Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans

Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans

Updated March 11, 2021
Veterans Health Administration: Gender-Specific Health Care
Services for Women Veterans
Introduction
 various types of women’s health care services that can
VHA had predominately provided general health care and
be accessed through the VA, and
gender-specific services (e.g., prostate exams) that were
 available support for other concerns, such as
geared to men, because the demographics of the veteran
homelessness.
population had been predominately male. The U.S. Census
Bureau began asking women about their military service in
Since its inception in the summer of 2018 through August
1980 and found that women veterans accounted for less
2020, more than 1,100 women had completed the training.
than 3% of the U.S. veteran population at the time. (VA,
VHA Enrollment Requirements
Women Veterans Report, https://go.usa.gov/xPzNC). In
The VHA enrollment requirements are the same for all
1981, Congress requested reports from the Government
Accountability Office (GAO) on women veterans’ access to
veterans, whether women, men, transgender (whose gender
VA benefits (https://go.usa.gov/xEBkM). At that time,
identities are different from their sex assigned at birth), or
intersex veterans (who are born with sexual and
GAO found that there was inadequate access to general
reproductive anatomies that are outside the definition of the
health, gynecological, and obstetrical care. Since then,
Congress passed a number of laws, such as the Women
male and female sex categories assigned at birth). The
Veterans Health Program Act of 1992 (Title 1 of P.L. 102-
Veterans’ Health Care Eligibility Reform Act of 1996 (P.L.
104-262) required the VA to establish an enrollment system
585, as amended), to specifically increase women veterans’
that all veterans must meet in order to be eligible to receive
access to gender-specific health care services through the
VHA. Recently, Title III of the Veterans COMPACT Act of
VA health care services. Enrollment in the VA health care
2020 (P.L. 116-214) required VA to report locations where
system is based primarily on veteran status (i.e., previous
women veterans use health care, among other things.
military service), service-connected disability, and income.
Veterans can apply to enroll in VA health care by mail,
Today, VHA offers a full suite of gender-specific health
telephone, and in person at a VA medical facility.
care services for women veterans. Gender-specific care is
Access to Gender-Specific Health Care
specialized care that is sensitive to the unique needs of
Services
women. It includes not only reproductive system specific
care but also general care that is sensitive to gender
The VHA operates more than 1,700 VA medical facilities
differences.
where veterans can access gender-specific health care
services. Veterans can also access these services from VA-
Of the total population of about 2.03 million women
contracted providers in their communities and from DOD
veterans, 755,807 were enrolled in the VA health care
providers at DOD medical facilities. (Veterans can access
system in FY2019. The states where the largest numbers of
certain gender-specific services such as infertility
women veteran VHA enrollees resided in FY2019 were
treatments only from non-VA providers.) In addition,
Texas, Florida, California, Georgia, and Virginia. Demand
veterans can access gender-specific health care services
for gender-specific care may grow, as the proportion of
through telehealth. Telehealth refers to a health care service
women veterans to the total veteran population is projected
that is provided via a technological method. The VHA
to increase by 0.6% annually through 2045. (Report to
provides women’s gender-specific telehealth services such
Congress, Locations Where Women Veterans Are Using
as gynecology through the VA Tele-Women’s Health
Health Care From the Department of Veterans Affairs,
program.
February 2021).
Overall, in FY2019, women veterans completed 5.6 million
Transitioning to VA Care
in-person appointments, 224,584 telehealth appointments,
The VA and the Department of Defense (DOD) jointly
and 1.7 million telephone appointments.
administer the Women’s Health Transitioning Training
Gender-Specific Health Care Services
(WHTT) Program, which aims to prepare servicewomen
All veterans access gender-specific health care services
and women veterans for VHA enrollment. The free training
through the VA as specified in the VA medical benefits
is delivered in-person and virtually. During the interactive
training sessions, servicewomen and women veterans
package. The VA medical benefits package refers to a suite
receive information on, but not limited to, the
of health care services that the VA covers and provides to
eligible veterans, generally at no cost to the veterans under
 process of becoming a service-connected veteran,
certain circumstances. In FY2019, the VA spent $6.3

billion on health care services for women veterans.
differences in the delivery of health care services
between VA and DOD medical facilities,
Discussed below are some gender-specific health care
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Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans
services that women veterans can access though the VHA,
In Vitro Fertilization (IVF). The Military Construction,
unless otherwise noted. This is not a comprehensive list.
Veterans Affairs, and Related Agencies Appropriations Act,
2021, which is Division J of the Consolidated
Primary Health Care Services
Appropriations Act, 2021 (P.L. 116-260), allows the VA
Women veterans can access a range of gender-specific
Secretary to use funds appropriated to the “Medical
primary health care services such as contraceptives, breast
Services” account to provide certain veterans with fertility
and cervical screenings, and menopausal support services
services using assisted reproductive technology such as in
through the VHA, in a Women’s Health Clinic and in a
vitro fertilization (IVF). IVF refers to the process of
mixed gender primary care clinic by a designated women’s
combining a male’s sperm with a woman’s egg outside of
health care provider. According to the VHA Directives
the woman’s body, which is performed in a medical
1341 and 1330.01(4), a transgender or intersex veteran can
laboratory.
access the aforementioned primary health care services
IVF is not a standard medical benefit to all veterans. Only
through the VHA, regardless of whether a change in sexual
certain female and male veterans who lack the ability to
anatomy has transpired.
naturally procreate may request IVF services, for
Intimate Partner Violence (IPV) Services
themselves and their spouses. Specifically, a female veteran
IPV is a subset of domestic violence, which in this context,
must have a service-connected disability that restricts her
involves a veteran’s experience of reoccurring violent
eggs from being successfully fertilized by sperm. The
physical, sexual, and psychological behaviors performed by
female veteran must also have ovarian function and an open
a current or former intimate partner. All veterans and their
uterine cavity. A male veteran must have a service-
intimate partners can access IPV services through the VA’s
connected disability that restricts the delivery of his sperm
IPV Assistance Program (IPVAP), which was established in
to a woman’s egg. This benefit will cover three IVF
2014. IVAP consists of a suite of integrated VA and non-
treatment cycles, which are not provided within VA
VA prevention, intervention, treatment, and support
medical facilities.
services. According to the aforementioned VA funding
Emergency contraception. Women veterans can access
report, 142 VA medical facilities and health systems have
emergency contraception from VA medical facilities.
designated IPVAP Coordinators. IPVAP Coordinators are
responsible for identifying, screening, assessing, and
Abortion. The VA medical benefits package does not
coordinating IPV related services.
include abortions, abortion counseling, or therapeutic
Military Sexual Trauma (MST) Services
abortions.
MST refers to physical sexual assault or sexual harassment
Newborn Health Care Services
occurring during military service that causes psychological
The Caregivers and Veterans Omnibus Health Services Act
trauma. P.L. 102-585 and subsequent laws require, among
of 2010 (P.L. 111-163), among other things, allows the VA
other things, the VA Secretary to administer an MST
Secretary to cover postdelivery health care services for
program whereby veterans can access counseling and
eligible newborns. The VA covers newborn care that is
medical and support services. The VA Military Sexual
rendered on the day of the newborn baby’s birth through the
Trauma (MST) Program is available to all veterans,
first seven full-days of the newborn’s life.
regardless of a veteran’s eligibility status for VA care and
service connection. A veteran does not have to disclose the
Recent legislation expanded the newborn health care
details of his or her MST experience to a VA provider in
benefit to add coverage for transportation and extend
order to access MST services. There are no out-of-pocket
coverage beyond seven days when medically necessary.
costs associated with MST care. In addition, the VA does
(See Section 9201 of P.L. 116-283 and Section 3006 of P.L.
not require veterans’ respective secondary health insurance
116-315).
plans to cover the costs of any MST-related health care
The eligibility criteria for newborn care is based on the
services. Each VA medical facility has an MST Coordinator
veteran-mother’s VHA enrollment. (Newborns born to
who is responsible for VA outreach and coordination of
women who are not veterans but have male veteran spouses
MST care.
are not eligible for this benefit.) The veteran-mother must
Maternity Health Care Services
meet three conditions for her newborn to become eligible to
The VHA currently provides and pays for a limited number
access care through the VHA. First, the veteran-mother
of maternity and newborn health care services to eligible
must be enrolled in the VHA. Second, the veteran-mother
veterans and their family members. Women veterans can
must have received maternity care through the VHA while
begin accessing VA maternity care as soon as their
pregnant with the respective baby. Third, the veteran-
pregnancies are confirmed. The VHA is different from
mother must have delivered the baby in either a VA-
other integrated health care systems because VA medical
contracted health care facility or VA medical facility. As
facilities do not operate full-service birthing centers with
noted earlier, babies generally are not delivered in VA
medical units such as maternity wards, newborn nurseries,
medical facilities. P.L. 111-163 also allows the VA to cover
and neonatal intensive care units. The VHA does not have
newborn care when a newborn is abandoned or placed for
the specialized health care providers or functioning
adoption by his or her veteran-mother.
birthing-related medical units in VA medical facilities to
Jared S. Sussman, Analyst in Health Policy
deliver babies on an ongoing basis . Women veterans deliver
babies at non-VA medical facilities such as DOD medical
IF11082
facilities and community hospitals. The VA may perform,
however, emergency childbirth deliveries.
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Veterans Health Administration: Gender-Specific Health Care Services for Women Veterans

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https://crsreports.congress.gov | IF11082 · VERSION 5 · UPDATED