Eight months after the Department of Veterans Affairs launched the MISSION Act to expand private care opportunities for veterans, the agency still doesn't know how many appointments have been completed or how much the expansion cost.
Senate Veterans Affairs Committee leaders told VA officials they were frustrated over the lack of information, wondering how the VA was celebrating the initiative as a success.
The MISSION Act replaced the expiring Choice Act in June 2019, intending to expand the opportunities veterans have to get "community" or private care on VA's dime.
A recent Inspector General report warned that at some VA's, referrals to private care already had lengthy wait times -- nearly two months -- even before MISSION launched, and that the problem could worsen without change.
Namely, because according to Chairman Sen. Jerry Moran, R-Kan., the number of patients seeking care outside VA is expected to increase from 648,000 to 3.7 million.
"This committee has concerns about how the VA is building out the network (of private providers) and its ability to meet veteran demand," Moran said. "We must take this opportunity to learn from (the Inspector General report) and have honest conversations about difficulties that could threaten the networks well before it is fully developed. We owe it to veterans to get MISSION right the first time."
MISSION is of critical importance in Moran's district, he said, which is as large as the entire state of Illinois but lacks a VA medical center.
"For veterans in rural areas in my state, MISSION's community care network is essential for timely healthcare," he said.
Ranking Member Sen. Jon Tester, D-Mont said they still don't know how much the MISSION Act costs, important data
“I don’t see how we can figure out how many dollars are associated with those appointments and whether the usage is in line with what you estimated when this program was set up,” said Tester.
Lawmakers originally allocated about $15 billion for MISSION Act expanded private care in VA's most recent budget.
Tester asked Stone if that $15 billion would be enough. But Richard Stone, executive in charge of the Veterans Health Administration said he didn't know.
"I think you asked the key question that keeps me up at night," he said, adding that VA is still totaling the reimbursement claims before the agency will know how many appointments were completed and how much it all cost. He estimated the cost so far at about $1 billion to $1.1 billion per month since MISSION launched last June, or about $8 billion to $9 billion.
Lawmakers were particularly concerned with cost since the previous Choice Act program routinely ran out of money and had to ask Congress for more on multiple occasions to keep funding veterans' care.
MISSION will be different, though, Stone said.
"I'm confident at this point that we are sufficiently funded -- that we won't be up here asking for additional dollars," he said.