Congressional lawmakers are taking steps to make it easier for veterans to access medical care outside of traditional Department of Veterans Affairs (VA) facilities. New bipartisan-backed legislation introduced in both chambers would reduce the bureaucratic barriers veterans face when seeking treatment at community hospitals and clinics, a move aimed particularly at improving care access for rural veterans.
Why Community Care Access Is Critical for Veterans
For many veterans, especially those living in rural or underserved areas, reaching a VA hospital can mean hours of travel and significant delays in receiving care. John-Paul Sager, a Marine Corps and Army veteran in Iowa, voiced his frustration at the time-consuming process to get approval for something as routine as chiropractic treatment. “It seems like it takes entirely too long,” he said.
The VA’s current Community Care program was designed to bridge these gaps by allowing eligible veterans to receive treatment at non-VA facilities, with the VA covering the cost. However, veterans often face hurdles such as lengthy approval processes, repeated paperwork, and inconsistent communication — obstacles that discourage many from even trying.
Proposed Legislation Seeks to Cut Red Tape
In response, Republican lawmakers, including Sen. Kevin Cramer (R-N.D.) and Rep. Mike Bost (R-Ill.), chair of the House Veterans’ Affairs Committee are advocating for legislative reforms to streamline the VA’s community care process.
Cramer’s bill would permit veterans living within 35 miles of a designated rural “critical access” hospital to bypass VA referrals entirely, allowing them to seek care directly at local facilities. This would particularly benefit veterans in places like western North Dakota, where the nearest VA hospital can be over 400 miles away.
“We can’t let the VA itself determine whether a veteran is qualified to receive local care,” Cramer emphasized. “My main concern is for veterans, not for the VA.”
Rising Demand, But Limited VA Reach
According to the VA, around 9 million veterans are enrolled in its health care system, with 3 million, including 1.2 million rural veterans using their benefits at non-VA facilities last year. Despite improvements made under previous laws like the VA MISSION Act, veterans still face cumbersome approval processes that discourage them from seeking timely and convenient care.
In towns like Park River, North Dakota, local providers such as First Care Health Center are ready and willing to treat veterans — but the paperwork and bureaucracy can be overwhelming. Marcus Lewis, the center’s CEO and a Navy veteran, shared his frustration: “You have to go through hoops. It’s frustrating. A lot of folks just don’t want to fight the system.”
Concerns Over Funding and VA Sustainability
Not everyone agrees on the proposed direction. Democratic lawmakers and several veteran advocacy groups worry that expanding community care without adequate safeguards could bleed resources from the VA’s own facilities.
“We must prevent funds from being siphoned away from veterans’ hospitals and clinics, or VA will crumble,” said Rep. Mark Takano (D-Calif.), the top Democrat on the House Veterans’ Affairs Committee. Organizations like Disabled American Veterans (DAV) also voice concerns, advocating for VA to remain the primary care provider. Jon Retzer, DAV’s deputy national legislative director, acknowledged the need for better access but emphasized that referrals from VA physicians ensure continuity and quality. “We want to ensure that the VA is the primary provider of that care,” he said.
Private Clinics Willing, But Burdened by Bureaucracy
The frustration is not limited to veterans. Private providers like Vanderloo Chiropractic Clinic in Waterloo, Iowa, often feel stuck between wanting to help and dealing with inefficient systems. The clinic’s office manager, Linda Gill, described the paperwork as burdensome and inefficient, even though reimbursement is similar to private insurance rates. “After what they’ve done for us? Please,” she said, underscoring the clinic’s decision to stay in the VA program out of commitment to veterans.
A Balancing Act Between Efficiency and Oversight
While the VA’s leadership, including Secretary Doug Collins, has pledged to improve the Community Care program without weakening its own infrastructure, no official comments have been made on the new legislative proposals. The department must balance improving access with preserving the integrity and sustainability of its core system.
Lawmakers like Bost continue to push forward, securing significant funding, including a proposed $34.7 billion for the Community Care program in 2026, a nearly 50% increase from previous years.
Veterans Deserve a Better System
Veterans like Sager represent the core of this national debate. Although he values the care and camaraderie he receives at the VA, he believes veterans shouldn’t have to jump through hoops for care they are entitled to especially when the VA doesn’t offer the needed service.
Chiropractic care isn’t available at his local VA clinic, so he’s sent to a private provider. Yet, each referral requires a new round of paperwork and follow-ups. “It shouldn’t be this hard,” Sager said.
Need Help Navigating VA Benefits or Community Care?
If you’re a veteran struggling to get timely care through the VA, especially when seeking non-VA treatment, Veterans Guide can help. Whether you’re trying to appeal a denied claim, increase your disability rating, or understand your options under the VA Community Care program, our team is here to support you every step of the way. Don’t fight the system alone contact Veterans Guide today to get the help you’ve earned through your service.
