A bipartisan group of senators has set up a roadblock, perhaps insurmountable, against a congressionally mandated US Dept. of Veterans Affairs proposal revamping its extensive network of hospitals and other health care facilities.
Twelve Senators, led by Veterans' Affairs Committee Chairman Jon Tester (D-Mont.), said in a June 27 statement that they oppose the process established by a 2018 law for launching an overhaul of VA’s system of facilities.
At issue is the process for an Asset and Infrastructure Review (AIR) Commission, created by the 2018 VA MISSION Act. That law required the VA to propose a reshaping of its portfolio of about 170 medical facilities, which the department says, makes it the largest U.S. integrated healthy care system.

VA’s proposal, issued in March, would shut some facilities, build new ones and expand or reconfigure others. At the time, the Associated General Contractors of America projected that the proposed program could mean billions of dollars for construction.

The proposal would respond to such trends as an increase in the number of veterans who live in certain parts of the South and West and a reduction in the number who live in the northeast and Midwest, a spokesperson said in March.

The age and condition of VA facilities also played a part in the department's plan. In the report outlining the new facilities network, department Secretary Denis McDonough said it would replace “old, outdated, run-down facilities with state-of-the-art facilities designed with veterans and VA employees in mind.”

The median age of VA’s buildings is almost 60 years, compared with a median of 8.5 years for U.S. private-sector hospitals. About 69% of VA’s hospitals are older than 50 years, the March report said.
Under the 2018 statute, after VA developed its proposal, the plan was to be reviewed by the AIR Commission, composed of nine presidentially nominated members who were subject to Senate confirmation.
The commission then was to study the plan, which it could alter, and submit its version to the President. He then could end the process at that point or send his recommendations to Congress.

Fierce Opposition

The lever that the 12 senators now are wielding is refusing to approve any nominees to the commission. Biden sent eight nominations to the Senate in March and one in June, but none has come up for a vote or even had a confirmation hearing.

Tester and the 11 other senators said in their statement that the AIR process “would put veterans in both rural and urban areas at a disadvantage” and added that the process “does not have our support and will not move forward.”

Besides Tester, the other anti-AIR Democrats are: Sherrod Brown (Ohio), Maggie Hassan (N.H.), Martin Heinrich (N.M.), Ben Ray Lujan (N.M.), Joe Manchin (W.Va.) and Patty Murray (Wash.).

Republicans who signed on to the statement are: Shelley Moore Capito (W.Va.), Steve Daines (Mont.), Rob Portman (Ohio), Mike Rounds (S.D.) and John Thune (S.D.). 

Tester’s stance is no surprise. Montana would lose a VA nursing home and two clinics under the VA proposal. At the time the proposal was released, he said that “any effort to kneecap our veterans’ health care is a non-starter for me."

Supporters Cite Outdated Facilities

The AIR program has its supporters. Sen. Jerry Moran, the veterans' affairs panel's top Republican, said in a statement, "Many of the VA's facilities are empty, underutilized and severely outdated."

Moran added, "We passed the VA MISSION Act to address these issues but by refusing to confirm commissioners, we are essentially shutting down the work of the AIR Commission and possibly our only opportunity to fix this long-standing issue."

“President Biden has insisted that our veterans in the 21st century should not be forced to receive care in early 20th century buildings. The median age of VA’s hospitals is nearly 60 years old, and that’s why the President requested nearly $20 billion in new VA infrastructure spending last year and it is why he has requested the largest ever investment in VA infrastructure in his FY23 budget," said Melissa Bryant, Acting Assistant Secretary for Public and Intergovernmental Affairs, in an email to ENR.

"Whatever Congress decides to do with the AIR Commission—which was called for in the 2018 MISSION Act—we will continue to fight for the funding and modernization that our veterans deserve,” she added.

If the AIR proposal doesn’t resurface in some form, decisions on funding and building new VA hospitals and clinics would continue to rest with Congress, including the appropriations committees. In the Senate, that key panel’s members include Tester, Capito, Heinrich, Murray and Moran.

The text of this article was updated on July 6, 2022, to reflect comments from the VA acting assistant secretary.