Department of Veterans Affairs community care payments top $36 billion in U.S. local economies

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VA community care payments $36B

Highlights

Department of Veterans Affairs community care payments exceeded $36 billion in fiscal year 2025, supporting 8.62 million enrolled veterans under the VA MISSION Act.
Texas, Florida, and California received the largest state-level VA community care payments in 2025 at $3.3 billion, $2.8 billion, and $2.1 billion respectively.
VA direct care spending reached $101 billion in fiscal year 2025 with 82,083,918 appointments, up 4.1% from 2024, and benefits backlog dropped 72% since Jan. 20, 2025.

Community care funding and program scope

As announced by the U.S. Department of Veterans Affairs, the payments are made under the bipartisan VA MISSION Act, which lets eligible veterans receive care from authorized non-VA providers at VA expense. The department says the Veterans Community Care Program is the fourth largest healthcare payer program in the country and supports healthcare services for more than 8.62 million enrolled veterans.

President Trump signed the MISSION Act in 2018 after it passed Congress with bipartisan backing. The Department of Veterans Affairs says the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, enacted in 2025, further reinforces veterans' ability to choose community care when it is in their best medical interest, while current law also allows that option when driving times or wait times exceed certain thresholds or when a needed service is unavailable through VA.

The department says community care operates alongside record spending on direct care. It says $101 billion is spent on direct care in fiscal year 2025, when VA completes 82,083,918 direct care appointments, up 4.1% from fiscal year 2024.

State distribution and healthcare system impact

The largest state recipients of VA community care payments in fiscal year 2025 are Texas at $3.3 billion, Florida at $2.8 billion and California at $2.1 billion. They are followed by North Carolina at $1.5 billion, Ohio at $1.3 billion, Tennessee at $1.2 billion, Pennsylvania at $1.1 billion, and Michigan, Georgia and Arizona at $1.0 billion each.

VA Secretary Doug Collins says the program supports both veterans' health needs and the economies of the communities where they live. The department says the funding is particularly important in rural areas, where providers can operate on margins of less than 1% and where federal healthcare payments can help facilities remain open for veterans, their families and other local residents.

The department also points to wider support for the policy, citing a March 2026 Rasmussen Reports survey that found 90% of likely military voters support access to community care. It says broader improvements under the current administration include 36 new healthcare clinics since January 2025, a 72% drop in the benefits backlog since Jan. 20, 2025, nearly $5 billion planned for facility modernization in fiscal year 2026, more than 180,000 new veteran healthcare enrollees in 2026, more than 2.8 million appointments offered outside normal operating hours since Jan. 20, 2025, and 51,936 homeless veterans permanently housed in fiscal year 2025.

Our earlier coverage of the court order blocking parts of the Education Department’s new graduate borrowing rules explained how the injunction preserves higher student-loan caps for advanced nursing and other healthcare programs while legal challenges proceed. We noted that the dispute centers on a narrower definition of “professional” degrees and has drawn policy attention because of concerns it could worsen healthcare workforce shortages.

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