DoD and VA Run Separate Systems, Both Failing Women in Uniform
Structural separation between military and veterans' healthcare creates distinct gaps for servicewomen that neither department has fully addressed, according to a physician with clinical expertise...
The Department of Defense and the Department of Veterans Affairs operate as two legally and administratively separate healthcare systems, and a September 2026 opinion piece in the Washington Examiner by a physician specializing in breast and gynecologic pathology argues that this division is producing compounding failures specifically for women who serve in the U.S. Military.
The two departments draw their authority from separate statutes and maintain separate provider networks, separate electronic health records systems, and separate enrollment processes. A service member who separates from active duty must re-establish care within the VA system rather than receiving a seamless transfer from DoD facilities. The Government Accountability Office documented transition gaps between DoD and VA recordkeeping as recently as its 2023 report on electronic health record modernization (GAO-23-105609), finding that data handoffs between the two systems remained incomplete.
Women now represent approximately 17.5 percent of active-duty military personnel, according to DoD's fiscal year 2023 demographics report. The VA's own data, published in its Women Veterans Report for fiscal year 2022, shows that the women veteran population grew by more than 85 percent between 2000 and 2022, reaching approximately 2.1 million enrolled or eligible veterans.
Despite that growth, the VA acknowledged in its fiscal year 2023 budget justification to Congress that staffing for women's health programs remained below target levels at numerous facilities. The document identified gynecology as one of the specialty areas with the longest average wait times for new patient appointments, though it did not publish a single national average figure broken down by gender.
On the DoD side, the Defense Health Agency, which consolidated military treatment facilities under a unified command structure beginning in 2018, has reported staffing shortages across its network. A 2022 report by the DoD Inspector General (DODIG-2022-107) found that military treatment facilities were not meeting all readiness and access-to-care benchmarks, particularly for specialty care.
The physician author of the Washington Examiner piece writes from a background in pathology focused on breast and gynecologic disease, the categories of conditions she identifies as receiving inadequate attention within both systems. She does not cite specific patient outcome statistics in the publicly available portion of the article, and the full text requires a subscription. What outcome data would answer the core clinical question, specifically comparative rates of delayed diagnosis for breast and gynecologic cancers among active-duty women versus civilian women of similar age, is not currently consolidated in a single public federal database.
Congress has taken incremental steps on the issue. The National Defense Authorization Act for fiscal year 2024, signed into law in December 2023 (Public Law 118-31), included provisions directing DoD to expand access to fertility treatments for servicemembers and to report on gaps in reproductive healthcare at military treatment facilities. The law did not mandate a unified DoD-VA data standard for tracking women's health outcomes across the transition from active duty to veteran status.
The VA's MISSION Act of 2018 (Public Law 115-182) expanded community care options, allowing veterans to seek care from civilian providers when VA facilities cannot meet access standards. Women veterans have used this authority to obtain gynecologic and obstetric care outside VA facilities, but GAO noted in a 2021 report (GAO-21-484) that the VA did not consistently track quality outcomes for care delivered through community providers, making it difficult to assess whether the referral system was producing equivalent results.
No single congressional committee has jurisdiction over both DoD and VA healthcare simultaneously. The Senate Armed Services Committee oversees the Defense Health Program, while the Senate Veterans' Affairs Committee oversees VA healthcare appropriations. The absence of a joint oversight structure means that the gap between the two systems does not fall cleanly within any one committee's mandate.
What remains unknown is the precise rate at which women are falling through the transition gap between DoD and VA care, and whether delayed specialty care at either system is producing measurable differences in clinical outcomes compared to civilian benchmarks. The records that would answer that question are the DoD and VA electronic health record databases, specifically linked longitudinal data tracking individual patients from active duty through veteran status. Neither department currently publishes that data in a form accessible for independent analysis. A formal request under the Federal Data Strategy or a congressional directive to the DoD and VA inspectors general to conduct a joint audit would be the mechanisms most likely to produce a public answer.