It looks like Washington just rescued the VA's private-sector care program — for now
Congressional Republicans and Democrats have reached agreement on a $3.9 billion emergency spending package to fill a shortfall in the Department of Veterans Affairs' program of private-sector care, seeking to avert a disruption to medical care for thousands of veterans.
The deal includes additional money for core VA health programs, as well. Veterans' groups insisted this money be included.
The compromise plan sets aside $2.1 billion over six months to continue funding the Choice program, which provides federally paid medical care outside the VA and is a priority of President Donald Trump. VA Secretary David Shulkin has warned that without legislative action, Choice would run out of money by mid-August, causing delays in health care.
The proposal also would devote $1.8 billion to authorize 28 leases for new VA medical facilities and establish programs to make it easier to hire health specialists. That cost would be paid for by trimming pensions for some Medicaid-eligible veterans and collecting fees for housing loans.
VA Secretary David Shulkin. Photo courtesy of VA.
A House vote was planned July 28, before members were to begin a five-week recess. The Senate is finishing up business for two more weeks and would also need to approve the measure.
Major veterans' groups had opposed the original House plan as an unacceptable step toward privatization, leading Democrats to block that bill on July 24. That plan would have trimmed VA benefits to pay for Choice without additional investments in VA infrastructure.
Put in place after a 2014 wait-time scandal at the Phoenix VA hospital, the Choice program allows veterans to receive care from outside doctors if they must wait 30 days or more for an appointment or drive more than 40 miles to a VA facility.
Rep. Phil Roe of Tennessee, chairman of the House Veterans Affairs Committee, told a hearing on July 27 that the six-month funding plan was urgently needed and would give Congress more time to debate broader issues over the future of the VA. He was joined by Rep. Tim Walz, the panel's top Democrat.
Sens. Johnny Isakson, R- Ga., (left) and Jon Tester, D-Mont (right)
"We are glad that veterans will continue to have access to care without interruption and that the VA will be able to improve the delivery of care by addressing critical infrastructure and medical staffing needs," Sens. Johnny Isakson, R- Ga., and Jon Tester, D-Mont., said in a statement.
Shulkin praised the agreement and urged the House to act swiftly. The legislation "will greatly benefit veterans," he said.
Still, while the agreement may avert a shutdown to Choice, the early disputes over funding may signal bigger political fights to come.
Photo by Michael Vadon
During the 2016 campaign, Trump had criticized the VA for long wait times and mismanagement, saying he would give veterans more options in seeing outside providers. At an event July 25 in Ohio, Trump said he would triple the number of veterans "seeing the doctor of their choice" as part of an upcoming VA overhaul.
His comments followed a warning by the leader of the Veterans of Foreign Wars against any Trump administration effort to "privatize" the VA. Speaking July 24 at its national convention in New Orleans, outgoing VFW National Commander Brian Duffy criticized the initial House plan as violating Trump's campaign promise to VFW that it "would remain a public system, because it is a public trust."
Shulkin announced the budget shortfall last month, citing unexpected demand from veterans for private care and poor budget planning. To slow spending, the department last month instructed VA medical centers to limit the number of veterans it sent to private doctors.
US Navy photo by Mass Communication Specialist 2nd Class Sean Furey
"This situation underscores exactly why Congress needs to pass broader and more permanent Choice reforms. Even after they finish scrambling to fund this flawed program, too many veterans will still be trapped in a failing system and will be unable to seek care outside the VA when they want to or need to," said Dan Caldwell, policy director of the conservative Concerned Veterans for America.
Currently, more than 30 percent of VA appointments are in the private sector, up from fewer than 20 percent in 2014, as the VA's more than 1,200 health facilities struggle to meet growing demands for medical care.
The VA has an annual budget of nearly $167 billion.