VA Mission Act: Veterans Healthcare Policy Analysis
This paper provides a policy analysis of the VA Mission Act of 2018, a landmark piece of federal healthcare legislation targeting U.S. military veterans. The paper outlines the eligibility criteria for VA care benefits, traces the evolution from the earlier Veterans Choice Act, and examines how the Mission Act expands community care access, reduces wait times, addresses funding gaps, and introduces evidence-based standards for pain management. It also discusses the infrastructural and financial challenges surrounding implementation, the federal goals motivating the policy, and the professional and moral obligations of Advanced Practice Registered Nurses (APRNs) in advocating for veteran populations.
- Introduction to the VA Mission Act: Overview of the Act's purpose and eligible population
- Expanding Community Care and Reducing Wait Times: Community care provisions and evidence-based care mandates
- Funding, Infrastructure, and Implementation Challenges: Funding gaps addressed and financing concerns raised
- Federal Goals and the Veteran Care Crisis: Federal motivation rooted in 2014 wait-time scandal
- APRN Advocacy and Professional Obligations: Nursing advocacy strategies and ethical responsibilities
- References: Cited sources supporting the policy analysis
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What makes this paper effective
- The paper situates the VA Mission Act within a clear historical timeline, tracing the policy evolution from the Choice Act through to the 2018 legislation, which gives readers useful context for understanding why the new law was necessary.
- It integrates multiple perspectives — legal eligibility, clinical practice (evidence-based pain management), funding, and nursing ethics — demonstrating breadth of analysis appropriate for a healthcare policy discussion.
- The inclusion of a distinct APRN advocacy section connects abstract policy goals to concrete professional responsibilities, grounding the analysis in nursing practice.
Key academic technique demonstrated
The paper uses policy analysis framing effectively: it identifies the target population, traces legislative history, outlines specific provisions, and connects policy goals to professional practice. This structure — problem identification, policy response, implementation considerations, advocacy — mirrors standard public health policy evaluation methodology.
Structure breakdown
The paper opens with a broad introduction to healthcare policy change before narrowing to the VA Mission Act's purpose and eligibility criteria. It then details expanded community care provisions and funding reforms, followed by a discussion of implementation challenges including infrastructure and financing. The final analytical section addresses federal goals, the 2014 media exposé that catalyzed reform, and the APRN's advocacy and ethical obligations. A formatted reference list closes the paper.
Introduction to the VA Mission Act
From time to time, healthcare policy changes are made in an attempt to achieve a set of goals affecting a specific population. Policy changes are largely inevitable given the dynamic nature of the healthcare industry and the need to address emerging concerns in society. One important piece of healthcare legislation passed in 2018 was the Veterans Affairs Mission Act, otherwise known as the VA Mission Act. In basic terms, the new law will "ensure easy and reliable access to care when Veterans need it; provide exceptional care to Veterans anytime, anywhere; and serve as a trusted, caring partner, helping Veterans and their families be healthy and well" (U.S. Department of Veteran Affairs, 2019).
The population the law targets comprises former members of the United States military — more specifically, those who would ordinarily qualify for VA care benefits. The basic eligibility standard is that a person should have "served in the active military, naval, or air service and was discharged or released under conditions other than dishonorable" (U.S. Department of Veteran Affairs, 2018). In essence, the new law further enhances veteran access to health care, especially with regard to the reduction of wait times.
Expanding Community Care and Reducing Wait Times
The first major measure undertaken to address veteran wait times was the enactment of the Veterans Choice Act. Although the Choice Act made it possible for veterans to obtain medical care from private-sector doctors approved by the VA, it did not manage to address the long wait times that veterans endured before gaining access to needed healthcare (Gordon, 2018). The VA Mission Act essentially extends the access veterans have to health care in the private sector. In addition to reducing wait times, the Act also introduces more options aimed at increasing the percentage of veterans actively making use of their VA benefits.
The new Act mandates the Department of Veterans Affairs to coordinate timely care through the extension of relevant assistance to persons in need of VA medical services. Unlike the arrangements under the Choice Act, the Department of Veterans Affairs has, according to Fulton and Brooks (2018), been mandated with providing "access to community care if VA does not offer the care or services the veteran requires, VA does not operate a full-service medical facility in the state a veteran resides, [or] the veteran was eligible for care in the community under the 40-mile rule in the Veterans Choice Program."
In a move designed to further enhance the quality of care veterans receive, the VA now has the mandate to ensure that evidence-based guidelines are adhered to by care providers. This is particularly relevant when it comes to approaches utilized in pain management and the prescription of opioid-based pain killers. There is also a requirement that the VA ensure health care providers at the community level gather relevant information regarding the medical history of patients.
Federal Goals and the Veteran Care Crisis
When it comes to the federal goals this policy attempts to address, the issue of U.S. veterans' access to medical care became especially urgent in Washington following a 2014 television investigative report that exposed the severe wait-time problems veterans were facing (Farmer, 2016). The feature revealed how long veterans were waiting to access care — in some instances so long that deaths were reported among persons in the queue waiting to see a doctor (Farmer, 2016).
Owing to their exposure to highly volatile situations during deployment, veterans often experience significant trauma that can negatively impact their mental wellbeing over the long term. In some instances, trauma symptoms are so severe that they give rise to physical health challenges and social dysfunction. Thanks to the VA Mission Act, veterans can now access same-day care for both mental health and primary care. Mental health appointments can even be self-scheduled by veterans with no referral required.
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