VA Restructuring Bill Slashes Regional Offices and Consolidates Veteran Care into Eight Networks Within One Year

The “VISN Reform Act of 2025” is a dramatic overhaul of how the Veterans Health Administration (VHA) manages veteran healthcare across the country. Essentially, it takes the current system of regional networks—called Veterans Integrated Service Networks, or VISNs—and forces a massive consolidation. The goal? To streamline operations, cut down on administrative bloat, and, ideally, improve patient care.

The Great Consolidation: Eight Networks Only

Currently, the VHA operates a larger number of VISNs, but this bill (SEC. 2) mandates that the entire system be reorganized into exactly eight geographically defined networks. This isn't just a rebrand; it’s a hard reset. The bill even spells out the mergers (SEC. 3), combining existing VISNs 1, 2, and 4 into a single network, for example. The Secretary of Veterans Affairs has just one year from the bill’s enactment to complete this entire realignment and consolidation. For veterans, this means the regional leadership and infrastructure managing their local VA hospitals and clinics are about to change rapidly, which always carries the risk of service disruption during the transition.

Headquarters on a Diet: The 50-Employee Cap

Perhaps the biggest administrative change is the strict staffing limit imposed on the newly formed VISN headquarters. Each of the eight new regional offices can have a maximum of 50 full-time employees, with no more than 10 of those being contractors (SEC. 2). The Secretary must submit a comprehensive plan to "right-size" the workforce within 180 days and ensure compliance within three years. This is a clear move to reduce administrative overhead and push resources closer to patient care. For the hundreds of people currently working in these regional offices, this means mandatory reorganization, reassignment, or job loss. The bill does require the VHA to offer licensed healthcare professionals at headquarters the chance to transfer to direct patient care positions without losing pay or benefits, which is a smart way to retain expertise and fill clinical gaps.

Centralized Power and Accountability

This legislation also significantly changes who is running the show. The head of each VISN will now be a Director, appointed by the President and confirmed by the Senate (SEC. 2). This makes the position a noncareer political appointee, which could bring increased accountability but also potentially politicize regional healthcare leadership. Furthermore, the bill centralizes authority by requiring every single employee at a VHA facility within a VISN to report directly to that VISN Director. This cuts out layers of bureaucracy, but it also concentrates immense power in a single regional leader, potentially eroding the autonomy of local hospital directors.

The Real-World Impact on Care

The bill aims to create an integrated health care system within each of the eight VISNs, requiring the Secretary to enter into agreements with public and private health care organizations as needed to serve veterans. It also mandates the use of national metrics to develop systems for "effective, efficient, and safe health care delivery that is rated highly satisfactory by patients and their families" (SEC. 2). This focus on patient satisfaction and efficiency is a positive goal.

However, the rapid one-year deadline for massive consolidation (SEC. 3) and the simultaneous gutting of administrative support at the regional level (the 50-person cap) introduces significant operational risk. If you’re a veteran relying on a specific service, any hiccup in the transition—from payment processing to scheduling—could mean delays in getting the care you need. The Secretary must certify that the reorganization won't reduce access to care, but the speed of the change makes that a challenging promise to keep.