Veterans die by suicide at a rate 50 percent higher than nonveterans—and nearly two-thirds of those deaths occur among men and women receiving all their health care from private providers in the communities where they live. That is where they are dying, and that, apparently, is where accountability vanishes.
VA Secretary Doug Collins and Republican congressional leaders profess to care deeply about veterans experiencing mental health crises while under the care of these private providers. But another pattern is also obvious: Every time Department of Veterans Affairs officials or Republicans in Congress have had the chance to hold private providers to the VA’s own quality standards for treating at-risk veterans, they’ve chosen not to.
In February, Collins declared: “Under President Trump, we are totally revamping the department’s approach to suicide prevention, with new leadership, a fresh focus on reaching those who need our help.” But the department’s actions tell a totally different story.
This week, a House Committee on Veterans’ Affairs subcommittee took up the Fostering TRUST Act of 2026, a bill that would require providers in both the VA and in the private sector under the VA’s Veterans Community Care Program (VCCP) to report suicide attempts and deaths at their respective facilities. Scrupulous monitoring isn’t currently mandated for the VCCP, an inconvenient truth freely admitted by a VA official who testified before the committee. Yet when this bill proposed to create exactly such a system, the VA refused to support it.
The VA rationale for this puzzling decision? According to the official’s written testimony, “If any suicide or attempted suicide by a Veteran on the property of a provider who furnishes care through the VCCP had to be reported, this could also pose a significant burden on these community providers and could disincentivize them from participating in the VCCP, which would reduce Veterans’ access to care.”
Read that again. What the VA is saying is that maintaining a robust network matters more than knowing the details about a veteran who died by suicide while in the care of a community provider. The department disregards crises to ensure health care privatization continues. If tracking those deaths might feel burdensome to providers and lead to them withdrawing from the VCCP, well, just skip it.
This moral abdication stands in stark contrast to the standards the VA has long insisted upon in its facilities. If a patient dies by suicide after being seen at a VA facility anytime in the prior six months, the VA conducts two separate postmortem reviews of that patient’s case. Those standards should be applied to VCCP care as well. They aren’t.
The VA official’s Fostering TRUST Act testimony shows that the department’s decision to give free passes to the VCCP is not an isolated case. A year ago, during the House markup of the Veterans’ ACCESS Act—legislation intended to accelerate the privatization of veterans’ health care—Democratic members offered amendments that would require VCCP providers to complete suicide prevention and mental health training that matches the instruction VA clinicians receive. The Republicans killed every single one.
Rep. Mike Bost (R-IL), the House Veterans’ Affairs Committee (HVAC) chair, dismissed the requirements as “red tape” that would “not let doctors be doctors” and warned that providers might flee the program rather than take a short training course. Those sentiments mirrored concerns the VA expressed at this week’s hearing: Bolster the referral pipeline and forget about what happens to patients inside it.
If that sounds familiar, that’s because it is. Rep. Lauren Underwood (D-IL) introduced a bill in 2020 that would have mandated all VCCP and VA providers take suicide prevention training. Though the legislation was discussed at an HVAC legislative hearing (full disclosure: I testified in support of the bill), lawmakers viewed the higher bar for providers as a hindrance and shelved it.
Similarly, the MISSION Act of 2018 mandated that VCCP providers who prescribe opioids to veterans to minimize the risk of overdoses receive and certify that they’ve reviewed the VA’s opioid safety guidelines. These policies require providers to examine state prescription drug monitoring databases prior to writing a new order. Medical records show that the preponderance of VA providers prescribing opioids checked the database beforehand. By contrast, the VA Office of Inspector General (OIG) found that 79 percent of VCCP prescribers had no documentation demonstrating they’d made the queries.
Confronted with these dangerous VCCP lapses that the OIG detected, a VA official indicated that “if VA were to penalize providers by restricting referrals or obstructing association to the community provider network, it would be a detriment to network adequacy.” The VA’s message was clear: Keep adding and retaining providers and ignore their deficiencies or lack of training.
The status quo is unacceptable. Americans need to know as much as possible about every veteran who dies by suicide no matter where that death occurs—and whether within inpatient or outpatient care. The current reporting framework, which includes only the VA, does not give Congress or the public enough information about those deaths. Nor does it identify what needs to improve or how to ensure accountability.
There is one sliver of encouraging news. In May, Reps. Bill Huizenga (R-MI) and Lou Correa (D-CA) introduced the Veterans Suicide Prevention and Care Enhancement Act that would incentivize VCCP providers to voluntarily undergo suicide prevention training. Completed training would be publicly acknowledged, but not required. That bill has already secured five Republican co-sponsors, a major pivot from Republicans’ disregard for the quality of care in the VCCP.
Veterans who seek care outside the VA system should not forfeit the right to the same high standard of care or the same level of scrutiny following a suicide that the VA provides. This should not be a controversial proposition. But the fact that it is tells Americans everything they need to know about who is being protected—and it isn’t veterans.
