More than a year after President Obama pledged to improve veterans’ health care following revelations that former service members died while waiting for treatment, critics contend his promises have proven empty.

If anything, they say, the situation for the men and women who serve this country has gotten worse.

“In our view, the administration has done absolutely nothing,” said Dan Caldwell, legislative and political director of Concerned Veterans for America. “In fact, they held up things that could make things better.”

Anger over inadequate health care for veterans is playing out against the backdrop of severe distrust of Obama, whose approval ratings among veterans and active-duty military personnel have slid to all-time lows.

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Reports in April 2014 that 40 veterans died waiting for treatment at Phoenix, Ariz., facilities run by the Department of Veterans Affairs sparked public outrage. The following month, the department’s inspector general found that staffers had kept 1,700 veterans using a VA hospital in that city on unofficial waiting lists to hide failure to deliver timely care. The VA’s inspector general called the falsified reports a systemic problem.

In June 2014, an internal audit found more than 120,000 cases where veterans did not receive care they needed from the VA.

Fallout from the scandal cost then-VA Secretary Eric Shinseki his job. Congress also passed the Veterans Access, Choice, and Accountability Act of 2014, giving veterans who have been waiting for care for more than 30 days, or who live more than 40 miles from a VA health facility, the option of using private medical providers.

Some lawmakers say veteran health care remains terrible. “I see no improvement at all,” said Rep. Bradley Byrne.

But some lawmakers say veteran health care remains terrible.

“I see no improvement at all,” said Rep. Bradley Byrne, an Alabama Republican and outspoken critic of the VA. “I see evidence of failure to improve all around me.”

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Byrne said complaints to his office remain high. He added the administration has not moved on building a health facility promised for his district.

The New York Times, citing VA data, reported in June that the number of veterans on waiting lists for treatment at VA health centers was 50 percent higher than at the same time last year.

That followed a Government Accountability Office report in February, in which inspectors said they had conducted eight audits in the previous year identifying problems; more than 100 areas of mismanagement remained unresolved.

Last month, a 4,000-page report commissioned by the VA found that patients in VA hospitals reported significantly less satisfaction on six of 10 measures compared with the evaluation of patients in non-VA hospitals.

Caldwell said the health care issue is a factor in the president’s unpopularity among the military. A poll of active-duty personnel in December by the Military Times found that only 15 percent approved of Obama’s performance, compared with 55 percent who disapproved. That was the lowest rating of Obama’s presidency, despite growing acceptance among military personnel for liberal policies such as gays in uniform and women in combat.

A Washington Post-Kaiser Family Foundation survey in August 2013 suggested that 65 percent of people who had served in Iraq and Afghanistan rated George W. Bush as a good commander in chief, compared with 42 percent who said the same thing of Obama.

Byrne said he believes Obama’s unpopularity runs deeper than the health care scandal.

The Obama administration and the new VA secretary, Bob McDonald, have resisted efforts to privatize veteran health care. 

“He’s proven over and over again that he does not care about veterans,” he said, pointing to Obama’s recent veto of a military spending bill. “He does not care about the military.”

Caldwell agreed.

“It took the president two months to give the operation opposing ISIL a name,” he said. “That’s just simple stuff. There is a lack of faith in their ability to manage and execute military operations.”

The Obama administration and the new VA secretary, Bob McDonald, have resisted efforts to privatize veteran health care. McDonald raised ire among Republicans when he tried to shift funds for the Choice Card program into other priorities. Congress ultimately agreed to let the VA move $3.3 billion to cover other account shortfalls.

Critics also lambasted the department for its narrow interpretation of the 40-mile rule — a straight shot from a veteran’s home to the facility, “as the crow flies.”

Eventually, the VA backed off from that interpretation and began calculating the mileage based on driving distance.

Caldwell said his organization favors turning the VA hospital system into a nonprofit organization and giving all veterans the option of using private medical providers at taxpayer expense. The bill also would allow veterans to start tax-shielded medical savings accounts to supplement their care.