GAO Reported Gaps in Veterans Health Care Access

A new federal report highlights significant hurdles for veterans seeking medical services in the Freely Associated States.

Updated on Sept. 30, 2026 in Military Jobs

Isometric editorial illustration of a stylized medical aircraft positioned above a minimalist island map, representing healthcare access challenges for veterans. — The GAO reported that veterans in the Freely Associated States face persistent barriers to specialty medical care and require costly travel to access services. AI Illustration. Upload story photo >

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Should the U.S. government fund equal health care access for veterans in U.S.-affiliated Pacific territories?

The Government Accountability Office released a report detailing restricted health care access for veterans living in the Freely Associated States. Veterans in these regions currently face high costs and limited specialty care, often requiring expensive travel to facilities in Honolulu or Guam.

Why it matters

The findings underscore ongoing challenges in extending medical support to veterans residing abroad, despite legislative authorization to expand services. The report reveals a gap between initial congressional mandates and the Department of Veterans Affairs' implementation progress.

Veterans seeking care typically pay over $1,000 for round trip airfare to reach facilities in U.S. jurisdictions. Full implementation of expanded medical services is estimated to cost $26 million for enrolled veterans.

The players

Government Accountability Office

This is an independent, nonpartisan agency that works for Congress to investigate how the federal government spends taxpayer dollars.

Department of Veterans Affairs

This federal agency is responsible for providing vital services to America's veterans, including healthcare, benefits, and memorial services.

State Department

This executive department manages the international relations of the United States and works with the VA to facilitate international agreements.

The details

Veterans in the Freely Associated States currently lack access to local telehealth services and specialty care, such as cardiology and oncology. Although the Department of Veterans Affairs submitted a draft action memo to the State Department in August 2026 to initiate necessary agreements, it previously declined to expand services in early 2025 citing equity concerns.

Congress authorized expanded services in 2024.
The VA informed Congress it would not expand services in April 2025.
The VA resumed discussions with the Freely Associated States in mid-2026.
A draft action memo was submitted to the State Department in August 2026.
The GAO released its report on September 25, 2026.

Market Landscape

This situation follows the implementation challenges set by the 2024 Compacts of Free Association amendments. The current lack of expanded care contrasts with the legislative intent of these agreements, which were designed to normalize services for veterans in the Pacific region.

Veterans residing in the Freely Associated States continue to shoulder significant out-of-pocket travel expenses for basic medical needs. Access to specialized treatments remains limited, with no immediate expansion of telehealth services expected in the near term.

The takeaway

The VA's transition from declining service expansion to pursuing international agreements marks a critical turning point for Pacific-based veterans. Veterans and their families should continue to monitor federal updates for potential changes to healthcare access and travel reimbursements.