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Guam veterans group worried Trump's VA cuts will upend care

Guam veterans group worried Trump's VA cuts will upend care

CBS News12-04-2025

Every week, in the U.S. Territory of Guam, a group of military veterans comes together and passes around a paddle, allowing each other to speak.
The gathering serves as their therapy for both the physical and psychological wounds sustained in combat in Iraq and Afghanistan.
For people in Guam, military service is an economic opportunity. Of the roughly 170,000 residents who live on the island, 24,000 of them are military veterans, the group says. Guam is home to two primary U.S. military bases: Naval Base Guam and Andersen Air Force Base. Despite that, there is only one small Veterans Affairs clinic on the island, with one psychologist.
Due to the lack of services here, Roy Gamboa assembled this group. He served 10 years in the Marine Corps. He calls the group "GOT YOUR 671." 671 is the area code for Guam.
"In the first couple of years, everything was coming out of our pockets," Gamboa said. "Since then we've applied for and received a couple of grants to help keep our doors open."
But the veterans in this group are worried about the looming
budget cuts to the Department of Veterans Affairs
. The agency has
terminated
585 contracts as part of an ongoing audit.
Gamboa worries his group could be next since the group is funded through a VA-issued grant.
Donovan Santos is also a combat veteran who says he has PTSD and chronic depression. He's now the person on the listening end of the group's suicide prevention hotline.
"I pretty much help those that fall through the cracks that feel like they're alone," Santos said. "I'm there with them on the ledge. I'm there with them to pull them back, to catch them."
Without the support from the group, Santos said he may not be alive. "Sometimes I wish my brothers were here and I wasn't," he said.
Gamboa says it's a fight they all hope to carry long into the future.
"I'll keep going," Gamboa said. "I mean, we were willing to die for each other in combat. I refuse to believe that it was all for nothing."
If you or someone you know is in emotional distress or a suicidal crisis, you can reach the
988 Suicide & Crisis Lifeline
by calling or texting 988. You can also
chat with the 988 Suicide & Crisis Lifeline here
.
For more information about
mental health care resources and support
, The National Alliance on Mental Illness (NAMI) HelpLine can be reached Monday through Friday, 10 a.m.–10 p.m. ET, at 1-800-950-NAMI (6264) or email info@nami.org.

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House GOP advances first 2026 funding bill out of committee

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The opinions expressed in this op-ed are those of the author and do not necessarily reflect the views of If you would like to submit your own commentary, please send your article to opinions@ for consideration. While attention remains focused on the looming crisis of Department of Veterans Affairs employees facing termination, an even more ominous threat to veterans' health care advances unnoticed through the halls of Congress. Three pieces of legislation are gaining momentum, each crafted to systematically dismantle VA-delivered care under the guise of sympathy for veteran suicide and mental health struggles. These bills could deliver the decisive blow in a long-standing campaign by proponents determined to privatize VA health care, collapsing the system by pulling funding it needs to care for veterans. Despite promises of greater "freedom," "autonomy" and "choice," unfettered private-sector funding threatens to narrow -- rather than expand -- veterans' actual options. 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A "Red Team" of independent health care experts concluded last year that the metastasizing growth of private-sector referrals placed the system in an "existential crisis." These allocations are draining resources from VA facilities, threatening to eliminate services and close facilities. This precarious situation is already evident under current eligibility requirements. Further statutory expansions of veterans' eligibility -- especially unfettered access -- for private-sector care would be financially unsustainable for VA direct care. Champions of privatization have introduced numerous bills designed to eliminate the requirement for VA authorization before veterans can access private care. These advocates have strategically seized upon veteran suicide and mental health crises as leverage points, exploiting the genuine sympathy these urgent issues generate to advance their broader privatization agenda that bears little connection to improving veterans' mental health. 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Even the VA Mission Act recognized this disparity, citing VA mental health providers as possessing unique "special expertise" that distinguishes them from their civilian counterparts. Similarly, the VA's suicide prevention initiatives exceed private-sector efforts. Each of the VA's 170 medical centers employs dedicated suicide prevention coordinators who collaborate with VA clinicians to oversee suicide risk screening, expedited mental health appointments, follow-up after missed appointments, safety planning, and medical record flagging. Annual suicide prevention and lethal means safety training is mandatory for all VA providers. Veterans receiving all their care through community programs experience higher suicide rates than those treated exclusively within VA facilities. The privatization push also wasn't driven by the private sector's capacity to deliver care more quickly. Most American counties lack a single psychiatrist, while 45% of rural counties have no psychologist. Veterans wait longer for mental health appointments through the VCCP than within the VA system itself. The VA system still has plenty more work to get done. Veterans currently wait an average of 17 days for a mental health appointment, while those requiring more intensive care face a 16-day delay from initial screening to admission into residential rehabilitation programs. In 2017, Jeff Miller, the recently departed chairman of the House Committee on Veterans' Affairs (HVAC), began working as a lobbyist for billionaire Steven Cohen, founder of the Cohen Veterans Network mental health clinic chain. Cohen objected to the VA's policy requiring prior authorization before reimbursing for private care. He sought to eliminate this regulation, allowing veterans to walk into his clinics, receive services, and send the VA the bill afterward -- no approval needed. Miller and Cohen Network representatives met with HVAC committee members and drafted legislation abolishing the VA's authorization requirement for mental health care. These efforts gained movement when then-Rep. Mike Gallagher, R-Wis., agreed to introduce their bill. The legislation faced immediate and unified opposition from major veterans service organizations. These groups recognized that the bill would undermine not only the VA's mental health services but also threaten the integrated health care system's overall structure. Faced with this resistance, the bill was quickly withdrawn. Talking to ProPublica, a former VA official presciently warned at the time, "If you start trying to carve into government money in veterans' care to feed things like the Cohen Veterans Network, that's actually privatization. It's going to be death by a thousand cuts." In 2019, veteran suicide statistics seemed to portray a devastating picture. Despite a decade of well-conceived efforts, the numbers simply weren't budging. Twenty veterans took their lives each day, 14 of whom were not using the VA for services. The unyielding problem begged for fresh approaches. This recognition sparked genuine bipartisanship on Capitol Hill. In the Senate, John Boozman, R-Ariz., and Mark Warner, D-Va., joined forces, while Representatives Jack Bergman, R-Mich., and Chrissy Houlahan, D-Pa., did the same in the House. Together, they crafted the IMPROVE (Incorporating Measurements and Providing Resources for Outreach to Veterans Everywhere) Wellbeing for Veterans Act -- a three-year pilot program to provide federal grants to community organizations already working on the ground to identify at-risk veterans disconnected from VA health care and furnish preventive services before suicidal crises emerged. What made the Improve Act truly unprecedented wasn't just its community-leveraging framework, but its insistence that renewed funding be based on demonstrated improvements. The bill's architects mandated capturing comprehensive outcome data at multiple points to distinguish which community programs enhanced veterans' mental resiliency over a long-term period and thereby reduced suicide risk. Meanwhile, Sen. John Tester, D-Mont., SVAC ranking member, was constructing his own comprehensive veterans' mental health bill. During negotiations, he agreed to include Improve Act language in the package, later renamed the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program after a 25-year-old Army sniper instructor who'd recently died by suicide. Tester's bill sailed through Congress, and the pilot Fox Grant Program began funding grantees in late 2022. The 18-month Fox Program review revealed a bleak picture of widespread ineffectiveness. Organizations were supposed to track participants' suicidal ideation, financial stability, mental health status and social supports before and after providing services, but most didn't do so. Out of all participating entities, only 295 people completed services and filled out at least one of the five required questionnaires. That's roughly, on average, four people per grantee -- a shockingly minuscule number. Even worse, the report failed to break down results by individual organization, making it impossible to determine whether they were helping improve veterans' well-being. As the three-year pilot approached the time for reauthorization in 2024, House and Senate committees held hearings to chart the program's future. However, applying the original renewal criteria for grantees would create a problem: If grant money was truly reserved for community programs that demonstrated improvement, many grantees would surely lose funding. The solution emerged as a sham workaround -- ensure private-sector money continued flowing by ignoring the requirement that grantees measure outcomes. Rep. Mariannette Miller-Meeks, R-Iowa, adopted this hands-off approach with her No Wrong Door for Veterans Act. It mandates a one-time initial screening while making no mention of pre and post assessment instruments designed to evaluate program outcomes and inform renewal decisions -- an omission that implicitly renders such evaluations voluntary. The potential abandonment of required pre and post comparative data troubled several lawmakers. House Democrats offered amendments to ensure continuation of outcomes tracking, but these were swiftly rejected. The No Wrong Door for Veterans Act contained two additional provisions that will accelerate privatization. One compressed VA access standards, the time limit the VA has to schedule, from 20 days to an unrealistic 3-day window for mental health referrals -- virtually guaranteeing automatic referrals to non-VA providers. Then, once Fox Grant recipients secure this expedited community care pathway, political pressure would inevitably mount to extend identical leeway to all enrolled veterans, draining more resources from VA facilities. Another provision posed an equally grave threat: The bill expands eligible grant recipients to include "mental health care entities" and permits them to offer non-emergency direct mental health treatment. This expanded scope would duplicate the mental health care provided at nearby VA and VCCP facilities, undermining the very agency it is intended to complement. A pair of other veterans' mental health bills have entered the legislative pipeline, each creating broad avenues for veterans to access private-sector services independently of VA involvement. One is the Veterans Health Act, introduced in 2023 by Jerry Moran, R-Kan., then the SVAC ranking member. The legislation includes a pilot program designed to expand access for veterans experiencing mental health and substance use disorders. Under this framework, veterans could schedule appointments directly with community providers, circumventing VA referral systems. Despite its pilot designation, the bill contains a mandate to expand this model across all health conditions throughout the entire VA system after three years. Moran reintroduced the pilot in March 2025 as part of the Veterans Access Act, which is slated for consideration this summer. The second bill -- the Recover Act -- introduced last fall by HVAC Chairman Rep. Mike Bost, R-Ill., would allocate grants to facilities for mental health services. This Cohen Veterans Network-backed legislation would create a parallel care system beyond services already available through the VA and the VCCP. This proposed arrangement raises troubling concerns about accountability. The VA would lose ability to oversee treatment furnished through these grants, while recipient facilities would face no requirement to share health records with VA providers -- a fundamental breakdown in care coordination that could leave veterans' treatment fragmented and potentially compromised. We've reached a critical juncture. The No Wrong Door for Veterans Act cleared the House in late May, leaving the Senate to make a pivotal choice: Advance this legislation or pursue legislation that retains accountability. Both the Veterans Health Act and the Recover Act are teed up for further attention. By the time America celebrates Veterans Day this fall, Washington may have delivered a mortal blow to the system uniquely designed to serve those who answered their country's call. -- Russell Lemle is a senior policy analyst with the Veterans Healthcare Policy Institute.

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