There’s a bill sitting before the U.S. Senate that would shake up how millions of veterans get preventive health services through the Department of Veterans Affairs. It’s called the Copay Fairness for Veterans Act, dropped this week with support from both parties, and it’s aiming at a gap that sponsors say is baked into the federal health system.
The legislation has two names on it: Democratic Senator Tammy Duckworth from Illinois—she’s a combat vet and sits on the Senate VA committee—and Republican Senator Susan Collins from Maine. They’ve been circling this same idea since 2019, but none of those earlier tries ever made it to the finish line.
There’s also a companion bill over in the House, labeled H.R.1644 for the 119th Congress, so it’s got a little more runway this time around.
The Unfairness Congress Is Trying to Fix for Veterans
VA healthcare runs on a priority group system, 1 through 8, and that decides who pays what. Vets with higher service-connected disability ratings usually don’t have copays. But the lower-priority groups—especially 7 and 8—have to fork over cash for outpatient visits and prescriptions, even for stuff that’s purely preventive.
We’re talking about medications like vitamin supplements for certain conditions, breast cancer prevention drugs, smoking cessation products, and aspirin. Also, cancer screenings, vaccines, and checkups. Stuff that in other systems—private insurance or military coverage—costs patients exactly zero.
Unlike private insurers, the VA isn’t bound by the Affordable Care Act’s rules that force private plans to cover preventive services with no cost-sharing. The VA plays by a different set of laws, and those don’t include that requirement.
The Bipartisan Bill They’ve Been Trying to Pass for Years
The Copay Fairness for Veterans Act does three specific things. First, it kills copays for all preventive services and meds delivered through the VA. Second, it aligns VA prescription copay standards with what private insurance and TRICARE use. Third, guarantees no-cost access to every FDA-approved contraceptive out there.
The bill’s definition of preventive services includes stuff rated A or B by the U.S. Preventive Services Task Force, vaccines recommended by the CDC’s advisory committee, and women’s services from the HRSA guidelines.
Duckworth put it this way: “After all they’ve done to serve our nation, it’s unacceptable that Veterans covered by the VA are uniquely singled out and forced to pay out-of-pocket for preventative health care. There’s no reason these copayments should be covered for nearly every ACA patient but not for our heroes. Our bipartisan legislation would eliminate these costs and help ensure VA patients are treated more fairly in the health care market.”
Nonprofit Organizations Backing This Bill
Three of the biggest veteran groups in the country have signed on: Veterans of Foreign Wars, American Legion, and Disabled American Veterans. Earlier versions also had support from Paralyzed Veterans of America and Women Veterans Interactive.
VFW’s executive director Robert E. Wallace said in a previous go-round: “Veterans who rely on VA for their healthcare needs and the uninsured are the only Americans forced to pay for preventive medications. There is no excusable reason why every other American can receive breast cancer prevention medicine cost-free, but veterans must pay.”
Collins added: “Preventive care helps veterans stay healthy and catch serious conditions early, before they become more difficult and costly to treat. This bipartisan legislation would eliminate unnecessary copayments for preventive services and make it easier for veterans to access the high-quality health care they have earned through their service to our country.”
This Isn’t Their First Try
Duckworth and Collins have been here before. Earlier versions floated around in 2019, 2020, 2021—same basic idea: kill preventive copays, match private sector standards, extend it to prescriptions. None of them made it into law.
In 2025, Representative Lauren Underwood testified before the House VA committee on similar legislation, so this thing has been kicking around Congress for multiple cycles. The current version picks up that thread and tries to ride the political vibe of the 119th Congress.
The bill’s been sent to the relevant VA committee for review. Whether it goes anywhere depends on the legislative calendar and how many more backers they can line up in both chambers.
