VA Mission Act: Enhancing Healthcare for Veterans

After passing through the Senate and House of Representatives, the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (“Act”) was signed into law by President Trump. However, shortly after signing the VA Mission Act bill into law, President Trump issued a signed statement which opposed certain funding measures and portions of the legislation.


The VA Mission Act is a $52 billion reform bill that is designed primarily to improve veteran access to and the quality of healthcare services provided by the Department of Veteran Affairs (“VA”). The Act addresses the following key initiatives:

  • Consolidation of seven different programs allowing veterans to obtain private or community healthcare;
  • Creation of an integrated network for the department and community care;
  • Provision of hired incentives for health professionals;
  • Expansion of assistance programs for caregivers of veterans; and
  • Creation of an infrastructure commission on modernizing VA medical facilities.

Proponents of the Act believe that it provides substantial reform to a “failed system” and adequately addresses many issues veterans currently face when trying to obtain adequate healthcare services. Additionally, many veteran organizations praise the bill for providing veterans with a variety of options in an effort to eliminate the notoriously long wait times at VA facilities.

Conversely, some individuals are skeptical and concerned about the “privatization of health services” for veterans, fearing that this may lead to a decrease in the resources available to current VA facilities and result in higher out-of-pocket costs for veterans.

Signed Statement by President Trump & Congressional Memo

While signing the Act into law, President Trump stated: “We’ve been looking for choice for a long time, and today is the day. So, it’s very important. Very happy”. Shortly thereafter, President Trump indicated that he was not in favor of certain portions of the law he had recently signed and issued a signed statement regarding the administration’s opposition. Outlined below are three provisions quoted by President Trump included within his signed statement:

  • Section 152(a) of the Act, would add a provision, 38 U.S.C. 1703E(g)(2)(B)(iii), that purports to require the Secretary of Veterans Affairs (the “Secretary”) to obtain the approval of the chairmen of two congressional committees before expending more than $50 million of appropriated funds in a fiscal year on certain pilot programs. Under the separation of powers, the Congress may not make the approval of members of Congress a precondition to the execution of the law. Accordingly, I direct the Secretary to treat section 1703E(g)(2)(B)(iii) as advisory and non-binding while still heeding section 1703E(g)(2)(B)(ii), which requires the Secretary to notify the congressional committees before exceeding the spending cap.
  • Section 202(c)(2) of the Act would require the President to consult with members of Congress on the appointment of the members to the Asset and Infrastructure Review Commission (the “Commission”), an executive branch entity. After reviewing recommendations of the Secretary regarding modernization and realignment of facilities of the Veterans Health Administration, the Commission will make recommendations for the President’s approval or disapproval. I anticipate that I will be able to consult with members of Congress on these appointments and will welcome their input, but a requirement to consult with the Congress in executive decision-making violates the separation of powers, including where the Congress has vested the President alone or a department head with authority to make appointments. I will accordingly treat this provision as hortatory but not mandatory.
  • Section 203(b)(6) and (c)(4) purport to require the Commission to make all information used in developing its recommendations to the President available to the Congress and the Comptroller General. Section 202(h)(5) purports to require all Federal agencies to make available to the Commission any information it considers necessary to perform its duties. My Administration will treat these provisions consistent with the President’s constitutional authority to withhold information which could impair foreign relations, national security, the deliberative processes of the executive branch, or the performance of the President’s constitutional duties.

In addition to the above provisions, and subsequent to the President’s signing of the bill, the administration separately sent Congress a memo outlining various objections to proposed funding measures for a new program.


Members of Congress, as well as the general public, are now concerned about how President Trump’s signed statement may affect and limit Congressional oversight of the bill’s implementation. Various leaders of veteran organizations have spoken out as a result of President Trump’s signed statements and the administration’s memo including American Legion’s spokesman, Joe Plenzler, who stated: “We are pleased the President signed it, and we look forward to implementing every piece of legislation as discussed and negotiated”.

Author: Hayley Shulman, CPA |[email protected]

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