Three leading Veteran Service Organizations have collaborated on a series of policy recommendations and priorities for the 116th Congress. From the Independent Budget website:
In light of the calls of some to further privatize VA health care and concerns about rising budget deficits, we remain ever vigilant to ensure that veterans and their families receive the benefits and health care services that they have earned and deserve. The [Independent Budget VSOs (IBVSOs) hold dear the longstanding responsibility of highlighting for the Administration, Congress, VA, and the American people, the unique benefits, specialized health care, infrastructure, education, employment, training, and memorial concerns and challenges being faced by our members, their families, and all veterans. Our decades of experience set the IBVSOs apart in the veterans’ community. Through The Independent Budget, we harness that experience and present real solutions to the concerns facing all of today’s veterans.
VHPI: The Independent Budget is a ‘realistic way forward’
“The Independent Budget is a sober set of recommendations in a time of upheaval at the Veterans Health Administration,” said Russell Lemle, a VHPI senior policy analyst. “This budget would ensure money for non-VA care would only go to providers whose qualifications, training and competence are as good as VA providers.”
VHPI projects the quality of care of non-VA providers could be improved through the Veterans Community Care Partners if Congress adopts the Independent Budget. The document states that health outcomes – not the number of veterans who use non-VA providers – must be the basis that determines successful veterans’ health care.
However, if the VA MISSION Act is implemented without careful monitoring of the care non-VA providers deliver to veterans, billions of dollars will be diverted from VA programs as veterans are pushed into inferior or unknown quality care provided by the private sector.
“Our nation has required much from our veterans, often leaving them with chronic illness and injury,” said Brett Copeland, VHPI’s executive director. “While non-VA care may be appropriate for some veterans, carving up the healthcare system best-suited to treat their unique conditions and needs will end up hurting them while bleeding taxpayers dry.” Read VHPI’s full press release here.
Wait Times at the VA
The notorious issue of VA wait times is back…except the problem seems to be in the private sector. A study, posted to the JAMA Network, examined wait times for new patients in primary care, dermatology, cardiology, and orthopedics. It found:
Access to care within VA facilities appears to have improved between 2014 and 2017 and appears to have surpassed access in the private sector for 3 of the 4 specialties evaluated. Read the full study at the JAMA Network.
The MISSION Act marches toward implementation
VHPI’s Suzanne Gordon and Jasper Craven report on frustration from Veteran Service Organizations who are being kept in the dark about implementation of the VA MISSION Act. From The American Prospect:
“There’s been lots of conflicting information over Mission’s statutes, and no transparency about the process since the bill was signed into law,” a senior legislative staffer at a major veterans’ organization told the Prospect. “We have some concerns that whoever they are collaborating with might be running this thing off the tracks, and pushing for privatization. It appears that we’re going to have to force our way into the door.”
Rick Weidman, executive director of the Vietnam Veterans of America, offered similar frustrations with Secretary Robert Wilkie’s VA. “These guys are incredible,” he said. “They summon you to a meeting with less than 24 hours notice and then if you can’t come they say you’re not interested. Nevertheless, we are going to go after them and continue to exert pressure to make sure veterans get the highest quality care.”
During a December hearing with Wilkie, Democratic Senator Jon Tester of Montana, who championed the Mission Act, said he was “increasingly concerned with the department’s planned implementation” of the law, and that it was “moving away from the direction it was headed just six months ago, make no mistake about that.”
A senior staffer in the agency’s central Washington office observed that “under the Trump administration, political appointees seem to have far more influence in policy making than agency policy experts.”
Tester and other members of the House and Senate Veterans Affairs Committees repeatedly asked Wilkie for details about the access and quality measures he is considering, but got no concrete replies. Wilkie said simply that that he would notify committee members after briefing President Trump, who has ultimate authority over how the rules are written. (Trump is expected to broadly announce his decision over Mission rules in his State of the Union addresses next month.)
The text of The Mission Act mandates that private care only be offered under a narrow set of circumstances, including when the VA can’t offer a specific service, a veteran faces an excessive wait or drive time, or when private care “would be in the best medical interest of the covered veteran based upon criteria developed by the [VA Secretary].” Yet Tester said in December that rules in the works could essentially create “automatic eligibility for community care.”
No new rules will be finalized until the summer, and VA sources are confused about exactly what the new standards may be. What’s clear, however, is that the new standards will almost certainly make it easier for private health care companies to capture more patients. The exact price tag for this increased level of private care is unclear, and Tester told Wilkie in December that it “concerns me that each time we’ve discussed this issue in the last two months, VA officials have given us wildly different estimates of how much this will cost.”
The Veterans Affairs Department’s newly expanded and consolidated private healthcare network for veterans could cost billions more than Congress projected when it passed the VA Mission Act.
This potentially major extra cost of $5 billion to $8 billion comes with the not-yet-finalized and not-yet-public draft regulations that will likely shape the VA’s community health program into a model similar to TriCare Prime, according to sources familiar to talks. TriCare Prime is the managed-care HMO plan for active service military that pays drastically low rates for treatment in private clinics and hospitals but also offers care in military health facilities.
The size of this new cost projection is delaying the VA’s proposed model at the White House Office of Management and Budget, where officials are evaluating the draft regulations, said a source close to the discussions.
ICYMI: The VA has awarded the first of its regional contracts for Community Care, worth upwards of $55 billion. Read more at Military.com.
“No Secret Plan” to Privatize the VA
Dr. Richard Stone, the head of the Veterans Health Administration, was adamant there is no ‘secret plan’ to privatize the health care system during a online town hall. Read more at Military.com.
Govt Shutdown Quick Clicks
VA Press Release:Secretary Robert Wilkie decries “veteran as victim stereotyping” in response to federal union
Concerned Veterans for America, an advocacy group funded by conservative billionaires Charles and David Koch, has pushed for an aggressive expansion of veterans’ health care into the private sector, as well as a faster process to fire VA workers. The group made strides on both issues since the beginning of 2017, with Trump touting them as major successes for veterans. Now, they’re concerned the policy initiatives could be undone.
“Over the past two years, we’ve had a lot of success passing reforms, like the VA Accountability Act and the Mission Act, that we’ve long-supported,” said Dan Caldwell, executive director of Concerned Veterans for America. “We’re switching to defense, ensuring those are properly implemented and not rolled back by policy adversaries in Congress. That’s a new posture for us.”
On Tuesday, the group released its legislative priorities for 2019, the first being to steer implementation of the VA Mission Act, a major reform bill that aims to shift billions of dollars for veterans’ health care to private medical facilities.
Quotable: Rep. Mark Takano, Chairman of the House Committee on Veterans Affairs
“The motivations of CVA are clear. They don’t have credibility with me, and I’m not going to give them credibility with the public…What I’m going to say to the public is, CVA’s mission is to privatize the VA. They’re driven by ideology, not by asking what’s best for veterans.”