Same Pay, Same Care: Cutting VA Waste and Prioritizing Veterans with Jeremiah Mosteller

In the next installment of the Big Ideas for Smaller Government series, host David From welcomes back Jeremiah Mosteller, Policy Director at Americans for Prosperity, to take a hard look at spending within the Department of Veterans Affairs—and what reforms are needed to better serve those who served us. Mosteller breaks down how the VA’s budget has quadrupled since 2004 even though the veteran population has declined by 30%. From bloated staffing levels to $4 million contracts for services that now cost just $5,000, this episode exposes how wasteful spending is draining resources from veterans and taxpayers alike. The conversation also focuses on one reform with huge potential impact: site-neutral payments. Right now, hospitals owned by large systems can charge the federal government far more than local, independent clinics for providing the exact same services to veterans. This creates perverse incentives, drives up costs, and limits care options. Adopting site-neutral payments would save taxpayers an estimated $14 billion—and give veterans more access to timely, local care. Mosteller also exposes how top VA officials actively discourage use of the Community Care Program, forcing veterans to wait months or drive hours for treatment—while simultaneously helping process healthcare claims for unauthorized migrants. This episode makes one thing clear: reforming the VA isn't about spending less on veterans—it's about spending smarter so veterans get the care they’ve earned.