HR-5277-119
Referred to the Subcommittee on Health.
Sponsored by Michael Lawler (R-NY)
What it does
The HEAL Act would raise the mileage reimbursement rate for veterans traveling to VA facilities for medical care, vocational rehabilitation, or required counseling — from 41.5 cents per mile to the current federal rate for privately owned vehicles (currently 70 cents per mile). It would also prohibit the VA from charging veterans a deductible for beneficiary travel related to examination, treatment, or care. Additionally, it would allow veterans service organizations and veterans service agencies that transport veterans to VA facilities to receive the same travel reimbursement as individual veteran beneficiaries.
Who benefits
Veterans who travel to VA facilities for medical care, vocational rehabilitation, or counseling — particularly those in rural or remote areas who drive long distances. Veterans with disabilities or limited mobility who rely on veterans service organizations for transportation. Veterans service organizations (VSOs) and veterans service agencies that provide transportation, as they would become eligible for the same reimbursement rate. Veterans with lower incomes for whom the current deductible may be a barrier to seeking care.
Who is hurt
The federal government (and by extension taxpayers) would bear higher costs, as both the increased per-mile rate and the elimination of the deductible would raise VA expenditures. The VA's administrative budget could face pressure if implementation requires updated systems or processes. Private medical transportation providers could face indirect competitive disadvantage if VSOs expand transportation services under the new reimbursement structure.
Supporters argue
Supporters argue that the current 41.5 cents-per-mile rate has not kept pace with actual vehicle operating costs — the IRS standard mileage rate for 2024 is 67 cents per mile, and the federal government's own rate for privately owned vehicles is 70 cents per mile. They contend that the existing deductible creates a financial barrier that discourages veterans, especially those with low incomes or chronic conditions requiring frequent visits, from accessing earned benefits. Aligning the VA rate with the federal standard, they argue, ensures veterans are not penalized for using a benefit they earned through service.
Opponents argue
Opponents argue that eliminating the deductible and nearly doubling the mileage rate would significantly increase VA travel benefit expenditures at a time of fiscal pressure, without a clear mechanism to offset the added costs. They contend that the deductible was designed to limit overuse of the travel benefit and that removing it could increase administrative burden and potential for fraud or abuse. Critics may also argue that resources would be better directed toward expanding VA telehealth services, which could reduce the need for in-person travel altogether.
Constitutional context
No significant constitutional issues are raised by this bill. Congress has broad authority under Article I to appropriate funds and set the terms of federal benefit programs, including those administered by the VA. No active constitutional tension areas are implicated.
Checks and balances
Congress sets the reimbursement rate and deductible rules by statute; the VA (executive branch) administers the program within those parameters; Congress retains oversight authority through appropriations and the Appropriations Clause (Art. I, §9, cl. 7).
Historical precedent
Congress has previously adjusted VA beneficiary travel reimbursement rates and deductible structures through legislation, including the Veterans Benefits Improvement Act of 2008, which modified eligibility and reimbursement terms for the beneficiary travel program.