At Hearing on VA Budget, Murray Underscores Commitment to Fully Funding VA Through Regular Order, Asks VA Secretary About Veterans’ Medical Care, Implementing PACT Act, EHR

***WATCH: Senator Murray’s opening remarks***


*** WATCH: Senator Murray’s questioning with VA Secretary McDonough***


(Washington, D.C.) – Today, at a Senate Appropriations Military Construction, Veterans Affairs, and Related Agencies subcommittee hearing on President Biden’s Fiscal Year 2024 budget request for the Department of Veterans Affairs (VA), Senator Patty Murray (D-WA), who Chairs the Senate Appropriations Committee and the Military Construction, Veterans Affairs, and Related Agencies subcommittee, spoke about how, as the daughter of a WWII veteran, ensuring veterans have the care and support they deserve is a top priority for her—and she reiterated her commitment to passing bipartisan funding bills that uphold our nation’s promise to our veterans. Secretary of Veterans Affairs Denis McDonough testified at the hearing.


“As we work to assess our nation’s needs for the year ahead, return to regular order, and pass bipartisan funding bills in a timely manner, we have a very serious obligation to make sure we provide for the men and women who fought and sacrificed to keep our country safe, and their families,” said Senator Murray. “No one who has put their life on the line for our country should struggle to provide for their family, put a roof over their head, pursue a higher education and a good-paying job, or get the health care they need.”


Senator Murray also emphasized the importance of fully funding VA through the regular appropriations process to ensure that our nation’s veterans are not shortchanged, saying: “When it comes to our veterans: we can’t cut corners, we can’t break promises, and we can’t let partisan politics get in the way of passing the funding VA needs. Let’s be clear: anything other than a regular appropriations process will have negative impacts across VA and will hurt veterans back in our states who need to get their claims processed, benefit from medical and prosthetic research, and get care related to their toxic exposure. Bottom line: if we fail to fund VA—and in a timely way—it’s our nation’s veterans who pay the price.”


Murray made clear that she would expect to hear from VA regarding its implementation of the Oracle Cerner Electronic Health Record (EHR) system and VA’s current contract renegotiation with Oracle Cerner.


“I also expect to hear more about VA’s electronic health record system,” began Senator Murray, regarding EHR. “As you know, the rollout at VA sites in Washington state has been an ongoing disaster, with new disruptions still happening. I’ve heard from providers who are burnt out trying to navigate this broken interface. Patients who were unable to get the medicine they rely on because of system malfunctions and even a patient who received a late cancer diagnosis because of flaws in the system—and that’s just what we know right now. It’s completely unacceptable.”


“I’ve been saying for quite some time now that VA should halt future roll outs in Washington state and focus on fixing the program where it already exists, like in Spokane and Walla Walla,” Senator Murray continued. “So, the Department’s ‘reset’ announcement last week to do just that, was certainly a sentiment I agree with. But I still want to know more about how exactly the Department is planning to get things on track, including by negotiating stronger performance incentives and penalties in a new contract.”

“I hope this reset means real results, but in the meantime, I’ll continue working with my colleagues to pass legislation that implements the kind of aggressive oversight needed to fix the current EHR system so these kinds of failures never occur again,” said Murray.


Murray spoke about how President Biden’s FY24 budget increases VA’s overall funding level by 5 percent and includes much-needed boosts for veteran suicide prevention, homelessness prevention, the caregivers program, and other vital services, as well as increased funding to improve VA infrastructure and implement the PACT Act—the largest expansion of veteran’s care in decades.

Murray also noted that the PACT Act was signed into law after VA’s request for discretionary funding for FY2024 was submitted and the President’s budget accounts for that by moving some funding meant for this work into the Toxic Exposures Fund (TEF), which didn’t exist when the funds were originally requested.


In her questioning, Murray asked Secretary McDonough about the assumption in President Biden’s budget request that spending on treatment for toxic-exposed veterans will grow. “Over the last few years, our veterans’ medical needs have grown—which has, of course, required more funding to ensure they are getting the care they need,” Murray said. “Medical care is an earned benefit of service, and this Committee has always ensured VA has the resources to meet our veterans’ medical needs.  This year’s budget request assumes relatively flat funding in discretionary medical care accounts and a higher rate of growth in spending on treatment for toxic exposed veterans in the Toxic Exposures Fund. Can you tell us what driving that assumption?

McDonough reiterated that, as the PACT Act envisioned, additional funding provided for toxic exposure will be funded through the TEF. McDonough also said that VA was not anticipating a “second bite” funding request next year.


Murray also asked McDonough about the demand for health care and benefits related to the PACT Act. “Last year, Congress did pass the PACT Act so we can fulfill our commitment to make sure veterans receive the care and support they earned, including veterans who experienced toxic exposures,” Murray said. “And I really do appreciate VA’s commitment to implement the law swiftly to make sure our veterans get this care. Based on what the Department has experienced to date, what is the demand for healthcare and benefits related to the PACT Act? And how does it compare to your initial projections?”

McDonough replied that VA is closely tracking both claims filed—with approximately 30 percent more claims filed than at this time last year—and the number of new veterans seeking additional care due to the PACT Act, with slightly fewer new veterans seeking care than the VA anticipated.


In her second round of questioning, Murray pressed McDonough about VA’s recent pause of the EHR system, saying “VA and Oracle Cerner are responsible for the system not working the way it should. You have said that during this reset period we’re now in, VA will prioritize stabilizing existing sites.  How is that different from the pause and the ‘assess and address’ periods? And when will we see Spokane and Walla Walla back to pre-EHR productivity levels?”


McDonough replied that the main difference is that VA will no longer try to both prepare for further deployment of EHR and make it right in the five centers where it is currently deployed, including Mann-Grandstaff in Spokane and Jonathan M. Wainwright in Walla Walla, saying: “The whole point of this reset is, clear away everything else, let’s focus on the five [centers], let’s get it right, and then we’ll talk about onward deployment.” Murray asked how this would affect VA’s FY24 budget request, to which McDonough acknowledged the request would look different and underscored his commitment to work with Murray closely on the specifics of the Department’s FY24 request for EHR.


Murray concluded her questioning by asking McDonough about the Department’s efforts to provide child care for veterans. “This is such a challenge for families. People are not taking their appointments, can’t get to appointments, child care is an issue—and I was really pleased, as I mentioned in my opening remarks, the budget outlined a plan to expand the child care pilot,” Murray said. “But I understand that we don’t have regulations and dedicated resources to IT development so we can expand that. What is your timeline on doing that?” McDonough replied that the Department’s goal is for child care centers to be fully operational by 2026—to meet the child care needs of 300,000 veterans—and to have functioning sites in 2024, providing drop-in and contracted child care services.