GAO Cited Gaps in Veteran Health Care Access
Veterans in the Freely Associated States currently face travel costs over $1,000 to access care.
Updated on Sept. 30, 2026 in Military Jobs
Live Poll
Should the U.S. government fund equal health care access for veterans in U.S.-affiliated Pacific territories?
A Government Accountability Office report released September 25, 2026, highlighted significant gaps in VA health care availability for veterans living in the Freely Associated States. These veterans must travel to Honolulu or Guam for most services, as the VA does not currently provide local or telehealth support in the region.
Why it matters
The lack of local medical infrastructure forces veterans to bear substantial out-of-pocket travel costs for essential care like cardiology and oncology. Although Congress authorized expanded services in 2024, the VA reversed an initial decision against implementation and is now coordinating with the State Department.
Full implementation of expanded care for currently enrolled veterans is estimated to cost $26 million, compared to $200 million if all potentially eligible veterans participate. Currently, veterans pay over $1,000 for round trip airfare to access facilities in Honolulu or Guam.
The players
Department of Veterans Affairs
A federal executive agency responsible for providing comprehensive medical care and benefits to military veterans.
Government Accountability Office
A federal legislative branch agency that provides auditing, evaluation, and investigative services for the U.S. Congress.
State Department
The federal executive department responsible for managing international relations and diplomatic agreements for the United States.
The details
The VA is currently pursuing partial implementation of medical services through a Circular 175 process, which requires international agreements with the Freely Associated States. This shift follows a year-long assessment period after the agency initially informed Congress in April 2025 that it would not exercise its newly authorized powers. Full integration of these services remains a complex logistical challenge, with regulatory changes expected to take more than two years to complete.
Timeline
Congress authorized expanded services via compact amendments in 2024.
The VA informed Congress in April 2025 that it would not expand services.
Discussions with the Freely Associated States resumed in mid-2026.
The VA submitted a draft action memo to the State Department in August 2026.
The GAO released its report on veteran health care gaps on September 25, 2026.
Market Landscape
This development marks a shift in how the VA handles health care delivery under the 2024 Compacts of Free Association amendments. The transition from an initial refusal to expand services toward a partial implementation strategy reflects ongoing challenges in aligning federal medical delivery with international compact mandates.
Operators and health providers should monitor the progress of the Circular 175 international agreements, as these will dictate the regulatory framework for future medical service expansion. Anticipate that full service delivery will require at least two years of additional regulatory alignment.
The takeaway
The VA is slowly moving toward expanding care for veterans in the Freely Associated States following congressional pressure. Stakeholders should track the status of the draft action memo submitted to the State Department as a key signal for when new service implementation might begin.
Further reading
For broader context on current veteran employment and service programs, visit the Military Jobs section.
Source note: This article includes information reported by Marianas Variety News & Views.
Live Poll
Should the U.S. government fund equal health care access for veterans in U.S.-affiliated Pacific territories?
