Blumenthal Raises Alarm Over Skyrocketing Cost of VA Community Care at Hearing

[WASHINGTON, D.C.] - At a Senate Veterans' Affairs Committee hearing today, Ranking Member Richard Blumenthal (D-CT) stressed his concerns with the skyrocketing cost of community care, which is provided when the Department of Veterans Affairs (VA) is unable to deliver health care to veterans in an accessible or timely manner.

Blumenthal pressed VA Chief Financial Officer Richard Topping on the disproportionate funding increase for community care, relative to VA direct care: "Since 2019, the funding for the VA community care program has increased from $9 billion to more than $48 billion in the VA fiscal year 2026 request. That's an increase of 530%. That's a staggering increase, wouldn't you agree?" When Topping agreed it was a significant increase, Blumenthal continued: "Over that same period, funding for VA direct care has increased by far less, about 200%...Why the disparity?"

Blumenthal asked Topping to explain why the rate of increase in spending on community care has far outpaced the rate of increase in the number of veterans served by community care. When Topping was unable to answer this question, Blumenthal replied: "…[W]e need to answer those types of questions. You don't have answers right now. You say that the program isn't designed to provide those kinds of answers, but anyone running a health care program would say we really ought to be answering those questions, wouldn't you agree?"

Blumenthal also stressed the importance of ensuring VA holds community care providers to the same quality standards and training requirements as VA doctors: "Shouldn't [community care providers] be absolutely required to meet the same standards of quality of training and efficiency and all of the criteria that a veteran going to a VA facility has a right to expect?"

In December, Blumenthal and his Democratic colleagues introduced the Honor Act-sweeping legislation to reform and improve VA health care that includes provisions requiring community care providers to meet the same training and quality standards required of VA providers.

The full text of Blumenthal's opening is copied below and a video link is available here.

Senator Blumenthal: Thank you, Mr. Chairman. Thank you to our witnesses for being here today and for your service to our country and to all the men and women who work with you, veterans among them, dedicated to the mission of providing gold standard health care to all of our veterans. We are here to discuss VA's next generation of community care contracts, which will total about a trillion dollars. To be live, as I understand it, in 2027, which gives us time to assess what the needs are for community care on contracts that will be indefinite delivery and indefinite quantity. Which is kind of scary when you think of all the indefinites there and it emphasizes the need for strong oversight on the part of the Congress and the Inspector General of the VA. And we cannot really talk about community care without talking about its impacts on VA's direct care budget. Because for many veterans care in VA facilities is veterans care and what they are seeing now is losses of staff through caps on workforce, the attrition of many of the skilled and dedicated men and women who have served, and the potential for lower quality if we take our eye off the ball of direct patient care through VA facilities.

My feeling is that the VA has to prioritize resources for expanding access to direct care by adding and expanding existing facilities, increasing staff to reduce wait times, and supporting the VA's gap services such as telehealth, emergent, and urgent care capabilities. Community care is a critical component and a supplement to VA direct care. It is veterans' care-community care is veterans' care no question. But it cannot supplant VA direct care. For all the reasons that everybody here knows well it is the preference that veterans have to seek care directly at VA facilities, at least for many of them through VA providers. It matches or outperforms the quality of community care in many instances, and it is a more efficient use of taxpayer dollars.

So first and foremost, we need access to information. The Chairman and I submitted a letter to the Secretary, after his appearance here, with very specific requests for information that he promised to provide. There has been no response so far. We are hoping, or at least I will speak for myself, that that information will be forthcoming. It is essential to judgements that will be made about community care as well as about direct VA care. I would oppose a blank check for community care without real guardrails and establishing those guardrails depend on getting straight answers from the department that enable us to do basic oversight including the requests that we made on the record. I will just say Committee staff have not received a quarterly briefing as of yet from the Office of Integrated Veterans Care - the office overseeing VA's community care system - and I am hopeful that we will see responsiveness on that score as well.

In short, information and communication must be a two-way street and not just with us but with veterans, they are the most important constituency here. And I know they expect straight answers, promptly, to questions that are raised in Committee hearings and also in the inquiries that we raise. So, again my thanks for being here today. And I am going to put that letter, Mr. Chairman is there is no objection, the letter that we did in the record.