After blocking plan that would have downsized Northwest VA hospitals, senators propose new path to modernizing VA infrastructure

WASHINGTON, D.C. – Last year, a bipartisan group of senators blocked a controversial process that would have downsized VA hospitals in Spokane and Walla Walla as part of an effort to reshape the Department of Veterans Affairs’ nationwide system of nearly 1,300 clinics and hospitals.

Now, a new bill introduced by Sens. Jon Tester of Montana, Patty Murray of Washington and other Democrats on the Senate VA Committee proposes a new path to modernizing the health care infrastructure on which more than 9 million veterans rely. But their plan will need to overcome many of the same challenges that doomed the previous process, known as the AIR Commission, in order for the VA to meet its obligations to veterans in the years ahead.

Last year, Congress passed a landmark bill that expands VA care for veterans exposed to toxic substances from burn pits, known as the PACT Act. Tester, who chairs the Senate VA Committee, said that bill – combined with new laws that expand mental health services and care for female veterans, among others – makes a modern hospital system even more necessary.

“All those bills are really good bills and they’re meant to do really good things,” Tester said in an interview. “But if there isn’t the facilities and the manpower to do that, then it ain’t going to get done.”

The new bill aims to give the VA a roadmap and consistent funding to carry out a long-term plan to construct and remodel the buildings it needs while getting rid of vacant buildings. It also would increase oversight to avoid the kind of wasteful spending that was exemplified by a hospital outside Denver whose construction went roughly $1 billion over budget.

To that end, it would require the VA to designate officials in charge of new infrastructure and disposing of abandoned buildings. VA leaders would have to present Congress with a 10-year infrastructure plan and a corresponding budget, which would improve continuity as department leaders come and go.

In a news conference Jan. 31, VA Secretary Denis McDonough said one of his major goals is showing that the department can avoid construction debacles like Denver’s and be a responsible steward of taxpayer money. He pointed to a successful project to build a new hospital that recently was completed in Orlando, Florida.

“We’re doing our part to prove to Congress and to veterans that we can be trusted with those resources,” he said. “Commensurate with that, we hope to see an increase in funding available for major construction. That’s a conversation we’re also having with the president.”

The AIR Commission process was established as part of the Trump administration’s signature veterans’ policy bill that passed in 2018. As required by that law, McDonough issued a set of recommendations in March 2022 that included downsizing Walla Walla’s VA hospital and ending inpatient services at Mann-Grandstaff VA Medical Center, turning the Spokane hospital into a clinic that would have to refer patients with serious ailments to other facilities.

Tester, Murray and 10 other senators – including five Republicans – effectively killed that proposal when they announced their opposition in June 2022, spurred by angry veterans and VA employees.

Stopping the unpopular process was the easy part. Coming up with a new plan that can draw bipartisan support and survive an eventual change in presidential administrations will be harder.

No one disputes that many VA facilities need to be renovated or replaced. The nation’s veteran population is aging and moving from the Midwest and Northeast to states like Arizona and Florida. That requires more and bigger hospitals and outpatient clinics in some places, while elsewhere the VA spends millions each year to maintain hundreds of vacant buildings.

The disagreements begin when it comes to the VA’s future. Some veterans’ groups that were influential during the Trump administration advocate for sending more veterans to private hospitals and even privatizing the VA altogether. While no Republicans have cosponsored his bill yet, Tester said he’s hopeful his fellow senators will see his proposal as a nonpartisan effort to make sure veterans get better health care and taxpayers get “the best bang for the buck.”

“In order for this to move, we’ve got to get some Republicans on,” he said. “I hope that they will look at it for what it is.”

The bill Tester introduced Jan. 25 along with Murray and fellow Democratic Sens. Sherrod Brown of Ohio and Mark Warner of Virginia has the support of most major veterans’ groups, including the American Legion, Veterans of Foreign Wars, Iraq and Afghanistan Veterans of America, Disabled American Veterans and Paralyzed Veterans of America.

In a statement, Murray said projects across Washington state would benefit from the legislation.

“Veterans and their families are owed more than just a debt of gratitude – they deserve the high-quality care they’ve earned for their service,” Murray said. “That’s why it’s really important we do all we can to ensure VA facilities are well-equipped to meet the needs of veterans all over the country.”