Biden’s infrastructure plan would finally fund VA’s hospital upgrades

President Joe Biden campaigned on a bold platform to modernize and “refresh” Department of Veterans Affairs (VA) hospitals and clinics across the country so as to “serve our veterans better” and ensure the VA “continues to lead in providing 21st century care.” 

At the end of March, he followed through on that pledge with a proposal — the American Jobs Plan — that includes $18 billion to improve VA hospitals, two-thirds of which are over 50 years old.

Biden’s plan calls for $3 billion to immediately rectify unsafe or inefficient conditions inside VA health care facilities, upgrade buildings to support the growing number of women veterans, and enhance campuses so that aging veterans can better access high-quality health care more quickly. The plan also includes $15 billion to totally replace 10 to 15 of the most neglected medical centers with new state-of-the-art facilities.  

These upgrades are long-overdue and must be expedited. Most importantly, this work must not be jeopardized by the launch of the Asset and Infrastructure Review (AIR) commission, a nine-member body that Biden will appoint in May. This commission, inserted into the controversial MISSION Act and largely insulated from congressional input, will decide which VA facilities to close or improve. It has been heavily pushed by officials tied to the Koch-backed Concerned Veterans for America. They have long been hellbent on obscuring the many benefits of the VA and want to shutter struggling VA facilities that could easily be renovated, better maintained or even expanded to help those who’ve served. 

Those in Congress committed to privatizing the VA, not improving its services, will surely argue that decisions about VA infrastructure should await the commission’s final report, which is due in 2023. This, despite the fact that the MISSION Act itself, in Section 208(b), specifies that the AIR commission’s deliberations should not interrupt the planning and implementation of VA projects.

Any delay in infrastructure improvement will jeopardize the health and wellbeing of millions of veterans as well as the workers who have dedicated their careers to caring for veterans. Indeed, infrastructure improvement has been made even more critical because so many veterans have lost their jobs — and thus their health insurance — due to the COVID-19 pandemic and are now seeking VA care.   

Although the VA delivers high quality health care that equals or outperforms the private sector on almost every measure, its mission to serve veterans is hampered by the fact that congressional allocations for VA repair and construction projects have long lagged. As a result, many indispensable improvements for decades-old facilities have been placed on hold indefinitely. This puts VA employees at risk if they work in hazardous buildings, like the one in West Haven, Conn., where two workers were killed in 2020 when a steam pipe exploded. Disregarding seismic deficiencies could lead to additional catastrophes. Furthermore, the VA can’t hire the needed tens of thousands of new employees while waiting to repair old infrastructure and construct new exam rooms and office space — creating unnecessary delays in care.    

Critics of allocating more money to VA construction claim it’s too extravagant. But investing in crucial projects will offset costs that increase over time with older buildings, and save money by delivering care in-house rather than outsourcing it to the more costly private sector. This work will also create jobs in communities across the country. 

The Biden administration’s goals and figures parallel those recently identified by officials inside the “Big Six” Veterans Service Organizations (VSOs), the Disabled American Veterans, Paralyzed Veterans of America and Veterans of Foreign Wars. Their collective Independent Budget advocates for immediate mission-critical repair and maintenance needs, urgent seismic corrections and new health care technology advances. VSOs maintain that delaying maintenance and upgrades would be more costly in the long run. 

The Biden plan has wisely identified that the old age and disparate conditions of VA facilities are not in line with the bedrock American principle of caring for our nation’s veterans. It also acknowledges that health care workers who serve veterans deserve a safe workplace. Legislators who promise to improve the lives of veterans should unite behind the plan and push for further funding in the future.

Russell B. Lemle, PhD., and Suzanne Gordon are senior policy analysts at the Veterans Healthcare Policy Institute.