirely too long,” he mentioned.
Many veterans reside hours from VA amenities, or they want well being providers that aren’t available from the VA. In such circumstances, the division is meant to supply a referral and pay for personal care. Critics say it typically hesitates to take action.
Republicans controlling Congress goal to streamline the method of acquiring what is called group care.
Two Republican senators have launched laws that will make it simpler for rural veterans to hunt care at native hospitals and clinics. The proposals would construct on VA group care applications that began underneath Democratic President Barack Obama and have been expanded in Trump’s first time period.
The proposals would construct on VA group care applications that began underneath Democratic President Barack Obama and have been expanded in Trump’s first time period.
Critics fear that steering veterans to personal care amenities drains federal cash from the VA hospital and clinic system. However supporters say veterans shouldn’t be pressured to journey lengthy distances or wait months for the remedy they may receive at native hospitals and clinics.
“My main concern is for veterans, not for the VA,” Sen. Kevin Cramer (R-N.D.) advised KFF Well being Information. “I don’t believe we have an obligation to sustain the bureaucracy.”
About 9 million veterans are enrolled within the VA well being system. Final yr, about 3 million of them — together with 1.2 million rural veterans — used their advantages to cowl care at non-VA amenities, based on knowledge supplied by the division.
Cramer co-sponsored a invoice that will enable veterans who reside inside 35 miles of a rural, “critical access” hospital to make use of VA advantages to cowl care there or at affiliated clinics with out referrals from VA workers.
Cramer, who serves on the Senate Veterans’ Affairs Committee, famous his state has only one VA hospital. It’s in Fargo, on the state’s japanese border, which is greater than 400 miles by automotive from elements of western North Dakota.
Many North Dakota veterans drive previous a number of group hospitals to get to the VA hospital for remedy, he mentioned. In the meantime, many rural hospitals are determined for extra sufferers and revenue. “I kept thinking to myself, ‘This doesn’t make any sense at all,’” Cramer mentioned.
Cramer mentioned earlier legal guidelines, together with the VA Mission Act, made it simpler for veterans to make use of their advantages to cowl care at group hospitals and clinics.
However he mentioned veterans nonetheless should fill out an excessive amount of paperwork and acquire approval from VA staffers to make use of non-VA amenities.
“We can’t let the VA itself determine whether a veteran is qualified to receive local care,” he mentioned.
U.S. Rep. Mark Takano of California, who’s the highest Democrat on the Home Veterans’ Affairs Committee, mentioned he sees the necessity for outdoor take care of some veterans. However he contends Republicans are going overboard in shifting the division’s cash to assist personal well being care amenities.
The VA offers specialised care that responds to veterans’ wants and experiences, he argues.
“We must prevent funds from being siphoned away from veterans’ hospitals and clinics, or VA will crumble,” Takano mentioned in a press release launched by his workplace. “Veterans cannot afford for us to dismantle VA direct care in favor of shifting more care to the community.”
Some veterans’ advocacy teams have additionally expressed considerations.
Jon Retzer, deputy nationwide legislative director for the Disabled American Veterans, mentioned the group desires to make it simpler for veterans to search out care. Rural and feminine veterans can have a very robust time discovering applicable, well timed providers at VA hospitals and clinics, he mentioned. However the Disabled American Veterans doesn’t wish to see VA amenities weakened by having an excessive amount of federal cash diverted to personal hospitals and clinics.
Retzer mentioned it’s true that sufferers typically anticipate VA care, however so do sufferers at many personal hospitals and clinics. Most delays stem from workers shortages, he mentioned, which afflict many well being amenities. “This is a national crisis.”
Retzer mentioned the Disabled American Veterans favors persevering with to require referrals from VA physicians earlier than veterans can search VA-financed care elsewhere. “We want to ensure that the VA is the primary provider of that care,” he mentioned.
Veterans Affairs Secretary Doug Collins has pledged to enhance the group care program whereas sustaining the power of the division’s hospitals and clinics. The division declined a KFF Well being Information request to interview Collins.
Marcus Lewis, CEO of First Care Well being Middle, which features a hospital in Park River, North Dakota, helps Cramer’s invoice. Lewis is a Navy veteran who makes use of the VA’s group care choice to pay for remedy of a again harm stemming from his navy service.
General, Lewis mentioned, the group care program has develop into simpler to make use of. However the software course of stays difficult, and members should repeatedly receive VA referrals for remedy of power points, he mentioned. “It’s frustrating.”
Park River is a 1,400-person city about 50 miles south of the Canadian border. Its 14-bed hospital provides an array of providers, together with surgical procedure, most cancers care, and psychological well being remedy. However Lewis commonly sees a VA van selecting up native veterans, a few of whom journey 140 miles to Fargo for care they’re entitled to obtain domestically.
“I think a lot of folks just don’t want to fight the system,” he mentioned. “They don’t want to go through the extra hoops, and so they’ll jump in the van, and they’ll ride along.”
Rep. Mike Bost (R-Sick.), chairman of the Home Veterans’ Affairs Committee, mentioned veterans in some areas of the nation have had extra bother than others in getting VA approval for care from personal clinics and hospitals.
Bost helped acquire the Home’s approval for Trump’s request for $34.7 billion for the group care program in 2026. Though spending on this system has gone up and down lately, the appropriation represents a rise of about 50% from what it was in 2025 and 2022. The Senate included related figures for subsequent yr in its model of a navy spending price range that handed Aug. 1.
Bost additionally co-sponsored a Home invoice that will spell out necessities for the VA to pay for group care.
Sager hopes the brand new proposals make life simpler for veterans. The Gulf Conflict veteran lives within the northeastern Iowa city of Denver. He travels about 15 miles to Waterloo to see a chiropractor, who treats him for again and shoulder ache from accidents he suffered whereas coaching Saudi troops in hand-to-hand fight.
Sager, who stays lively within the Military Reserve, additionally visits a Waterloo outpatient clinic run by the VA, the place his major care physician practices. He appreciates the company’s mission, together with its employment of many veterans. “You just feel like you’re being taken care of by your own,” he mentioned.
He believes the VA can run a powerful hospital and clinic system whereas providing options for veterans who reside removed from these amenities or who want care the VA can’t promptly present.
The native VA doesn’t supply chiropractic care, so it pays for Sager to go to the personal clinic. However each few months, he must receive recent approval from the VA. That usually requires a number of cellphone calls, he mentioned.
Sager is one in every of a couple of dozen veterans who use the group care program to pay for visits at Vanderloo Chiropractic Clinic, workplace supervisor Linda Gill mentioned.
Gill mentioned the VA program pays about $34 for a typical go to, which is comparable to personal insurance coverage, however the paperwork is extra burdensome. She mentioned leaders of the chiropractic follow thought-about pulling out of the VA program however determined to place up with the hassles for a great trigger. She needs veterans didn’t have to leap by so many hoops to acquire handy care.
“After what they’ve done for us? Please,” she mentioned.
