After 20 years of combat, U.S. troops have come home from Afghanistan, putting an end to military engagement in America's longest war. Combat operations have also ended in Iraq, though thousands of troops remain in-country.

But as decades of war come to an end, and Congress begins to look back at what those wars have cost the country and the American people, there is a less obvious cost than the lives lost and dollars spent that can't be overlooked — the cost in physical and mental injury to veterans.

Recently, the Cost of War Project released a report on the cost of care for veterans of the wars in Iraq and Afghanistan.

The research they brought together indicates "post-9/11 troops experienced more frequent and longer deployments, higher levels of exposure to combat, higher rates of survival from injuries, higher incidences of serious disability, and more complex medical treatment."

Specifically, more than half of the severely disabled veteran population is from the post-9/11 wars. That isn't surprising given that more than 77% of post-9/11 era veterans were deployed to a war theater at least once, and 58% served in a combat zone. More than 40% of post-9/11 veterans have a service-connected disability, more than 20% have a disability rating above 60%. Those numbers are a significant uptick from veterans of past wars.

Post-9/11 era veterans have unique physical and mental health needs compared with veterans of wars past. As that population ages, their needs will continue to change. That will have a significant impact here in Florida.

Florida is home to more than 1.4 million veterans, the third-highest veteran population in the country. The Department of Veterans Affairs projects Florida will jump to the second-highest veteran population by 2040.

The VA must be prepared to care for these veterans, and the VA MISSION Act's Community Care Program has an important role to play in ensuring timely, quality care. Community Care standards require veterans to be offered non-VA care if VA wait times are longer than 20 days for primary care or 28 days for specialty care. But investigations into compliance with the law in Florida are proving concerning.

Earlier this year, a series of investigative reports found the VA's Bay Pines and James Haley Medical Centers are not accurately calculating wait times, using an outdated method to set appointment dates. That method may be keeping many who are eligible for community care from getting timely, needed treatment. In the Bay Pines VA network, only 8% of patients were offered community care in 2020.

The reports also found that an Afghanistan War veteran who visited Haley waited five months for community care. During that time, this veteran was in debilitating pain that took a toll on his physical and mental health.

Sadly, there are likely dozens of stories just like that one here in Florida. When the VA refuses to comply with the law, veterans end up paying the price.

But there is hope for progress if the VA and lawmakers are willing to prioritize the needs of veterans.

First, the VA has to be transparent about its wait time data. Americans for Prosperity Foundation recently filed a lawsuit to require multiple VA facilities, including several in Florida, to comply with a Freedom of Information Act request to provide data on actual wait times at local facilities, whether VA is accurately calculating wait times, and if community care standards are being complied with.

When that data has been provided, we'll have a better picture of what everyday appointment scheduling practices are like, and how to move forward. The difficulty in assessing the situation is already a cause for concern.

Second, the VA MISSION Act needs to be properly implemented and fully complied with. That includes adhering to new access standards for community care and updating scheduling practices. Veterans can't wait for treatment while bureaucratic red tape slows down the process.

Veterans, and especially those with service-connected injuries, need the health care they were promised, whether that comes from the VA or from their local providers.

America's veterans have always answered the call to serve this country. As a nation, we have a responsibility to ensure their health care works for those who need it now and those who will need it for decades to come.

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Jimmie T. Smith is a coalitions director with Concerned Veterans for America in Florida and a U.S. Army veteran.