A handful of lawmakers are again making attempts to open 24 new Department of Veterans Affairs facilities across the country, some of which have been held up by Congress for two years.

The VA must receive congressional approval to lease medical facilities with annual rent payments totaling more than $1 million, according to federal law. Combined, the 24 facilities -- most of them outpatient clinics -- would cost about $228 million during the lease periods, which in some cases can last 20 years.

Congress has not approved a medical facility lease for the VA since 2014, said the office of Sen. Mark Warner, D-Va.

Warner and Sen. Susan Collins, R-Maine, reintroduced legislation that would give the VA the go-ahead to open the clinics. Rep. Julia Brownley, D-Calif., reintroduced a similar measure in the House.

One of the pending leases is for a new outpatient clinic in Hampton Roads, Va., totaling more than $18 million. In 2014, veterans at the Hampton VA Medical Center suffered the longest average wait times in the country for primary care, the Hampton Roads Daily Press reported. The wait times resulted from an increase in the number of patients, along with space and staff shortages.

Warner, who represents Virginia in the Senate, said health care providers at the hospital need the clinic to better manage their workload.

"Veterans deserve convenient access to the high-quality health care they have earned through their service," Collins said in a written statement. "These facilities... will allow veterans to receive outpatient care without the stress and difficulty of traveling to larger VA medical centers, which may be located far away from their homes."

One of the pending leases is an expanded outpatient clinic for Collins' constituency in Portland, Maine, totaling about $6.9 million. A $6.3 million clinic is planned for Oxnard, California, in Brownley's district. The facilities span 12 other states.

Last May, 15 senators wrote to Sen. Johnny Isakson, R-Ga., -- chairman of the Senate Veterans' Affairs Committee -- and Sen. Richard Blumenthal, D-Conn., the top Democrat on the committee, asking that they act to approve the 18 leases pending at the time.

The VA has also been struggling to work with Congress to gain the approvals. James Sullivan, director of the VA's Office of Asset Enterprise Management, told a House committee in September that many of the VA's 10- to 15-year leases are coming to an end. Without authorization for the new leases, some facilities might be forced to close and new ones might not open immediately, he said.

"Without authorization from Congress, VA cannot begin work to secure needed leased space to meet the needs of veterans seeking VA health care," Sullivan testified. "Failure to receive authorization will have a growing and worsening effect on veteran access to care nationwide."

At the September hearing, lawmakers voiced concern the VA had not provided proof that leasing medical facilities was more cost-effective than building their own.

VA leases haven't been approved on a regular basis since 2012, when the Congressional Budget Office changed how it estimates costs, Warner's and Collins' offices said. The Congressional Budget Office previously noted only the annual cost of the leases, but, in 2012, it began recording the total cost of the leases up front.

If the leases were approved, Congress would still have to decide each year whether to appropriate annual funds for them, Warner's office said.

Fifteen cosponsors signed onto the Senate bill, S. 233. Brownley's legislation, H.R. 90, has nine cosponsors.

Brownley also introduced legislation this session to prohibit Congress in the future from appropriating funding for a medical facility lease without also approving the lease.