Assessing the Availability and Effectiveness of Healthcare Services for U.S. Veterans

October 25, 2024

The U.S. values its veterans, but providing them with top-notch healthcare remains a significant challenge. 

Pew Research Center estimates that there are more than 18 million veterans in the country today, making up about 6% of the adult population. Of these veterans, roughly three-quarters (78%) served during wartime, while 22% served during peacetime.

The demographic profile of veterans is evolving. Today, 28% of veterans are younger than 50, a figure that is expected to increase to 34% by 2048. This trend is particularly significant given that the overall share of older Americans is projected to grow in the coming years. As the veteran population ages and becomes more diverse, the demand for healthcare services will continue to rise.

It is imperative to assess the availability and effectiveness of healthcare services for U.S. veterans to ensure that they receive the care they need and deserve. 

Overview of Veterans’ Healthcare System

According to the National Institutes of Health (NIH), the Veterans Health Administration (VHA) is the nation’s largest integrated healthcare system. The comparisons between VA and non-VA settings have shown that VA care generally performs similarly or better in most aspects of healthcare quality.

A key part of veterans’ healthcare services is the VA’s effort to address both physical and mental health needs. This includes offering services that range from primary care to specialized treatment for conditions like post-traumatic stress disorder (PTSD).

However, challenges with access to care led to significant legislative reforms, starting with the Veteran Access, Choice, and Accountability Act of 2014. This act allowed veterans to seek care from community providers if they could not get a VA appointment within 30. 

It also permitted access for veterans who lived more than 40 miles from a VA facility. The funding for the Choice Act concluded in 2017. It was replaced by the MISSION Act in 2018, which broadened the criteria for veterans to receive community care paid for by the VA.

These reforms raise important questions about the quality and safety of community-provided healthcare compared to VA-delivered care. Ongoing assessments continue to compare clinical outcomes, access, patient experience, and costs between VA care and VA-funded community care options.

The PACT Act: A Game Changer for Veterans’ Health

The PACT Act, signed into law in 2022, is the most substantial expansion of healthcare and benefits in the history of the VA. A key highlight of the PACT Act is its emphasis on supporting veterans who were exposed to toxic substances while serving. The act:

  • Expanded access: Veterans exposed to toxins like burn pits or other substances during specific wars can now get VA healthcare without applying for disability first.
  • Presumptive conditions: The PACT Act adds more medical conditions to the list of illnesses that are supposed to be caused by military service. This makes it easier for veterans to get benefits.
  • Health screenings: The VA will now check every veteran for exposure to harmful substances, which can lead to earlier diagnosis and treatment.

What are presumptive conditions?

Traditionally, veterans needed to prove their service caused their health problems to receive disability benefits. Presumptive conditions, established by law, eliminate this need. For instance, if a veteran has lung cancer and served in an area exposed to Agent Orange, the VA presumes their service caused the illness. This simplifies the claims process and helps veterans access the care they deserve.

Who is eligible under the PACT Act?

Veterans who served in Vietnam, Iraq, the Gulf War, Afghanistan, or any other combat zone since 9/11 are now eligible for VA healthcare enrollment. Additionally, veterans who were deployed for the Global War on Terror or were exposed to toxins while serving can now more easily get healthcare. While the PACT Act doesn’t guarantee enrollment for everyone, it opens the door to accessing valuable health services for millions of veterans.

Addressing PFAS Exposure: A Struggle for Recognition and Compensation

Due to exposure to per- and polyfluoroalkyl compounds (PFAS), which are frequently present in aqueous film-forming foam (AFFF), veterans have had significant health issues. AFFF is used extensively for firefighting at military facilities. 

According to Nisqually Valley News, many veterans are suffering from illnesses linked to PFAS exposure. Unfortunately, the VA doesn’t currently consider PFAS-related illnesses as service-connected disabilities, making it hard for veterans to get the deserved compensation. 

The VET PFAS Act, introduced in 2023, aims to change this by providing compensation for veterans and their families affected by PFAS. 

PFAS, known as “forever chemicals” because they don’t break down easily, have been linked to serious health problems. These include infertility, weakened immune systems, and several types of cancer. Contaminated drinking water, particularly at military bases where AFFF has been used, has become a significant concern.

Veterans can file VA claims for exposure to AFFF. However, the claims process can be cumbersome, with many veterans experiencing bureaucratic obstacles that delay or deny their claims for exposure to PFAS. 

TorHoerman Law notes that the PACT Act allows veterans exposed to toxic substances like PFAS to file claims for related health issues. This legislation facilitates access to legal recourse for veterans seeking justice.

As awareness grows and legislation evolves, veterans must understand their rights and avenues for seeking compensation for these harmful exposures.

What are the PFAS rules for 2024?

In April 2024, the EPA implemented a significant regulation. It designates two commonly used PFAS—perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS)—as hazardous substances. This designation aims to enhance cleanup efforts and hold those responsible for PFAS contamination accountable.

Addressing the healthcare needs of veterans requires a comprehensive approach that considers both the immediate and long-term consequences of military service. This includes offering accessible mental health services, ensuring timely physical healthcare, and addressing the needs of veterans exposed to hazardous substances.

It is also essential to raise awareness of the health challenges faced by veterans and advocate for policies that support their well-being.


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