Prodding the Snail?

I am a trans veteran under Veteran's Administration health care. While I am the first to admit my history with the VA has been pretty good, the record with others has been spotty, depending where you were/are.

One thing is for sure though, once the VA approved HRT for trans vets years ago, any movement towards approval of any so called "bottom" or cosmetic surgery has been imperceptible.

Now though "the snail (VA)" has been prodded by a group calling itself   "The Congressional LGBT Equality Caucus Transgender Equality Task Force" is  urging the Department of Veterans Affairs (VA) to move swiftly to ensure access to medically necessary surgical care for transgender veterans.  The lawmakers recently wrote in a letter to VA Secretary Robert McDonald. “We urge you to move forward with publishing a proposed rule to remove the arbitrary and outdated restriction that prohibits VA from providing medical services to treat gender dysphoria."
The letter was led by Rep. Mike Quigley (D-Ill.) and also signed by Democratic Reps. Mike Honda (Calif.), Jackie Speier (Calif.), Raúl Grijalva (Ariz.), Bonnie Watson Coleman (N.J.), and Del. Eleanor Holmes Norton (D.C.).
In June, news emerged of a VA proposal that would allow coverage of surgeries deemed medically necessary on a case-by-case basis. At the time, VA officials said the change had been in the works since 2014.
Of course, the proposal does not include a timeline for when coverage might begin, but such changes can take years to come into place. (normal)
The VA already covers transition-related care for transgender vets, including hormone replacement therapy and pre- and post-surgical care.
But it's been barred from covering any actual surgery since 1999 Which means the snail might need far more than a prod to move on actually approving SRS. 
Plus, since the VA has the apparatus set up to send us outside the system to approved providers, the excuse of not having a trained staff to do it just doesn't hold water.