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The Department of Veterans Affairs (VA) amends its medical regulations to revise the exceptions to the exclusion on abortions and to remove abortion counseling from the medical benefits package. VA is also amending its medical regulations to revise the exceptions to the exclusion on abortions and to remove abortion counseling for Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) beneficiaries. These amendments will restore VA regulations in place prior to 2022 and will ensure that VA provides medically needed care and protects the lives of veterans.

Statement of Need:

With this final rule, VA reversed an unnecessary and unwise 2022 revision to the medical benefits package and reinstated the full exclusion of abortions and abortion counseling, restoring VA’s medical benefits package to where it had been working effectively since it was first established in 1999. The action continues to ensure that VA protects the lives of veterans without providing unnecessary care.

Summary of the Legal Basis:

E.O. 14182; 38 U.S.C. 1710, 1781. VA will revise 38 CFR 17.38 and 17.272 to clarify what care is needed or medically necessary and appropriate.

Alternatives:

VA considered continuing with the current regulatory framework or adopting narrower or broader exceptions, but doing so would not be consistent with E.O. 14182 and statutory authorities. Moreover, VA’s chosen course of action restores the medical package that had been in place and effective for over 20 years, without need for change.

Anticipated Costs and Benefits:

Estimated costs are $2.3 million over five years and $5 million over 10 years, primarily due to increased maternity and newborn care. Cost savings from reduced abortion-related services and travel are estimated to be $700,000 over 10 years. The effects on society (quantified resource costs and savings) are estimated to be a net cost of $11.9 million over 10 years.

Risks:

Some Veterans and CHAMPVA beneficiaries, who are expected to seek care outside of VA, may face increased financial costs. The final rule will reduce legal and policy risks by aligning regulations with statutory authorities and past practice.