GAO: VA moves toward limited health-care expansion for Palau veterans

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October 3, 2026

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GAO: VA moves toward limited health-care expansion for Palau veterans

Overview:

Palau veterans face limited access to U.S. Department of Veterans Affairs health care, with no VA facilities in the Freely Associated States and costly travel to Guam or Hawaii. A new Government Accountability Office report says the VA is moving toward a limited expansion that could include local care reimbursement, telehealth, medicine delivery and travel benefits.

By: L.N. Reklai

The U.S. Department of Veterans Affairs is pursuing a limited expansion of health-care access for veterans in Palau and the other Freely Associated States after previously deciding not to implement broader authorities approved by Congress, according to a new Government Accountability Office report.

The report found that veterans in Palau, the Federated States of Micronesia and the Marshall Islands face significant obstacles obtaining VA care because there are no VA facilities in the three countries, specialty and mental-health services are limited, and travel to Guam or Hawaii can be expensive.

For veterans in Koror, the closest VA clinic is in Guam, about a two-hour flight away. GAO said veterans generally must pay their own transportation costs to travel from the Freely Associated States to U.S. VA facilities, and the lowest round-trip fares reviewed by the agency exceeded $1,000.

VA now plans to pursue selected services for veterans with service-connected conditions, including reimbursement for care obtained locally, telehealth services, medicine and medical-supply delivery, and travel benefits. The agency has begun the process needed to negotiate agreements with Palau, FSM and the Marshall Islands, but it did not provide a timeline or updated cost estimate for implementation.

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