Bill Overview
Title: Independent VA Audit Act
Description: This bill requires the Department of Veterans Affairs (VA) to seek to enter into an agreement with a nongovernmental entity to audit the VA's health care system, including with respect to the timeliness of available appointments for veterans to receive hospital care and medical services. The VA must submit the audit to Congress not later than December 31, 2023.
Sponsors: Rep. Gosar, Paul A. [R-AZ-4]
Target Audience
Population: Veterans receiving VA healthcare services
Estimated Size: 9000000
- The bill impacts the Department of Veterans Affairs, which provides healthcare services to U.S. veterans.
- There are millions of veterans in the United States who utilize the VA for healthcare services.
- Any audit of the VA's healthcare system will potentially impact all these veterans by influencing potential changes or adaptations in the system based on the audit's findings.
Reasoning
- The policy directly impacts U.S. veterans who utilize the VA healthcare system, focusing on auditing the system for efficiency and effectiveness.
- Given the budget constraints of $15 million in year 1 and $15 million over 10 years, the impact will be focused on potential improvements derived from the audit findings.
- Most significant impact will be on veterans experiencing delays or inefficiencies in receiving care, as these areas are targeted for assessment.
- Veteran wellbeing is self-reported through Cantril measures before and after policy implementation, showing improvements especially for those impacted by current system delays.
- Not all veterans will see an immediate or direct change due to the policy, especially if their access is already efficient; thus the 'none' impact rating applies for some cases.
Simulated Interviews
Retired (Ohio)
Age: 68 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I think the audit could potentially highlight the inefficiencies I've experienced at the VA, especially long waiting times for appointments.
- It might bring more transparency and improvement to the system.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Nurse (California)
Age: 34 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- The audit sounds beneficial, but I'm worried about whether real changes will follow.
- I do hope that wait times will be reduced for non-critical issues.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 7 |
Retired (Florida)
Age: 75 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- At my age, health services are vital, and the VA is essential for me.
- An audit could hopefully streamline processes and make it easier for us older veterans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
Teacher (Texas)
Age: 40 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- I think it's a good step, but I'm personally not affected much since I don't use VA services often.
- It's great if it helps others who need it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Mechanic (New York)
Age: 55 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- I'm hopeful that this policy will finally address some long-standing issues I've faced like long wait times and overbooked clinics.
- It could improve both mental health access and physical care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 4 |
Software Developer (Arizona)
Age: 29 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- I just got out of the service and haven't really made much use of VA benefits.
- The audit seems like a good idea for those who depend on it more than I do.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Community Volunteer (Pennsylvania)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I believe transparency from audits could potentially increase the trust and efficiency of VA services.
- I've been facing appointments being booked up months in advance, so this would be a welcome change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 5 |
Police Officer (Illinois)
Age: 38 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- Even though I don't use the VA as much, other veterans do, and they deserve better services than what I've heard about.
- The audit might ensure changes in efficiency.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Small Business Owner (Colorado)
Age: 48 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I hope the audit leads to better service delivery.
- My business means I can't afford to spend a lot of time waiting for appointments.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Retired Engineer (Virginia)
Age: 65 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- Hopefully, the audit really sheds light on some inefficiencies and backlog problems at the VA.
- Older veterans need streamlined services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Cost Estimates
Year 1: $15000000 (Low: $10000000, High: $20000000)
Year 2: $0 (Low: $0, High: $0)
Year 3: $0 (Low: $0, High: $0)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The primary cost drivers are the selection and contracting of a qualified audit firm.
- The comprehensiveness and depth of the audit can affect the final costs.
- Successful implementation could lead to indirect benefits through operational improvements at the VA.