Originally published on Start at Zero on Substack.
In September, GAO told Congress something that should stop every public finance officer cold: the VA’s electronic health record modernization - a program originally sold on a $10 billion contract ceiling with Oracle Cerner - is now projected to cost roughly $48 billion once deployment and sustainment are included. The contract ceiling itself has already been raised once, from $10 billion to $27 billion. GAO says it still hasn’t received a cost estimate or integrated master schedule reliable enough to validate any of VA’s numbers.
Then GAO delivered the second gut punch. Of the 18 recommendations GAO had made to fix the program’s management, cost estimating, scheduling, training, and data quality problems, VA had fully implemented four. Fourteen remain unaddressed - twelve of them flagged as priority recommendations tied directly to future site deployments.
VA’s response to an unresolved, unvalidated, under-governed program? Nine more site deployments in 2026, on the way to roughly 170 sites by 2031. The House VA Committee didn’t wait for VA to explain itself. It subpoenaed Oracle’s leadership.