As the debate continues on whether the U.S. Department of Veterans Affairs should push forward with a new hospital on Brownsboro Road or open up the site selection process once again, U.S. Rep. John Yarmuth tells IL it is likely too late to change sites without adding another 10-year delay to the project. However, he notes that with the incoming administration of President-elect Donald Trump — who is considering the Brownsboro site’s chief critic in Congress as the VA’s new secretary — there is still a chance that the project could be stopped in its tracks.
While saying he has been “pretty agnostic” about the site for the new VA hospital, Yarmuth adds that his personal preference would have been to put it in West Louisville, where it would provide more of community-wide benefit. However, that was not the preference of the VA, and “having listened to a lot of the veterans, I don’t think they would be particularly happy with that.”
The VA says the 64-year-old Robley Rex VA Medical Center on Zorn Avenue is outdated and needs to be replaced, and Yarmuth notes the VA took the uncharacteristic step of receiving public input on where this replacement should go, with many veterans saying it should not be downtown.
“I personally asked General [Eric] Shinseki, when he was VA secretary, if he would direct his people to hold a public hearing, because they weren’t going to do it,” says Yarmuth. “I said the vets really want to be heard on this. So he agreed to do that, and they ended up having two. It was actually because of those hearings that they decided they would pursue a suburban site to try to capture as much of the flavor of Zorn Avenue as possible. I don’t know the Brownsboro does that… they’re going to have to plant a lot of trees to get to that point.”
Yarmuth says strong criticism of the VA’s purchasing of the Brownsboro property is valid, as “I know we overpaid and the appraisal was flawed, that the VA screwed up. They’ve admitted that.” He adds that his personal preference for a new VA hospital would have been at 18th and Broadway in the West End, “but there was no interest on the part of [property owners] the Bridgewaters to use the property for that reason, they focused on Walmart.”
While there has been a renewed call for the VA to open up the site selection process to include vacant West End properties where large development plans recently have collapsed — including this Walmart and the FoodPort at 30th and Muhammad Ali — Yarmuth adds that the Brownsboro site still meets the specific requirements laid out by the VA, while “my guess is that the FoodPort (property) doesn’t, probably 18th and Broadway doesn’t quite… it certainly doesn’t meet the criteria as well as Brownsboro does.”
Yarmuth questions whether there is much opportunity to switch the location of the hospital now, and even if the VA changed course, “estimates are that it would add 10 years to the project if it was switched. So we’d be talking about (opening in) 2030-something, rather than 2020-something.”
However, Yarmuth does say there remains a possibility that the VA may decide to put the brakes on the construction project at Brownsboro, depending on which direction the Trump administration decides to go with the agency.
Sen. Mitch McConnell of Kentucky has a large amount amount of sway as the majority leader of the chamber — and his wife Elaine Chao was nominated by Trump to be secretary of his Department of Transportation — and Yarmuth suspects “if Mitch really put his foot down that he could force the Trump administration to reconsider.” However, he adds that McConnell’s “only public statement on this is ‘let’s get it built,’ as far as I know,” so that would seem unlikely.
But such an intervention by McConnell might not be necessary for the VA to change course, as one of the top contenders being considered by Trump’s transition team to run the agency also happens to the be largest critic in Congress of the VA’s site selection process in Louisville, particularly the agency’s preference for the Brownsboro property.
U.S. Rep. Jeff Miller, R-Fla., is the outgoing chairman of the House Committee on Veterans’ Affairs, where over the past few years he has relentlessly blasted the VA for its long wait times for veterans seeking care at their medical facilities, as well as massive cost overruns and corruption at several of the VA’s construction projects for new hospitals. He was one of the earliest backers of Trump’s campaign in Congress and served as its advisor on veteran issues, and has expressed interest in running the agency to push through massive reforms that Trump also supports.
A particular focus of Miller’s scorn for the VA has been how it handled the site selection process in Louisville, including the inflated purchase price of the Brownsboro property and the VA’s failure to fully consider alternative sites. This Summer, Miller went as far as to pull authorization for the Louisville project’s $150 million in construction funds from a spending bill, though this authorization was later snuck back in and approved in the middle of the night — which several sources close to the matter have suspected was McConnell’s doing.
Yarmuth says that if Miller is named VA secretary, “I would worry about the project… because he’s raised so many great questions about it and it’s the largest project that’s on the books for them right now.”
Another factor that could halt a new VA hospital project in Louisville — whether at Brownsboro, the West End, downtown or anywhere else in the city — would be a major reform effort to allow veterans to use their benefits to seek medical care via private providers outside of VA facilities.
Following the VA’s wait time scandal in 2014, Congress passed legislation creating a pilot program where certain veterans could seek free health care in the private sector if they could not schedule a VA appointment within 30 days. Trump, Miller and several other candidates for VA secretary all support expanding that program, but most mainstream veterans service organizations fear wholesale privatization will inflate costs while gutting current VA facilities and services.
If massive reforms go through allowing any veteran to receive free health care in the private sector, Yarmuth agrees that decreased demand at VA facilities might kill any desire for the agency to spend exorbitant sums of money on constructing new medical facilities, with Louisville currently on the top of that list. While he is open to debate about expanding the current pilot program to some extent, Yarmuth adds that he will oppose any effort by the Trump administration to fully privatize the VA — along with many veterans groups.
“I think if there was a move to totally privatize the care, the veteran community would freak out,” says Yarmuth. “I think that would be an incredibly toxic thing for the administration to do… I know that there’s going to be a move to privatize just about everything under this administration, it seems like. I’m relatively confident that debate is going to happen.”
Yarmuth adds that full privatization would be counterintuitive to its stated goal, as it would actually reduce veterans’ access to quality care.
“Just because they give veterans a voucher to go visit another private doctor doesn’t mean they’re going to find a doctor,” says Yarmuth. “And the number of doctors is not going to automatically increase. So they’re going to be out there competing with everybody else for attention. And I’m not sure it would really add to the quality of care, overall, that vets receive.”
Such privatization efforts may also undermine the desire to push further with reforms to fix the many problems uncovered at VA facilities in recent years, according to Yarmuth.
“There have been a lot of improvements made over the last few years, but there are still a lot of problems,” says Yarmuth. “But if you’re committed to basically privatizing the whole system, then are you really going to work very hard to correct the flaws of the existing one? I think that’s a serious issue in any confirmation process.”
The new deadline to submit public comments to the VA on its environmental study, which named the Brownsboro site its “preferred alternative” for a new medical facility, is Jan. 11 — nine days before Trump’s inauguration.