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“Hearing to Consider Pending Legislation’”

Senate Veterans Affairs Committee Hearing

December 10, 2025 (recording here)

HEARING INFORMATION

Witnesses & Written Testimony (linked) (Panel One):

• Margarita Devlin, MA, CRC: Principal Deputy Undersecretary for Benefits, U.S. Department of Veterans Affairs

  Accompanied by:

• Thomas O’Toole, MD: Acting Assistant Under Secretary for Health for Clinical Services, Veterans Health Administration

Witnesses & Written Testimony (linked) (Panel Two):

• Mr. Morgan Brown: National Legislative Director, Paralyzed Veterans of America

• Ms. Nancy A. Springer: Acting Director, National Legislative Service, Veterans of Foreign Wars of the United States

• Mr. Barton Stichman: Co-Founder & Special Counsel, National Veterans Legal Services Program

Keywords mentioned:

• Veterans Affairs, Fisher House, SERVE Act, healthcare access, ACA tax credits, veteran benefits, toxic exposure, falls prevention, veteran claims, appeals efficiency, scam prevention, rural healthcare, veteran suicide, IVF

IN THEIR WORDS

OPENING STATEMENTS FROM THE COMMITTEE

• Chairman Jerry Moran noted that the committee would consider 24 bipartisan bills, including his Fisher House Availability Act and the SERVE Act. He described the Fisher House bill as expanding lodging eligibility so families of service members could stay at VA Fisher Houses when care was nearby, while still prioritizing VA patient families. He explained that the SERVE Act would strengthen collaboration between VA medical centers and military treatment facilities to improve access to care and training opportunities for VA and DoD providers. He emphasized that these bills, together with the broader agenda, reflected a shared, bipartisan commitment to expanding care and benefits for veterans, survivors, and their families.

• Ranking Member Blumenthal highlighted an imminent vote on extending enhanced Affordable Care Act tax credits, warning that 267,000 veterans would lose affordable coverage if the credits expired. He stressed that many of these veterans did not qualify for Medicaid, TRICARE, Medicare, or VA care and would otherwise have faced a “perfect storm” of higher costs and longer waits. He argued that failing to extend the credits would shift billions in additional costs onto the VA while devastating veterans and their families. He then outlined key bipartisan bills he supported, including measures to improve the VA’s appellate efficiency, research health effects in descendants of toxic-exposed veterans, and investigate historic discrimination against LGBTQ service members.

SUMMARY OF KEY POINTS (PANEL ONE)

• Ms. Margarita Devlin explained that the VA had submitted detailed views on all 24 bills and highlighted several it supported or supported in principle, including the Fisher House Availability Act and the SERVE Act, while noting the need for clarifying amendments on feasibility and roles. She described the VA’s existing suicide prevention and firearm lock box efforts, its research framework for toxic exposures, and support for expanding Purple Heart recipients’ GI Bill transfer rights, again with technical changes. She closed by affirming the VA’s willingness to work with the committee on amendments and to answer questions on any bill on the agenda.

• Chairman Moran asked how the VA, DoD, and Congress could improve access to care beyond the SERVE Act, and Dr. O’Toole cited longstanding collaboration, a shared mission, and opportunities for joint credentialing and models like the Lovell Federal Health Care Center.

• Chairman Moran then confirmed with Dr. O’Toole that the Fisher House bill would eliminate legal ambiguity so facilities could confidently house eligible service member families when space was available.

• Chairman Moran revisited toxic-exposure research, pressing the VA on a 2018 National Academies report that found no generational association and confirming there was currently no VA research focused specifically on descendants of toxic-exposed veterans.

• Ranking Member Blumenthal asked whether the VA had analyzed the impact on VA health care costs if 267,000 veterans lost ACA enhanced tax credits, and Dr. O’Toole admitted there was no internal analysis but did not dispute that the costs would likely reach the billions.

• Ranking Member Blumenthal then pressed on why the VA had failed for months to provide a list of contracts cut under DOGE or to brief the committee, and both Ms. Devlin and Dr. O’Toole promised to get back to him.

• Ranking Member Blumenthal also complained that the requested VA and community wait-time data had not been provided after 200 days, securing a commitment for an update before the holiday recess.

• Sen. Thom Tillis followed up on ACA subsidy losses by asking whether the VA could identify veterans on exchange plans who might actually be eligible for VA care and reach out to them, framing it as both a funding issue and an opportunity to deliver better care. Dr. O’Toole said he did not know whether the VA could do that analysis and would need to respond later.

• Sen. Tillis then confirmed that the VA had submitted formal positions on all bills, including some bills it opposed, and probed on a cemetery eligibility bill, which Ms. Devlin said fell under the National Cemetery Administration’s purview and was addressed in written testimony.

• Sen. Patty Murray opened by criticizing the Trump administration and Speaker Johnson for blocking IVF affordability policies in the FY26 NDAA. She also expressed frustration that her Veteran Families Health Services Act was left off the agenda, then asked for an acknowledgement that service members faced higher infertility rates. Dr. O’Toole said he was not personally familiar with the data but accepted her statement.

• Sen. Murray described a Purple Heart veteran who could not transfer GI Bill benefits because he received his award after service and asked if the VA supported her corrective bill. Ms. Devlin said the VA backed the intent but needed clearer Department of Defense transfer roles.

• Sen. Murray then promoted her Molly R. Loomis descendants-of-toxics bill and challenged the VA’s reliance on a 2018 study to oppose new research into health effects in veterans’ children.

• Sen. Kevin Cramer used his time to outline the Critical Access for Veterans Care Act, explaining that rural veterans in states like North Dakota and Montana relied on scarce VA infrastructure and that current prior authorization rules, fine print, and administrative hurdles effectively denied them timely community care their civilian neighbors already enjoyed.

• Sen. Cramer argued that forcing veterans to wait days, weeks, or months for permission to use nearby critical access hospitals amounted to discrimination and defeated Congress’s intent. Dr. O’Toole responded that the VA strongly supported the bill’s goal of helping rural veterans but wanted to work with Sen. Cramer on clarifying language distinguishing prior authorization from clinical necessity so the system would remain workable.

• Sen. Maggie Hassan first asked when the VA would make public the action plan, ordered by a Trump-era executive order, on bringing a full-service VA hospital to New Hampshire so Granite Staters could review and comment. Dr. O’Toole said he lacked a date but emphasized that it was a priority for the secretary and took the request for the record.

• Sen. Hassan then cited Federal Trade Commission figures showing hundreds of millions in fraud losses for veterans and military families and asked about impacts and the VA’s response. Ms. Devlin said scams evolved constantly, reported that the VA had prevented $9.6 million in theft, described one-on-one remediation, and supported codifying a scam and fraud officer to coordinate anti-fraud work across the VA.

• Sen. John Boozman asked whether VA policy allowed physician assistants to sign death certificates and how the Veteran Burial Timeliness and Death Certificate Accountability Act would address delays that left families waiting weeks for benefits and burial honors. Dr. O’Toole said the VA supported the bill with amendments to include independent primary-care PAs and to use a “two business days” standard, reflecting real-world logistics.

• Sen. Boozman also asked about the internal process for signing death certificates, and Dr. O’Toole described notifications from medical examiners or morticians and a new directive and training to standardize clinician responsibilities.

• Sen. Boozman then questioned on the importance of timely death benefits and on scams, and Ms. Devlin emphasized fraud prevention, remediation, and survivor benefit timeliness.

• Sen. Angus King pressed on his firearm lock-box bill, emphasizing that about one veteran every two hours dies by firearm suicide, and argued that a free, voluntary lock-box program modeled in Utah could save lives by inserting time between ideation and action. Dr. O’Toole agreed that delaying access to lethal means could prevent suicides, described the VA’s targeted lock-box distribution for higher-risk veterans and broader gun-cable efforts, and said the proposed $5 million authorization and program scope needed more work.

• Sen. King then turned to fall prevention, calling it “low-hanging fruit” for reducing costs and disability, and questioned the VA’s resistance to his falls-office bill. Dr. O’Toole replied that the VA had already created a falls office within the patient safety structure.

• Sen. Elissa Slotkin asked why the VA opposed the Molly Loomis descendants-of-toxic-exposed-veterans bill and whether the VA had any active research specifically focused on children of burn-pit-exposed service members. Ms. Devlin pointed to PACT Act-driven research structures, collaboration with the National Academies, and a 2018 report that found no significant generational association, and she confirmed there was no current descendant-specific project despite veterans’ concerns.

• Sen. Slotkin then raised persistent problems with records flowing back to the VA when veterans use community care and described a bipartisan Caring for Our Veterans Health Act to improve information sharing. Dr. O’Toole acknowledged Inspector General findings and said the VA preferred to address the gaps through new “next-gen” third-party administrator contracts and business arrangements rather than additional legislation.

SUMMARY OF KEY POINTS (PANEL TWO)

• Mr. Morgan Brown focused on three bills his organization viewed as most important to its members. He supported the Review Every Veteran’s Claim Act, explaining that too many claims were denied solely because veterans missed a disability examination, often for legitimate reasons or contractor error, and that VA records frequently already contained sufficient medical evidence. He supported the Veterans Appeals Efficiency Act, which aims to add transparency and data to appeals and remands, while urging a feasibility study before the Board of Veterans’ Appeals aggregated cases. He also endorsed the SERVE Act, arguing that stronger VA–DoD joint-use agreements could expand access, reduce costs, and improve outcomes by sharing facilities, staff, and resources.

• Ms. Nancy Springer said her testimony covered all bills but would highlight three priorities. She supported the Review Every Veteran’s Claim Act to prevent veterans from restarting claims after a single missed examination and urged the VA to use existing evidence or flag missed exams instead of denying outright. She backed the Veterans Appeals Efficiency Act for allowing aggregation of similar appeals, potential precedential authority, limited remands, and better reporting so that the system could move cases faster and more consistently. Finally, she endorsed the SERVE Act, emphasizing that expanded VA–DoD resource sharing could have reduced travel and wait times, better used federal medical capacity, and improved continuity of care for veterans near military facilities.

• Mr. Barton Stichman strongly supported the Veterans Appeals Efficiency Act as a way to make VA claims adjudication faster, more accurate, and more efficient. He explained that it would restore the veterans court’s ability to certify meaningful class actions by counting similarly situated veterans with pending BVA or regional office claims toward class numerosity, reversing the Federal Circuit’s Score v. McDonough decision and preserving class relief. He added that the bill would clarify and encourage use of limited remands with timelines and confirm the Board’s power, after a feasibility study, to aggregate similar appeals and issue precedential decisions, bringing the VA in line with other agencies.

• Chairman Moran asked the panel whether veterans were frequently denied claims solely for missing disability examinations and whether the Review Every Veteran’s Claim Act was necessary. Mr. Brown said data were limited, but service officers regularly saw such cases. Chairman Moran signaled support for legislative fixes if the VA did not act administratively.

• Chairman Moran then asked the panel how the SERVE Act could ease gaps during the transition from DoD to the VA. Mr. Brown and Ms. Springer used personal stories to stress continuity when veterans could keep seeing familiar military providers. Chairman Moran highlighted Fort Riley and Kansas facilities as examples of where stronger sharing could matter.

• Sen. King asked whether Paralyzed Veterans of America supported his bill allowing active-duty service members to pre-enroll in VA health care before separation to avoid gaps in coverage, and Mr. Brown said PVA was supportive.

• Sen. King then revisited his falls-prevention proposal, asking whether a dedicated falls-prevention office or strengthened existing structures would best protect older veterans. Mr. Brown endorsed having a clear single point of contact while noting the VA’s progress, and Ms. Springer favored reinforcing and codifying current programs so that falls screening and counseling occurred at every appointment, not just during annual exams.

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