Alaska veterans fly to Seattle for cancer care. The Senate is arguing over why.

Alaska has more veterans per capita than any other state and no VA cancer center of its own. When an Alaska veteran needs specialty cancer care the Anchorage system cannot provide, the referral usually goes to Seattle, the VA's designated hub for the entire northwest region.

That is the backdrop to a fight aired in the Senate Veterans' Affairs Committee on Wednesday over how the VA spends money meant to bring advanced cancer care to veterans. Congress appropriated $5 million for the department's precision oncology program for prostate cancer. Sen. John Boozman pressed VA oncology director Dr. Michael Kelly on whether it went where lawmakers intended. Kelly said the department spread it across more than 100 sites rather than deepening the original 21 specialized centers, and defended that as consistent with congressional direction.

The stakes are measurable. Gina Carrithers of the Prostate Cancer Foundation testified that veterans treated at the specialized centers are 57 percent more likely to get precision genetic testing than veterans elsewhere in the system. Whether the wider network reaches Alaska was not addressed at the hearing.

Committee Chairman Jerry Moran has introduced legislation to permanently authorize and expand the program. The committee did not vote on it.