Improving Access to Women's Health at the VA

On December 4, 2025, the U.S. Department of Veterans Affairs (VA) announced that women Veterans will no longer need a primary care referral to access gynecology services, thereby removing a barrier to accessing this vital care. At first glance, this may seem like a small thing – but it is most definitely a big thing. Removing even one step in accessing health care can make all the difference for a Veteran to access preventive care, such as cancer screenings, or to receive what may be life-saving treatment. Removing even one barrier helps individual Veterans and reduces overall cost, but it also decreases overall cost by preventing long-term and chronic disease, and by diagnosing potentially life-threatening illness at an earlier stage, improving outcomes, and allowing patients and Veterans more options for care.

Women are the fastest-growing cohort within the Veteran population. In 2000, women made up 4% of the Veteran population. In 2023, that percentage had grown to 11.3%, and VA estimates it will reach 18% by 2040. In 2023, the average age of women accessing VA healthcare was 52, and 22.5% were aged 65 or older. In total, more than 600,000 women Veterans receive healthcare at VA each year. While VA does provide obstetric care to women Veterans – around 4,000 births annually – for the most part, VA serves older women, facing menopause and chronic conditions.

In 1923, VA served its first women Veterans, admitting women Veterans of WWI at the Milwaukee and Danville Branches of the National Home for Disabled Volunteer Services. As more women served and the service of women in the armed services gained greater recognition (e.g., policy changes in eligibility for VA services), VA has removed many barriers for women Veterans, such as the referral requirement.

At times, VA has had to be creative in its policy changes to improve access to care for women. In 2008, VA began its Women Veterans Health Primary Care Mini-Residency Program, during which primary care providers received training in clinical updates in women’s health, including pelvic exams, cervical cancer screening, contraception management, abdominal pain, endometrial issues, and post-deployment care of women Veterans. The mini-residency program has grown significantly and now uses innovative technology, including simulation labs, to learn procedures and improve their competency.

Over the past several years, bipartisan legislation has significantly improved access to care for women, both by making it easier to receive payments for conditions such as breast cancer and by ensuring access to healthcare.

There is room to do even better here:

• On December 10, 2025, a bipartisan group of U.S. Senators Richard Blumenthal (D-CT), Jerry Moran (R-KS), Mazie Hirono (D-HI), and John Boozman (R-AR) introduced the not-yet-numbered Mammography Access for Veterans Act, with support from multiple veterans services organizations including DAV, PVA, WWP, IAVA, and MOAA, to make permanent the telescreening mammography pilot program.
• Expanding age limits for dependents within the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA): CHAMPVA provides healthcare coverage like Medicare for spouses, dependents, and survivors of disabled veterans. It can be a true lifeline for families, especially in families where caring for a disabled Veteran can make finding and maintaining employment with healthcare benefits impossible. Unlike most health plans, however, under CHAMPVA, dependents age out at 23 if they are enrolled in school. For dependents who are neither enrolled in school nor married, coverage ends at 18. Legislation has been introduced over the past few Congresses, but has not gained traction.
• Eliminating co-pays for preventive care: Unlike other health plans, VA has not removed co-pays for all preventive care. While some progress has been made (i.e., the FY 2025 NDAA eliminated copays for birth control for TRICARE), previous Congresses have introduced legislation, but none has been passed.

Improving access and innovation for women Veterans doesn’t just help Veterans. For example, under the MAMMO Act, VA is studying accessibility of breast imaging for veterans with specific disabilities such as spinal cord injuries – VA’s innovation around this population will expand services for all women in the future. Together, policy changes like the one VA just made and continued bipartisan work on the Hill make programs and services easier for women Veterans and their families to reach.

Milestones in Women's Veteran Healthcare

• In 1945, VA began hiring women physicians specializing in the care of women Veterans.
• In 1985, VA placed Women Veteran coordinators in benefits offices.
• The Veterans Health Care Act of 1992 authorized VA to provide gender-specific services, such as Pap tests, contraception, and mammography.
• In 2008, VA hired full-time Women Veterans program managers at each VA medical center.
• In 2010, VA policy began requiring a woman’s health provider at every clinic.
• In 2012, VA established a maternity care coordination policy, allowing every pregnant Veteran to access care coordination during their pregnancy.

Bipartisan Breakthroughs in Breast Screening

2022: Under the PACT Act, breast cancer is a presumptive condition for Veterans exposed to toxins during their service, making it much easier for Veterans to obtain service connection.

2022: Bipartisan legislation titled the Making Advances in Mammography and Medical Options for Veterans Act (MAMMO) was signed into law requiring VA to expand mammography services to include:

• Implement a 3-year pilot to provide telescreening mammography – while the pilot is ongoing and a report is not due to Congress until a year after the pilot ends, there is evident progress being made.
• Upgrade to 3D mammography.
• Improve genetic and molecular testing.
• Study the accessibility of breast imaging for veterans with disabilities such as paralysis.

2023: Dr. Kate Hendricks Thomas SERVICE Act – Veterans under 40 who may have been exposed to burn pits and other toxins during their service become eligible for breast cancer risk assessments and mammograms at VA.

Meg Kabat is a licensed clinical social worker, former Chief of Staff at the U.S. Department of Veterans Affairs, and former National Director of VA’s Caregiver Support Program.