The Trillion-Dollar Handoff Nobody Voted On

The VA just issued the largest service contract in government history. Congress found out when the vendors did.

Feb 09, 2026

The Gist

The VA is handing up to $1 trillion in veteran health care to private insurance companies over the next decade. Congress wasn’t briefed before the contract dropped. The oversight committee was told some topics were off-limits. No vote is required. Proposals are due March 16, 2026 — five weeks from now.
This article breaks down the money, the players, and what it means for your claim.

On December 15, 2025, the Department of Veterans Affairs dropped a Request for Proposals that will reshape how 9 million veterans get their health care for the next decade.

The price tag: up to $700 billion. Some estimates put it closer to $1 trillion.

The House Veterans Affairs Committee — the body constitutionally charged with overseeing VA spending — learned the details at the same time the insurance companies did.

No vote. No advance briefing. No public debate.

Just a procurement document posted on SAM.gov two weeks before Christmas.

What Is CCN Next Gen?

The Community Care Network Next Generation contract replaces the current system that lets veterans get VA-covered medical care from private providers. Right now, two companies — Optum (owned by UnitedHealth Group) and TriWest Healthcare Alliance — manage five regional networks covering every state and territory.

The new contract collapses those five regions into two: East and West. It restructures the entire relationship between the VA, private insurance companies, and the community providers who actually treat veterans.

This is the second time VA has issued large contracts with health plans to coordinate private-sector care. The first was in 2018, after the MISSION Act. Those contracts are expiring. What replaces them will define whether the VA remains a health care provider — or becomes a health care payer.

That distinction matters more than anything else in this conversation.

The Numbers Tell the Story

Community care already consumes over 40% of all veteran health care. The FY2026 budget request puts community care spending at $48 billion — up 26% from $38 billion the year before. Secretary Collins announced full-year authorizations for 30 medical conditions, eliminating the requirement that veterans return to VA every few months for reauthorization.

That’s not expanding access. That’s building an exit ramp from VA care.

Meanwhile, VA lost approximately 30,000 employees in 2025 through attrition, early retirements, and the hiring freeze. Another 25,000 vacant positions were eliminated in December. The department that hired 62,000 people in a single year to implement the PACT Act is now running with fewer staff than it had before the law passed.

Fewer VA staff means longer wait times. Longer wait times mean more veterans get referred to community care. More community care volume means bigger contracts. Bigger contracts mean less justification for VA staffing.

It’s a ratchet. And it only turns one direction.

For 29 years, veteran communities like HadIt.com have operated on a simple principle: Leave No One Behind. That principle doesn’t work when the system designed to catch you is being outsourced to companies that get paid whether you fall or not.

Congress Found Out Last

On January 22, 2026, the House Veterans Affairs Committee held a hearing titled “Community Care Network Next Generation: One Trillion Dollars of Oversight.”

Read that title again. Congress named its own hearing after the oversight failure.

Chairman Mike Bost — a Republican from Illinois, not a partisan critic of this administration — opened with a statement that should alarm every veteran in America:

“I understand the VA finds it unprecedented to hold a hearing on an active contract solicitation. I appreciate the sensitivity of the contract, but it is also unprecedented to avoid Congress’s oversight of $1 trillion of spending. My staff and the ranking member’s staff have been told that some topics are off limits because of the sensitive nature of the contract and solicitation.”

Read that again. Seriously, read it again: “My staff and the ranking member’s staff have been told that some topics are off limits because of the sensitive nature of the contract and solicitation.”

WITAF.

The committee that oversees VA was told there were topics they couldn’t ask about regarding a contract worth more than the annual GDP of most countries. Bipartisan staff — both Republican and Democrat — were kept in the dark.

The ranking Democrat on the committee wasn’t even briefed before the RFP dropped. A source told Military Times that the VA provided no information to the committee’s Democratic leadership before the December 15 announcement.

This is not how a democracy handles a trillion dollars.

Who Benefits?

The current CCN is managed by Optum — a subsidiary of UnitedHealth Group, the largest health insurance company on Earth — and TriWest Healthcare Alliance. Under the new structure, VA says “multiple national and regional health plans” can compete.

That sounds good on paper. But expert testimony at the January 22 hearing exposed serious structural problems.

Dr. Rachel Madley, Executive Director of the Center for Health and Democracy, told the committee that the proposed contracts create inherent conflicts of interest. Insurance companies that are increasingly consolidating with medical providers would be building their own provider networks and scheduling patients into them. The incentive to steer veterans toward providers the contractor owns — rather than the best providers for the veteran — is baked into the structure.

The contracts also require “value-based care” models. In a not-for-profit system, these can work. When operated by corporations whose primary obligation is shareholder profit, they can lead to rationed care.

Rep. Morgan McGarvey of Kentucky put it plainly: “I don’t trust big insurance companies to take care of anybody. The sole thing that motivates them is profit. It’s not people, and it’s certainly not our veterans.”

The Privatization They Swore Wasn’t Happening

VA leadership has been saying for years that community care isn’t privatization. It’s “choice.” It’s “access.” It’s “modernization.”

But the math doesn’t lie.

When community care was 20% of veteran health care, it was a supplement. At 40%, it’s a parallel system. At 50% or higher — which is where these contracts are headed — the VA becomes an insurance company with a hospital system it’s slowly defunding.

Dr. Madley’s testimony laid out the data: increasing funding for community care decreases funding for VHA direct care. The VA’s own hospitals provide care more efficiently, with significantly lower administrative overhead. Traditional Medicare — the closest public-sector comparison — runs administrative costs around 1.3% of total spending. Private insurers typically run 12-18%. Madley told the committee that VA administrative costs are comparable to Medicare’s, making them roughly ten times lower than the private insurance companies now bidding on CCN Next Gen. Veterans seen at VA facilities face shorter wait times for many services and receive better outcomes for exposure-related illness and mental health.

Kyleanne Hunter, CEO of Iraq and Afghanistan Veterans of America and a Marine veteran, testified to Congress in July 2025: “Community care is a vital part of overall veterans’ health care, but especially as we consider rising costs, we need to be clear that the evidence does not bear out that community care is a meaningful replacement for all direct VA care.”

The evidence says VA care is often better and cheaper.

The contract says we’re buying more of the alternative.

What a Payer Doesn’t Do

This is the part nobody in the procurement office wants to talk about.

When the VA is a health care provider, it does things no insurance company will ever do. When it becomes a health care payer — which is what a trillion-dollar contract with private insurance companies makes it — those things disappear. Not all at once. Gradually. Then all at once.

Research vanishes. VA operates one of the most important medical research programs in the world. Nearly 80% of VA researchers also provide direct patient care — they’re not in a lab somewhere, they’re treating you on Tuesday and running a clinical trial on Wednesday. That bench-to-bedside pipeline produced the implantable cardiac pacemaker. The CAT scan. The nicotine patch. The first successful liver transplant. The shingles vaccine. Three Nobel Prizes. Seven Lasker Awards. The Million Veteran Program — one of the largest genomic databases on Earth — exists because VA researchers can track health outcomes across millions of veterans over decades.

UnitedHealth Group doesn’t do that. Optum doesn’t do that. No private insurance company runs long-term research on burn pit exposure, Agent Orange cancers, or Gulf War illness. They don’t have to. Their obligation is to shareholders, not to the 23-year-old Marine who inhaled toxic fumes at a burn pit in Balad and won’t develop symptoms for another fifteen years.

VA researchers recently found that veterans exposed to military burn pits had three times the level of carbon particles in their lungs compared to unexposed people. They found that toxic exposure increased suicidal ideation by 50%. That research happened because VA doctors treat burn pit veterans and study burn pit exposure in the same integrated system.

A payer writes a check. A provider finds out why you’re dying.

Training collapses. More than 70% of all U.S. doctors received training at a VA facility. Every year, VA trains 62,000 medical students and residents, 23,000 nurses, and 33,000 other health care trainees. No single institution in America trains more doctors or nurses. When VA hospitals shrink because the patients are being routed to community care, the training pipeline shrinks with them. That doesn’t just hurt veterans — it hurts every American who will eventually need a doctor.

Specialized expertise walks out the door. Your local community hospital doesn’t have a spinal cord injury center. It doesn’t have a blind rehabilitation program. It doesn’t have clinicians who’ve spent their careers treating combat PTSD, traumatic brain injury, military sexual trauma, or the specific pattern of blast injuries from IEDs. VA built those specialties because the private market never would — there’s no profit margin in treating a Vietnam veteran’s Agent Orange-related peripheral neuropathy forty years after exposure.

When a private insurer takes over care coordination, veterans get routed to whatever provider is in-network. Not whoever knows the most about their condition. Whoever costs the least.

The Fourth Mission dies. VA has a statutory obligation — its “Fourth Mission” — to serve as the nation’s medical backstop during emergencies and disasters. During COVID, VA deployed personnel to over 50 states and territories, treating veterans and non-veterans alike. VA maintains 48 Federal Coordinating Centers for mass casualty events. During Hurricane Maria, VA deployed hundreds of employees to Puerto Rico in rotating two-week shifts.

Insurance companies don’t deploy to disaster zones. They process claims from disaster zones. There’s a difference.

Institutional memory evaporates. VA tracks your health across your entire post-service life. It connects the knee injury from jump school in 1987 to the degenerative arthritis claim in 2026. It links the Gulf War deployment to the unexplained chronic fatigue twenty years later. That longitudinal view — one patient, one system, decades of data — is what makes VA uniquely capable of identifying service-connected conditions that private doctors don’t think to look for.

A community care provider sees you for an episode. VA sees you for a lifetime. Or it used to.

Prior authorization enters the chat. Here’s what veterans using community care need to understand about the insurance companies bidding on CCN Next Gen: according to a KFF analysis of CMS data, Medicare Advantage plans — run by the same companies — denied 4.1 million prior authorization requests in 2024. Only 11.5% of those denials were appealed. But of the ones that were appealed, 80.7% of the denials were overturned. That means millions of people were denied care they were entitled to, and most of them never fought back.

That’s the business model. Deny first, pay later, count on people giving up.

Now imagine that model managing health care for 9 million veterans.

Who Gets Richer

This is the part you’re not supposed to ask.

UnitedHealth Group — the parent company of Optum, which currently manages community care in three of VA’s five regions — reported $400.3 billion in revenue in 2024. That’s not a typo. Four hundred billion. Its adjusted profit was $25.7 billion. Its CEO, Andrew Witty, earned $26.3 million in total compensation that year — 348 times the median salary of a UnitedHealth employee. The six major national health insurance CEOs earned a collective $159.4 million in 2024.

TriWest Healthcare Alliance, which manages the other two VA regions, has its own history. In 2020, TriWest agreed to pay $179.7 million to the Department of Justice to resolve allegations that it retained overpayments from the VA — including cases where VA paid TriWest twice for the same services. That was the second settlement in eight years. In 2012, TriWest paid $10 million to settle allegations it defrauded TRICARE by billing the government higher rates than it had negotiated with providers.

These are the companies bidding on CCN Next Gen. These are the companies that will manage up to a trillion dollars in veteran health care over the next decade.

Every dollar that flows through a private administrator generates overhead that doesn’t exist when VA treats you directly. Administrative costs. Network management fees. Executive compensation. Shareholder returns. Profit margins. Lobbying budgets. Legal departments built to fight the same claims they’re paid to process.

When VA treats a veteran at a VA hospital, one hundred cents of every dollar goes to care, training, and research. When VA pays a private insurer to arrange that same care in the community, some portion of every dollar is siphoned into corporate infrastructure that has nothing to do with whether a veteran gets better.

That’s not a conspiracy theory. It’s a business model. And the CCN Next Gen contract is about to scale it up by a factor of ten.

The Math Nobody’s Running

Here’s the question Congress should be asking but isn’t: What would happen if that same money went directly into VA?

The CCN Next Gen contract is estimated at $70 to $100 billion per year at peak. Even at the low end, that’s $70 billion annually flowing to private companies to arrange care that VA could provide itself — if anyone bothered to invest in it.

Let’s run the math they won’t.

Staffing. The average VA employee salary is roughly $73,000 per year. At $70 billion, you could hire 958,000 full-time VA employees. VA currently employs about 400,000 people. You could more than triple the workforce. You wouldn’t need to — but even dedicating a quarter of that spending to new hires would add 239,000 doctors, nurses, mental health providers, and claims processors to a system that everyone agrees is understaffed.

Facilities. Congress recently authorized $79.7 million for a single new community-based outpatient clinic in Hampton Roads. A major VA health care center in Charlotte cost $104 million. Full VA medical center replacements — like the New Orleans facility built after Katrina — run $1 billion or more. These aren’t cheap. But at $70 billion a year, you could build dozens of new medical centers and hundreds of new clinics — every single year. In five years, there wouldn’t be a rural veteran in America more than 45 minutes from a VA facility.

Wait times. The entire justification for community care is that VA can’t see you fast enough. But VA can’t see you fast enough because Congress has systematically underfunded staffing while simultaneously expanding eligibility through the PACT Act. The answer to “we don’t have enough doctors” isn’t “send the patient somewhere else at twice the cost.” It’s hire more doctors.

Research. VA’s entire research budget is approximately $2 billion per year. That $2 billion produced the cardiac pacemaker, the CAT scan, the nicotine patch, the shingles vaccine, and three Nobel Prizes. Imagine what happens with $4 billion. Or $10 billion. That’s the kind of investment that produces the next breakthrough in TBI treatment, the next generation of prosthetics, the next discovery about burn pit exposure — research that no private insurer will ever fund because there’s no quarterly earnings call where “we figured out why Gulf War veterans are dying” moves the stock price.

The real cost comparison. Community care consistently costs VA more per patient than treating that same veteran in-house. VA’s own data has shown this repeatedly. Madley told Congress that VA’s administrative costs are comparable to Medicare’s — roughly 1.3% of total spending — while private insurers run 12-18%. That means for every $100 spent through community care, $12 to $18 goes to overhead. Through VA directly? About $1.30.

Over a decade, at $700 billion to $1 trillion in contract value, that overhead gap translates to somewhere between $75 billion and $167 billion in administrative costs alone — money that buys no care, treats no veteran, and funds no research. It pays for executive suites, shareholder dividends, and lobbyists who will argue for even more privatization next year.

Nobody in the procurement office is running this comparison. Nobody in Congress is demanding it. The question isn’t whether community care has a role — it does, and it should, especially in rural areas where VA facilities don’t exist. The question is whether you build a system that creates those facilities, or one that profits from their absence.

Right now, we’re choosing the second one.

The Promise Wasn’t a Contract

Buried in the contract details is a $300 million investment to modernize VA’s electronic health record system to industry standards. Richard Topping, VA’s assistant secretary for management, told Congress this is essential because VA’s current system is “more than 30 years old” and requires manual loading of patient records.

This is the same VA that has already obligated $13.8 billion on EHR modernization — the Oracle Health project — with life cycle cost estimates ranging from VA’s own $16.1 billion to an independent estimate of $49.8 billion, according to GAO. The project was paused in 2023 after deploying to just five sites, restarted in late 2024, and remains one of the most troubled IT programs in federal history. As of February 2025, 94% of VA medical centers still don’t have the new system.

Now the CCN Next Gen contract bets on EHR interoperability as a central feature. If it works, records flow seamlessly. If it doesn’t — and there’s a $16 billion track record suggesting it might not — veterans’ medical records get lost between systems. Again.

The contract’s promised 8-14% cost savings over the decade depend on this interoperability working. The VA is projecting $54 to $100 billion in reduced community care spending from better management. That projection is built on a technology foundation that has failed repeatedly — and that GAO has flagged with 18 recommendations, 16 of which remain unimplemented as of December 2025.

What This Means for Your Claim

If you’re a veteran with a VA disability claim, a pending appeal, or a service-connected condition being treated at a VA facility, this contract matters.

Here’s why:

Your medical records could change hands. The shift to new contractors means your community care records may be managed by different companies. If you’re building a claim that depends on treatment records from a community provider, make sure you have personal copies of everything. Don’t rely on the system to maintain continuity during a contractor transition.

Access patterns may shift. If you’re currently seen at a VA facility and referred to community care, the referral process, the provider network, and the authorization timeline are all changing. The full-year authorizations for 30 conditions sound convenient — until the provider network changes and your doctor isn’t in it anymore.

The workforce cuts affect claims processing. The same staff reductions that push more health care to community care also affect VBA — the arm that processes disability claims. Fewer employees processing more claims means longer waits. The PACT Act created millions of newly eligible veterans. The staff hired to process those claims is being cut.

Document everything yourself. In a system undergoing this much structural change, institutional memory disappears. Keep copies of every appointment, every diagnosis, every referral. Build your evidence file like nobody’s going to do it for you.

Because increasingly, nobody is.

Five Weeks

Proposals for the CCN Next Gen contract are due March 16, 2026.

Five weeks from the day this article publishes.

Once those proposals are submitted and contracts awarded, the structural shift is locked in for a decade. The contracts include a three-year base term with three two-year option periods and a one-year extension — up to ten years total.

This isn’t a policy proposal. It’s not a CBO budget option. It’s not a bill sitting in committee.

It’s a procurement action. It requires no vote. No filibuster. No signing ceremony. Just a contracting officer and a pen.

By the time most veterans hear about it, it will be done.

What You Can Do

Contact your representatives. Both the House and Senate Veterans Affairs Committees have signaled they want more oversight. Tell them to demand full transparency before contracts are awarded. The hearing on January 22 was, in Chairman Bost’s words, “only the beginning.” Make sure it’s not the end.

Contact the Senate Veterans Affairs Committee. They’re planning additional hearings on CCN Next Gen. Your voice — especially if you use community care — matters in shaping those hearings.

Talk to your VSO. Veterans of Foreign Wars, Disabled American Veterans, Iraq and Afghanistan Veterans of America, and other organizations have been raising concerns. Make sure they know this is a priority for their members.

File your claims now. If you’ve been waiting to file a disability claim or an increase, the current system — with its current staffing, current rating criteria, and current VA infrastructure — is the system you want processing your claim. What comes after the structural changes may not be.

Keep your records. If you receive any care through community care, request and keep copies of all medical records, referral authorizations, and treatment documentation. Contractor transitions are when records disappear.

The Promise

Abraham Lincoln’s promise — “to care for him who shall have borne the battle, and for his widow, and his orphan” — is carved into the wall at VA headquarters in Washington.

It doesn’t say “to purchase care from the lowest bidder.”

It doesn’t say “to issue an IDIQ contract for care management services.”

It doesn’t say “to outsource the obligation to corporations whose legal duty is to maximize shareholder value.”

The VA was built to provide care. Not to broker it.

A trillion-dollar contract awarded without a congressional vote, briefed to oversight committees at the same time as vendors, with topics declared off-limits to the people’s elected representatives — that’s not modernization.

That’s a handoff.

And if veterans don’t speak up in the next five weeks, it’ll be permanent.

They're going to push back. I already answered.

Tbird is a Navy veteran (VAQ-34, 1983-1990) and founder of HadIt.com, one of the oldest veteran-run VA disability claims communities on the internet (est. 1997). For 29 years, HadIt.com has operated on one principle: Leave No One Behind. That means no paywalls on claims information, no sales pitches, and no staying quiet when the system built to serve veterans gets handed to the people who profit from denying care. Contact: founder@hadit.com

This article is for informational purposes only. HadIt.com does not provide legal advice. For assistance with your specific VA claim, consult an accredited Veterans Service Organization (VSO) or VA-accredited attorney. Find accredited representatives at VA.gov’s eBenefits.

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