Republican vice presidential nominee Sen. JD Vance expressed support for expanding veterans' ability to use private doctors in a podcast interview this week.
During an appearance on the Shawn Ryan Show released Wednesday, Vance was asked by the host, a former Navy SEAL who said he stopped using the Department of Veterans Affairs after one try, whether he would consider privatizing veterans' health care.
"I think I'd consider it," replied Vance, a former enlisted Marine who deployed to Iraq in a public affairs role.
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Vance, who said the VA was his main health care system for a few years after leaving the Marine Corps, then elaborated that, while he believes parts of the VA "actually work very well," he thinks veterans should have more flexibility to seek private health care.
"Let's say you're in a rural hospital; the closest VA is 120 miles away. Why force a veteran to drive two and a half hours to that VA facility when he can get cheaper and good care right in his backyard?" Vance said. "So, I wouldn't say get rid of the whole thing. I would say give people more choice. I think you'll save money in the process. You'll also give veterans more optionality."
The comments reopened a bitter debate this election season over the future of the VA. Democrats have been accusing Republicans broadly and GOP presidential nominee former President Donald Trump specifically of wanting to privatize the VA, a charge Republicans have denied.
Democratic presidential nominee Vice President Kamala Harris' campaign quickly seized on Vance's remarks, posting to social media a nine-second clip of Vance saying he would consider privatization.
"This isn't just some misguided policy idea; it's a slap in the face to the men and women who served this country, coming from the man running alongside the candidate who called them 'suckers' and 'losers,'" Sen. Tammy Duckworth, D-Ill., a Harris campaign co-chair and Iraq War veteran, said in a statement provided by the campaign. "Veterans deserve better than candidates who will turn their health care into a business opportunity the minute they get the chance."
The Trump campaign shot back that the Harris campaign was taking Vance out of context.
"In the full exchange, Sen. Vance clearly says he would not privatize the Department of Veterans Affairs," William Martin, a spokesperson for Vance, said in a statement to Military.com. "The Kamala campaign is once again twisting his words and lying about his position because they have nothing but a record of abject failure to run on. It's also worth noting that JD personally relied on the VA for years after leaving the Marine Corps. They should be ashamed for intentionally lying about a veteran when it comes to providing quality care and coverage for our veterans."
During his first term in office, Trump expanded veterans' ability to see non-VA doctors using VA funding by signing the Mission Act. While veterans had already been able to seek outside health care following the 2014 VA wait-time scandal, the Mission Act grew the number of veterans eligible for outside care and consolidated several different community care programs into one.
VA guidelines established under the Mission Act say veterans can seek outside care if they face more than a 30-minute drive for primary care or mental health services or 60 minutes for specialty care -- meaning the veteran described in Vance's scenario of driving two and half hours should already be eligible for community care.
The Mission Act received bipartisan support when it passed in 2018, but it has since become more partisan. Republicans have alleged that the VA under the Biden administration has undermined the law by limiting the number of referrals to community care. Congressional Republicans have introduced bills to strengthen the eligibility guidelines and make it hard for the VA to deny a referral.
Democrats, meanwhile, charge that the GOP is ultimately aiming to privatize the VA.
They point to Project 2025, a conservative think tank blueprint for a future Republican president that calls for retooling the VA's disability ratings system to find "cost savings" and says the next administration should "rapidly and explicitly codify VA Mission Act access standards in legislation to prevent the VA from avoiding or watering down the requirements in the future."
The plan was written by former Trump administration officials and others with ties to Trump, though Trump has tried to distance himself from the document.
While Vance asserted that expanding access to outside doctors could cut costs, VA officials have said community care costs have been growing at an unsustainable rate since the implementation of the Mission Act.
During the podcast interview, Vance also discussed the need to fire "bad apples" within the VA.
"Probably 90%, 95% of the people who work at the VA are fantastic human beings, but then you've got, like, a small slice of the VA that's bad apples that make it really hard for everybody else to do their job," Vance said. "This is why veterans spend three hours on the phone trying to get an appointment. This is why you have people committing suicide because they're waiting 28 days to get an appointment with a doctor. Like, just crazy, crazy stuff. But it's a small sliver of the VA. You ought to fire those people, right?"
In his first term, Trump also signed a law called the Department of Veterans Affairs Accountability and Whistleblower Protection Act that sought to make it easier for the VA to fire employees accused of misconduct or poor performance.
But the law faced legal challenges that weakened its effectiveness and prompted the Biden administration to stop using the expedited firing authorities granted by the bill. Republicans in Congress have been working to revive the authorities.
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