AFGE applauds the announcement of a bipartisan group of 12 senators, including a majority of the Senate Veterans’ Affairs Committee, that they would block the confirmation of the nine-member Asset and Infrastructure Review (AIR) Commission that would have considered closing or eliminating services at hundreds of VA facilities nationwide.
These senators took action after months of activity led by our union across the nation. AFGE launched a campaign called “Save My VA” with a website, toolkit, map of the proposed closures, analysis of the flawed recommendations, and more.
Our local leaders held rallies around the country opposing the VA’s AIR Commission recommendations and helped lead a coalition of veterans, advocacy groups, lawmakers, community and union members who all understood that modernizing our VA health care system begins with investment, new facilities, and adequate staffing – not hospital closures.
The committee’s decision not to confirm the AIR Commission nominees effectively blocks the automatic closures, but it does not repeal the law that created the commission’s general move toward privatizing health care for veterans.
The MISSION Act, which spawned the AIR Commission, includes provisions for a similarly broad facilities review every four years, though without the automatic bulk closure process. VA Secretary Denis McDonough has said he will use that law to implement future changes in the VA’s integrated health care system.
Congress can put a final stop to the fatally flawed AIR Commission by enacting the bipartisan McGovern-Fitzpatrick amendment to the 2023 National Defense Authorization Act. The amendment would repeal the AIR Commission process entirely and allow Congress to focus on the essential work of funding and rebuilding VA’s infrastructure and reaffirm its commitment to veteran-centric VA care.
AFGE has strongly opposed the AIR Commission and privatization of VA services our veterans rely on for their life-sustaining care. Here’s why:
1. The AIR Commission is part of a bigger push to privatize the VA and send veterans to for-profit hospitals not equipped to treat them
Did you know that veterans who are rushed to a non-VA facility are more likely to die than those taken to a VA hospital? That most private hospitals are not equipped to treat veterans with their unique needs? That fraudulent billings filed by for-profit providers are rampant, and taxpayers are footing the bills for services never performed? That a former VA secretary denounced the push to privatize VA services as “a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans”?
The AIR Commission was created along with a massive, new permanent contract care program as part of the VA MISSION Act in 2018, which was put together by pro-privatization special interests like the Koch brothers and their front organization “Concerned Veterans for America.” The law was designed to funnel dollars to the private, for-profit sector, allow for the outsourcing of 36 health care categories including mental health care and spinal cord injury care, and allow a corporate-style commission to decide which VA facilities to close, which is what is now known as the AIR Commission. The act will force veterans into a for-profit private hospital after the closure of their VA facility with few mechanisms to hold private providers accountable.
By passing the MISSION Act, Congress was punting on their responsibility to care for the men and women who have served our country. It was a sad day for the 9 million veterans who rely on the VA for their health care and for the more than 120,000 veterans who work there.
VA privatization received support because the VA was not adequately funded to meet the demands of veterans. The VA under the previous administration, for example, left 50,000 positions unfilled.
Since the 2018 passage of the MISSION Act, the results validated AFGE’s warnings and concerns about the agency’s overreliance on private-sector providers. Fraudulent billing, scandals, inferior treatment, and uncontrolled costs were just some of the issues associated with private-sector providers.
Instead of expanding private care, the VA should invest in its own facilities, services, and workforce – 1 in 3 themselves are veterans.
There is a place for private sector providers in the VA health care system, but it should only be to supplement a high-quality in-house VA capacity, NOT to replace it.
2. Veterans prefer to be cared for by VA staff at VA hospitals
Veterans overwhelmingly prefer to be cared for by medical professionals at VA facilities.
This is no surprise because the VA is the only healthcare system in the nation specifically built to serve the unique needs of veterans. The VA serves veterans from every war, with any injury, making it the cornerstone of our nation's promise to the servicemen and women who answered the call when their country needed them. A recent study found that among hundreds of thousands of older veterans who were treated at VA emergency departments had 46% lower mortality than those who were seen outside the VA at private hospitals – and costs were 21% lower too.
Non-VA hospitals are simply not equipped to treat veterans with their unique needs. VA hospitals are world-class and have often outperformed non-VA hospitals.
To many veterans, their local VA is also their community where they meet other veterans and are treated by staff who know what they’ve been through.
Our nation’s heroes shouldn’t be forced to navigate the patchwork of for-profit, private care, competing with non-veterans for appointments and hospital beds and left to their own devices to find providers with the ability to treat the complex health issues with which many veterans struggle.
Further sending veterans to private hospitals will also have a devastating impact on the VA’s role in conducting groundbreaking medical research and serving as the main source of training for doctors, nurses, therapists and other medical professionals in the midst of a severe medical staffing shortage.
3. The VA is using unreliable, pre-pandemic data to justify closures
100% of data the VA used to propose shutting down or downsizing VA facilities and sending veterans outside the VA is unreliable pre-pandemic data. Earlier this year the nonpartisan Government Accountability Office (GAO) torched the data underlying VA’s recommendations.
The VA’s assumption of excess capacity in the private sector and its ability to take care of veterans is simply a myth, as it was even before the pandemic. Take New York, for example. Only 2% of New York private providers are ready to provide timely and quality care to veterans. That myth became clear during COVID-19. Across the country, we saw hospitals overrun with patients lying in the hallways, medical staff trying to set up pop-up tents to help treat more people. In short, the VA didn’t factor in the pandemic and extreme healthcare shortages already hurting rural areas.
Amid the chaos, the VA absolutely rose to the occasion. The VA’s 4th mission is being available to the public in times of emergency, and so the VA not only took care of veterans but also others who needed help. If the VA continues to push for privatization, it will cause irreparable harm to its critical national role to save the lives of all Americans during pandemics and other national emergencies.
In addition to the wrong assumption about the private sector’s excess capability, one of the most important criteria the VA used to justify closures was staffing levels. The previous administration intentionally kept more than 50,000 positions vacant as part of its privatization agenda. That’s when they measured staffing levels to justify the closures. Now the VA is saying it has to privatize because it’s understaffed. It failed to consider the VA’s own capacity to take care of veterans now and in the future with full funding and full staffing.
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