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Adds new subsection (e) 'Employment assistance' requiring the Secretary to provide employment assistance to individuals designated as primary providers of personal care services, including reimbursement of certification/relicensure fees (maximum lifetime reimbursement $1,000), access to Department training modules at no cost for continuing professional education credit, and, in consultation with the Secretary of Defense and the Secretary of Labor, access to Military OneSource, the Veterans' Employment and Training Service, and appropriate VA programs; access is available while participating in the program established under subsection (a)(1) and during the 180-day period following cessation of participation unless dismissed for fraud, abuse, or mistreatment.
Amends 38 U.S.C. 1781 by (a) inserting text into subsection (a)(4) as described; and (b) in subsection (d) redesignating existing paragraph (4) as paragraph (5) and inserting a new paragraph (4) that makes an individual ineligible for medical care under this section during the 180-day period specified under subsection (a)(4) if the individual is entitled to hospital insurance benefits under part A of the Medicare program.
Amends VA caregiver law to limit eligibility for certain VA medical care when a caregiver has Medicare Part A during a specific 180‑day period, and adds new job and training supports, studies, and reports to help family caregivers transition out of caregiving and return to the workforce. It also directs GAO and VA to study and report on retirement savings options and how VA assists caregivers who leave caregiving roles.
Amend subsection (a)(4) of 38 U.S.C. 1781 by inserting additional text before the final comma. (The actual text to be inserted is not shown in this document.)
Redesignate paragraph (4) of subsection (d) of 38 U.S.C. 1781 as paragraph (5).
Insert a new paragraph (4) in subsection (d) stating that, notwithstanding other provisions of subsection (d), an individual is not eligible for medical care under section 1781 during the 180-day period specified under subsection (a)(4) if the individual is entitled to hospital insurance benefits under Part A of the Medicare program during that period.
Adds a new subsection (e) "Employment assistance" to 38 U.S.C. 1720G requiring the Secretary of Veterans Affairs to provide employment assistance to individuals designated as primary providers of personal care services under 38 U.S.C. 1720G(a)(7)(A).
Reimburse fees for certifications or relicensure necessary for employment for an individual designated as a primary provider of personal care services.
Who is affected and how:
Family caregivers / primary providers of personal care for veterans: Directly affected. They may gain access to reimbursements, training, referrals to employment programs, and expanded post‑program supports designed to help them return to work or transition out of caregiving. However, some caregivers who are entitled to Medicare Part A may lose eligibility for VA medical care during the specified 180‑day period.
Veterans: Indirectly affected. Improved caregiver employment stability and supports may help long‑term caregiver retention and quality of care; changes in caregiver medical eligibility could alter caregiver health coverage and capacity.
Department of Veterans Affairs: Responsible for implementing new employment-support services, expanded post‑program supports, and producing the required retirement feasibility report. VA will incur administrative and program costs and must coordinate with DoD, DOL, and Treasury as required.
Government Accountability Office and Treasury: GAO must complete an assessment report within two years; Treasury will be consulted for the retirement pathway feasibility report.
Employers and workforce programs (including DoD and DOL initiatives): May see increased referrals and participation from caregivers; employers may benefit from hiring trained former caregivers but may need to adapt hiring/outreach practices.
Likely effects and tradeoffs:
Positive: Better access to training and employment services can improve caregivers’ economic security and ease transitions back to the workforce. Feasibility work on retirement pathways could lead to new savings options for caregivers who have limited access to employer retirement plans.
Negative/risks: The Medicare Part A eligibility rule narrows VA medical coverage during a defined window and may reduce short‑term access to VA medical services for caregivers who are Medicare‑eligible. Implementation will require VA administrative capacity and potentially funding; absent explicit appropriations, program expansion could be constrained.
Uncertainties: The actual scope and cost depend on the implementing regulations, definitions of covered services/reimbursements, and whether Congress provides dedicated funding to support these new services and any future retirement‑savings program changes.
Expand sections to see detailed analysis
Read twice and referred to the Committee on Veterans' Affairs.
Introduced March 6, 2025 by Jerry Moran · Last progress March 6, 2025
Committee on Veterans' Affairs. Ordered to be reported with an amendment in the nature of a substitute favorably.
Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 119-86.
Read twice and referred to the Committee on Veterans' Affairs.
Introduced in Senate