Key Takeaways
- •Douglas Allen Collins (Secretary, Department of Veterans Affairs) presented a $488.2 billion fiscal year 2027 budget request, representing a 7.7 percent increase to expand veterans' healthcare and benefits.
- •Collins highlighted that the Veterans Benefits Administration reduced its claims backlog from 260,000 to 77,000 while successfully launching the electronic health record modernization system at facilities in Michigan.
- •Sen. Ossoff (D-GA) questioned Collins regarding a 17.2 percent funding increase for privatized community care compared to a 2 percent increase for direct VA medical care services.
- •Sen. Baldwin (D-WI) raised concerns about the elimination of 30,000 unfilled clinical positions, while Sen. Boozman (R-AR) praised the department's progress in modernizing electronic medical records.
- •The subcommittee will monitor the Restructure for Impact and Sustainability initiative to consolidate administrative functions and evaluate the department's efforts to improve rural healthcare and suicide prevention.
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Hearing Analysis
Overview
This hearing focused on the Department of Veterans Affairs (VA) budget request for fiscal year 2027, which totals $488.2 billion. The discussion centered on the department's efforts to manage the massive expansion of benefits and healthcare eligibility triggered by the PACT Act and the MISSION Act while simultaneously undergoing a major organizational overhaul. Central to the testimony was the "Restructure for Impact and Sustainability" (RISE) proposal, a plan to streamline administrative functions and improve healthcare delivery across the VA’s vast network of medical centers and clinics.
Key Testimony & Policy
Secretary of Veterans Affairs Douglas Allen Collins and VA Chief Financial Officer Richard F. Topping presented a budget request representing a 7.7 percent increase over fiscal year 2026 enacted levels. The request includes $144.7 billion in discretionary funds and $337.7 billion in mandatory funds, with $54.6 billion specifically allocated to the Toxic Exposure Fund. A major pillar of the request is $4.2 billion for the Electronic Health Record Modernization (EHRM) program, an $840 million increase intended to accelerate the deployment of the Oracle Cerner system following a successful recent rollout in Michigan.
Secretary Collins detailed the RISE proposal, which aims to consolidate administrative functions above the clinic level, reducing the number of Veterans Integrated Services Networks (VISNs) to five and creating Health Service Administrators (HSAs) to oversee smaller clusters of hospitals. This reorganization is intended to give hospital directors more autonomy and reduce bureaucratic delays in hiring and procurement. On the benefits side, Secretary Collins highlighted a dramatic reduction in the disability claims backlog, which dropped from 260,000 to 77,000 during his tenure. He also announced a plan to simplify the disability benefits application from 18 pages down to three or four pages by July 2026.
Infrastructure and construction were also major themes. The VA requested $10.4 billion for major and minor construction, including $5 billion for deferred maintenance. Specific projects mentioned included medical center expansions in Indianapolis, New Hampshire, and San Antonio, as well as the expansion of four national cemeteries. The Secretary also discussed the "CHIP-IN for Vets Act," praising its success in leveraging community partnerships for projects like the Tulsa facility with Oklahoma State University.
Notable Exchanges & Partisan Dynamics
Ranking Member Jon Ossoff (D-GA) expressed significant concern regarding the balance between direct VA care and outsourced community care. He noted a 17.2 percent increase in the Medical Community Care account compared to only a 2 percent increase for direct care, questioning why the VA is prioritizing privatized care when its own data shows direct VA care often yields better outcomes. Sen. Ossoff also pressed the Secretary on the potential closure or scaling back of services at clinics in Tennessee, New York, Maine, and Arkansas, reminding the department that federal law requires a formal impact analysis be provided to the committee before any such closures.
Sen. Gary C. Peters (D-MI) and Sen. Tammy Baldwin (D-WI) raised alarms about clinical staffing levels. Sen. Peters pointed out that despite the successful EHRM rollout in Michigan, the state faces severe shortages in 76 occupational categories. Secretary Collins countered that while raw staffing numbers have increased by 14 percent since 2019, patient interactions only grew by 6 percent, suggesting a need for better allocation rather than just more hiring.
Sen. Kirsten E. Gillibrand (D-NY) confronted the Secretary regarding the closure of the Schenectady VA clinic, emphasizing the two-hour drive time veterans in rural areas would face to reach the Albany facility. Secretary Collins defended the decision, stating the contract clinic was underperforming and failing to meet VA standards, but he agreed to explore the possibility of establishing a VA-run clinic in the area.
Organizations Mentioned
- United States Department of Veterans Affairs (VA): The primary subject of the hearing, responsible for managing the $488.2 billion budget request and implementing the RISE reorganization. - National Cemetery Administration (NCA): Praised for its efficiency and "one chance to get it right" motto; the budget includes $500 million for cemetery expansions. - Togus VA Medical Center: Identified as the oldest VA facility in the country; Sen. Susan M. Collins (R-ME) highlighted its $594 million in needed infrastructure improvements. - Centers for Medicare & Medicaid Services (CMS): Mentioned regarding the high quality ratings of VA hospitals compared to private sector facilities. - Disabled American Veterans (DAV): Noted for its partnership in providing volunteer drivers for rural veterans, a pool that is currently shrinking due to an aging volunteer base. - Oklahoma State University (OSU): Cited as a successful partner in the Tulsa facility project under the CHIP-IN for Vets Act. - United States Postal Service (USPS): Criticized by Sen. Mike Rounds (R-SD) for poor service in South Dakota, which has led to veterans missing appointments and delayed prescriptions.
What's Next
The VA plans to continue the EHRM rollout with upcoming deployments in Ohio, Indianapolis, and Alaska. The department is also working to finalize the simplification of the disability benefits application, with a target release date around July 4, 2026. Regarding the RISE reorganization, the VA will continue transitioning to the new five-VISN structure and HSA model. The subcommittee requested follow-up documentation on clinic closure impact analyses and specific staffing numbers for pain management and opioid safety programs.
Transcript
Good morning. The subcommittee will come to order. Mr. Secretary, we are really thankful that you're here today to discuss the fiscal year 2027 budget and fiscal year 2028 advance appropriations request for the Department of Veterans Affairs. I would also like to recognize the VA Chief Financial Officer, Mr. Richard Topping, who is here to provide the technical budget support if necessary. He's going to answer the really difficult questions. And it's not hard to understand why that might be necessary in the sense that the budget request is a total of $488.2 billion in fiscal year 2027 for the Department of Veterans Affairs, representing a 7.7 percent increase over fiscal year 2026 enacted levels. This includes $144.7 billion in discretionary funds, $337.7 billion in mandatory funds to include $54.6 billion for the toxic exposure fund and advance appropriations for fiscal year 2028. Landmark pieces of legislation like the PACT Act and the MISSION Act have reshaped access for veterans to healthcare. The creation of these programs has ensured more veterans are eligible to receive care and have access to the resources needed to exercise these earned benefits. This subcommittee has worked tirelessly to ensure that the department has the resources it needs to deliver world-class healthcare to those that have served. The budget request also includes significant investment in systems modernization to support veterans who use VA services and the dedicated workforce that is essential to providing a positive veterans experience. For instance, this year's budget request includes $4.2 billion, an $840 million increase to support the continued deployment acceleration of electronic medical record. The VA faced significant challenges during the early rollout stages. However, VA's current leadership has adapted and earlier this month delivered what seems to be a very successful rollout in Michigan. Secretary Collins, we look forward to an update on this program and hope we are on track to make health records boring again. Mr. Secretary, your RISE proposal would consolidate administrative functions in the Veterans Health Administration above the clinic level. This subcommittee is interested in an update on the proposal, the expected efficiencies you hope to gain, what risks the VA is evaluating as it considers the final proposal, and any budget implications. In addition to updates on those big picture items, we also look forward to hearing details about the department's request for mental health services, including efforts to prevent veteran suicide, initiatives to prevent veteran homelessness, resources dedicated to care for women veterans, and efforts to improve care for our rural veterans. I would be remiss to not publicly acknowledge the retirement of long-time clerk of this subcommittee. For a dozen years, Patrick Magnuson has worked tirelessly to ensure adequate funding for VA and military construction through some of the most challenging and dynamic years in our nation's history. Thank you, Patrick, and Godspeed in your retirement. [Applause.] I understand you got a bunch of medals last night. I'm surprised you're not wearing them. [Laughter.] We do appreciate your, appreciate all of your hard work. Before we hear from the Secretary, I want to advise the subcommittee that Secretary Collins has a family matter to attend to immediately after the hearing. He's been gracious enough to go ahead and come and testify regardless of this, but we will aim to finish no later than noon to allow him to catch his flight. With that, I'd like to recognize my colleague and friend and ranking member, Senator Ossoff, for any opening comments that he may have.
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