Walter Reed National Medical Center, the nation’s largest military hospital, is getting bigger.

The Roosevelt Pavilion, a six-story, 500,000-square-foot tower with six operating rooms and 1,000 spaces for clinical and administrative work, opened in June. It’s a major milestone in the $600 million upgrade of the military hospital in Bethesda.

“Today, we are not just cutting a ribbon. We’re opening the doors to a new era of care, readiness and innovation — one that builds on a powerful legacy and rises to meet the readiness needs of tomorrow’s force,” Dr. Stephen Ferrara, the acting assistant secretary for defense health affairs, said at the opening ceremony.

Although half of Congress remains in shutdown recess as Republicans and Democrats near a compromise over health care tax credits, not everything is paralyzed. There’s a behind-the-scenes push to open some of that new space to a group not automatically served at Walter Reed.

Veterans.

“It’s just, how do we actually make it work?” said U.S. Rep. Sarah Elfreth, one of the authors of the idea. “It’s a great idea in concept. But to the point of the fine details, of sharing of digital records, we’re working through it.”

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The primary focus of military hospitals such as Walter Reed is treating combat injuries, but they offer a range of medical services for active duty personnel and their families.

Some specialties, such as the amputee clinic at Walter Reed, help veterans.

But unless there’s a special agreement between the Department of Defense and the Veterans Administration, veterans can’t use all the services.

When Elfreth met with hospital leadership earlier this year, they suggested increasing veterans’ access. The expansion was planned while the U.S. was fighting in Iraq and Afghanistan, but almost a decade later, the larger capacity is more than needed in a period of relative peace.

Making that mismatch worse, the Defense Health Agency can’t recruit enough medical professionals. It is studying a reorganization of military hospitals across the country, possibly closing some and converting others to small clinics.

Elfreth discovered her interests matched those of Sen. Jerry Moran, chair of the Senate Veterans Affairs Committee. One of the hospitals being reviewed, Irwin Army Community Hospital at Fort Riley, is in the Kansas Republican’s home state.

Making it easier for veterans to seek care at military hospitals nationwide might save some of the hospitals and benefit vets.

“Increased collaboration between Veterans Affairs and the Department of Defense’s Defense Health Agency benefits the veterans and service members receiving care, and it provides the military providers with the experience necessary to maintain their operational readiness,” Moran said.

It could also help fill that new space at Bethesda. Just how many veterans it might help remains unclear.

“We don’t know the exact number,” Elfreth said. “Frankly, I’ve asked, if we have to move to a pilot program, what could that look like? They want to be able to do this, and they have the capacity to do it.”

Most veterans use their service health care benefits like insurance, paying for care through community hospitals and physicians. When treatment requires heading to a Veterans Administration hospital or clinic, things can get rough.

In August, ProPublica reported that the agency lost 600 doctors and 2,000 nurses in the first half of this year, thanks to blind cost cutting by President Donald Trump. The shortage pushed the average wait time for outpatient surgical appointments to 41 days.

In a June report to the House Veterans Affairs Committee, the Government Accountability Office recommended expanding the special agreements and opening military hospitals to veterans wherever possible.

“These agreements can result in greater access to care for veterans and cost savings for the federal government, in part because of the discounted rate that VA and DOD pay each other for health care delivered under such sharing agreements,” the report reads.

Moran introduced an amendment in the National Defense Authorization Act, the massive Pentagon spending bill, to require training on sharing hospitals for both agencies’ staff.

Elfreth is working with Republican Rep. Derek Schmidt of Kansas, both members of the Armed Forces Committee, to get that language approved in the final version of the bill. It’s currently in a conference committee waiting for the House to return.

Getting something done is proving harder in Washington than it was in Annapolis for the former state senator. Finding out that there’s a way to accomplish something during a politically charged recess was a revelation.

“If we can deliver this, I will have done something this year,” she said.

Expanded veterans services at Walter Reed could have a huge impact in surrounding Maryland and Virginia, particularly in areas such as traumatic brain injury and post-traumatic stress.

Since it started 12 years ago, the Medical Center Addition and Alteration Program demolished four outdated buildings to make way for the Roosevelt Pavilion. It includes 200 private, single-bed rooms.

When the final phase is done in 2028, two more buildings will be torn down to make way for a four-story replacement.

Together with the Roosevelt Pavilion, the changes will add 135,000 square feet to the medical center and significantly upgrade treatment facilities.

Elfreth explained the plan during a roundtable with veterans at the American Legion Post 7 in Annapolis.

Veterans shared stories of difficulty getting claims approved, of uncertified companies that offer help with claims, only to walk away when something goes wrong.

Rob Couture, director of public affairs for the Veterans of Foreign Wars, said the challenge to getting more veterans into underused DOD hospitals won’t be sharing agreements, but making the medical record systems talk with each other.

In the end, though, it may be the military that reaps the biggest benefit at Walter Reed and beyond.

“Because the war ended in Afghanistan,” Couture said, “there is a fear that the skills of our health care providers would atrophy.”