Since Grievous Angel at Rochesterturning has a full write-up of Massa's Press Conference, I'll stick to color commentary on this one.
This plan is a big deal. It advocates major, systemic changes in the way we handle Veterans' health. Veterans' care has been effectively rationed by a system where Vets must travel to a VA hospital or clinic to receive care. In rural areas, as Massa pointed out, this means hours of car travel. Even in the Rochester area, there's no inpatient medical facility. If a Vet needs surgery, they must travel to Buffalo or another area hospital.
In other words, today's VA is a treatment system. Massa's proposal would turn it into a hybrid treatment and insurance system. Vets would be able to receive treatment at non-VA facilities "when there are no VA facilities in the area." In those cases, being a Vet is like having an insurance plan.
Massa's proposal to change the VA system to the equivalent of an insurance card may lead to more utilization of VA benefits, and therefore more cost. Veterans who use private insurance today because of the hassles involved in the VA system might choose to use the VA if they can keep their local providers.
The most controversial part of Massa's proposal is the inclusion of Veterans families in the mix. This is an extension of the traditional role of the VA which will probably draw a lot of criticism.
Other than the family provision, it's very hard for a politician to stand up and argue against Massa's plan. It's mainly a practical list of things we must do if we're going to keep our promise to take care of the Veterans of our two lengthy and costly wars.