Healthcare workers, states push back on VA hospital shakeup

States, politicians and healthcare workers are speaking out against the Biden administration's plan to restructure the veteran's healthcare system, which calls for the closure of hundreds of hospitals and clinics and the construction of new facilities.

Those pushing against the plan, including nursing unions, argue the restructuring plan would limit veterans' ability to seek care.

The plan:

The $2 trillion proposal, which still needs approval from an independent commission, Congress and President Joe Biden, calls for a makeover of the infrastructure in the veterans healthcare system. Specifically, the initial proposal includes closing or rebuilding 35 aging Veterans Affairs medical centers in 21 states and building 14 VA hospitals, according to the Military Times

Under the initial proposal, the VA would have 140 more multispecialty community-based outpatient clinics, 48 more inpatient partnerships, 27 more standalone community living centers, 14 more healthcare centers, 14 outpatient partnerships and 12 more standalone residential rehabilitation treatment programs, according to The Washington Post. All together, considering the additions and closures, the proposal would result in three fewer VA medical centers, 86 fewer community-based outpatient clinics and 86 fewer other outpatient services clinics, according to the Post

The driving force behind the proposal is the VA's desire to cut billions in spending to maintain old facilities, according to the Post. About 70 percent of the VA's healthcare facilities were built more than 50 years ago. The health system needs $61.6 billion in construction upgrades.

The VA seeks to reduce the number of aging facilities with unused inpatient beds and replace them with new facilities or different outpatient services. While some VA facilities may lose services, such as emergency care, they may gain others, such as mental health or urgent care.

The pushback:

Republican Sens. Shelley Moore Capito and Joe Manchin, who both represent West Virginia, penned an April 5 letter signed by 12 senators that calls on the Biden administration to work with Congress and local stakeholders to understand the effects of the proposal in each state. The senators worry the plan would hinder veteran's access to healthcare. 

"For many elderly veterans, VA facilities are the only place they seek care," the letter states. "The reasons veterans often cite are that they are better understood, respected and cared for at their local VA medical center. VA facilities often serve as the crux for elderly veterans' community."

In New York City, the VA plans to close two hospitals, a move opposed by two Democratic lawmakers representing New York, including Senate Majority Leader Chuck Schumer and U.S. Rep. Carolyn Maloney.

Mr. Schumer said he's creating a "battle plan" against the proposal, according to amNY.

"Our vets sacrifice so much, and so that is why, when it comes to their care, we want to invest in it, not deplete it or cut it — not on my watch," Mr. Schumer said March 27, according to amNY. "The battle plan to ensure vets across New York, from Brooklyn and beyond, get the care they fought for has been drawn."

Ms. Maloney joined union workers and veterans outside the Manhattan VA Medical Center in protest of the proposed closure, amNY reported April 18.

There is similar pushback in other states as well. For example, in Massachusetts, nearly every member of Massachusetts' federal delegation signed a letter asking the VA to reconsider the closure of Northampton (Mass.) VA Medical Center. 

"We are very concerned that this recommendation could jeopardize veterans' access to high quality, specialized care that the veterans living in Central and Western Massachusetts deserve," the lawmakers wrote in an April 14 letter to Veterans Affairs Secretary Denis McDonough.

Registered nurses and healthcare professionals from Massachusetts represented by the Massachusetts Nurses Association, rallied March 28 outside the Northampton VA Medical Center, opposing its planned closure.

The VA restructuring plan also faces pushback in South Dakota. Gov. Kristi Noem slammed the VA's plan to close or downsize several VA facilities in her state, saying the Biden administration "betrayed the men and women who put their lives on the line to defend our nation and our freedoms."

Several lawmakers from South Dakota, including U.S. Sen. John Thune, a Republican, also spoke out against the VA proposal.

"Let me put this as plainly as I can: The VA is wrong, period," said Mr. Thune, according to the Argus Leader. "This is a massive mistake, and I will do everything within my power to show the administration, by working with the Asset and Infrastructure Review Commission, why it would be in everyone's best interest, especially South Dakota's veterans, to immediately change course."

In Ohio, U.S. Sen. Sherrod Brown, a Democrat, is pushing back on a proposal to close the Chillicothe (Ohio) Veterans Affairs Medical Center and build a new community-based outpatient clinic in a nearby city. The proposal also would move inpatient acute mental health and residential rehabilitation to the Dayton VA Medical Center and offer other care at other VA clinics. 

"Why would you come into one of the best mental health services anywhere in Chillicothe — why would you disrupt that?" Mr. Brown asked, according to The Ohio Capital Journal. "Why would you take these services away and force veterans, many of whom are older and unable to travel as far, to drive to Dayton?"

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