CRITICAL ACCESS HOSPITALS
S.1868, the Critical Access for Veterans Care Act, introduced by Kevin Cramer (R-ND) and Tim Sheehy (R-MT), was deliberated at the Senate Committee on Veterans’ Affairs legislative hearing on March 18. 2026, and was voted to be advanced. The bill would fundamentally reshape how rural veterans access private healthcare services. The legislation establishes a new paradigm by allowing veterans enrolled in the VA healthcare system to self-refer to any Centers for Medicare & Medicaid Services-designated Critical Access Hospital (CAH) or its affiliated clinic that is located within 35 miles of where they live. Veterans could bypass VA authorization and receive services in these facilities, even in rural locales where a nearby VA Community-Based Outpatient Clinic (CBOC) or a contracted Community Care Network (CNN) provider has readily available appointments.
Despite its seemingly straightforward title, the bill will not improve access to healthcare, expedite care delivery, reduce travel burdens, or enhance network critical care capacity for rural veterans. What it does do is erode the requirements meticulously developed for a veteran to be eligible to receive services from a Community Care Network provider under the VA MISSION Act of 2018. Since rural veterans already possess extensive access to non-VA care, the bill’s purpose seems to be to remove the utilization oversight (routine in the private sector) that the VA currently applies to CCN eligibility.
VHPI just completed a study (posted here) mapping every VA facility located within 40 miles of the Critical Access Hospitals named in the bill. The findings are striking: in 845 cases, the VA already has a nearby facility. This will accelerate the privatization of the VA healthcare system.
