White House officials say the president’s new infrastructure plan includes enough funding to replace “10 to 15” aging Veterans Affairs hospitals across the country with new medical centers, but department officials haven’t determined yet which communities might benefit from the money.
Administration staff have been touting the $2 trillion infrastructure improvement plan in recent days as they try to build support among skeptical members of Congress — largely Republicans — and the public for the massive spending package.
Included in the total is about $18 billion for Veterans Affairs projects, with most of that total going to upgrading current department facilities and replacing others.
“This funding will also help accelerate ongoing major construction projects to … replace outdated medical centers with state-of-the-art facilities to provide our veterans the care they deserve,” said Terri Tanielian, special assistant to President Joe Biden for Veterans Affairs.
A pair of senators want to undo plans for a VA closing commission to start work in coming years.
VA Secretary Denis McDonough called the money a “down payment” on plans to modernize the department’s medical facilities, saying as many as 30 may need to be replaced in coming years.
“The median age of a private hospital in the U.S. on a national basis is roughly 11 years old,” he said. “The VA portfolio has a median age of 58 years old, and 69 percent of VA facilities are older than 50 years.
“So when you think about all the technology and everything else that we’re moving into modern hospitals, you can see why we’re so concerned about this footprint. A lack of modern infrastructure actually limits our ability to meet the evolving health-care needs of veterans.”
VA today manages more than 1,700 hospitals, clinics and other health-care facilities. Department spokesman Terrence Hayes said VA has not yet determined which locations would be at the top of the list for replacement, if the infrastructure plan is approved.
“The foundational criteria for project selection are based on the age and condition of the existing facility, as well as projected demand in the facility’s catchment area,” he said. “Selection of these sites will be informed by a data-driven model currently under development that takes these factors into account.”
The White House’s push to replace some VA hospitals comes ahead of a congressionally mandated, multi-year review of the department’s footprint across America, with an eye towards possibly closing some facilities.
Under that plan — using a panel styled after the military’s base closure commission — Biden will select members of an Asset and Infrastructure Commission for VA later this year.
The commissioners — who will need Senate approval before starting their work — will spend seven months compiling their recommendations, which will be followed by a series of public hearings on potential facility closings or expansions. Final decisions on changes are expected in 2023.
McDonough said he is not concerned by critics’ questions on whether the department should be investing billions in new construction ahead of that commission review.
“The footprint of VA itself needs modernization and needs addressing, not least because of the age of the facilities,” he said. “This will be handled very transparently with our partners on Capitol Hill.”
House Armed Services Committee Chairman Adam Smith said he doesn't see pay cuts or benefits trims as a good solution to reducing defense spending.
VA has received significant criticism in recent years for the cost of new construction, especially as conservative groups have pushed for most department dollars to fund private care medical appointments instead of VA expansion.
For example, the Rocky Mountain Regional VA Medical Center, located outside of Denver, opened in 2018 after five years of delays and more than $1 billion in cost overruns.
But House Veterans’ Affairs Committee Chairman Mark Takano said he is not concerned that the new infrastructure spending bill will undermine future changes in VA’s infrastructure.
“We know right now in certain parts of the country where we have VA medical centers that we need upgrades,” he said. “But we need to go through the process of assessing where our VA footprint needs to go smaller or go bigger.”
For now, those potential improvements hinge on whether the infrastructure plan moves ahead. No timeline has been set by Democratic leaders in the House and Senate for when the proposal could be considered by members.