As Trump Pledges to Triple Private Care for Vets, Congress Struggles to Save VA Program

Update: Since the publication of this story, VA Secretary David Shulkin announced that House and Senate lawmakers have reached an agreement that, if approved, would provide the department with $2.1 billion for the Choice Program while authorizing 28 “major medical leases.”

House Democrats blocked a measure to provide the Veterans Affairs Department with a funding surge for its troubled program to provide more patients with private care, just weeks before it is set to run out of funding.

Republicans pushed the measure after VA Secretary David Shulkin alerted lawmakers in June the funding reserve for the Veterans Choice Program would evaporate by early August. Shulkin had told Congress the $1.1 billion pot from the initial $10 billion allocated would last into fiscal 2018, but had to revise that estimate because of a reported uptick in popularity.

On Tuesday speaking before an AMVETS post in Struthers, Ohio, President Trump claimed the number of veterans given approval by VA to see private doctors has “nearly doubled.” Shulkin, however, testified to Congress last month the authorizations have increased 30 percent from 2016. Trump appeared undeterred by the current funding crisis, saying the Choice approvals would be “tripling up very shortly.”

AMVETS helped sink the Choice extension bill, saying any bill to provide more funding to the program should also boost resources for internal VA care. Seven other organizations, such as Veterans of Foreign Wars and Disabled American Veterans, joined AMVETS in criticizing the offset for the $2 billion in new Choice funding, which would have extended a cut to pensions for veterans living in Medicaid-covered nursing facilities.

The vote’s failure created an opportunity for the House and Senate to work in tandem to “rapidly reach agreement to continue funding the Choice program uninterrupted in the short term -- without forcing veterans themselves to pay for it -- while also making long overdue and urgent investments in VA health care capacity for the long term,” the groups said.

Rep. Phil Roe, R-Tenn., who chairs the House Veterans' Affairs Committee, expressed his disappointment with the vote while noting Democrats had previously supported the program’s extension. Congress created the Choice Program in 2014, and it allows veterans more than 40 miles from a VA facility, who require services unavailable at a VA facility or who faced a wait of more than 30 days, to receive private care. It was originally scheduled to sunset in August, but President Trump in April signed a bill that passed unanimously in both the House and Senate to eliminate that end date.

“This was a bipartisan agreement, and I’m disappointed the concerns raised on the House floor today were not mentioned during what I thought was an open and honest conversation,” Roe said. “I will continue to fight tirelessly to ensure the Choice Fund does not run out of money so veterans can continue to access care.”

Rep. Tim Walz, D-Minn., the top Democrat on Roe’s committee, said his Republican counterparts failed to build consensus among all stakeholders, but suggested the Senate is close to a bipartisan proposal before the looming deadline.

“Democrats deeply value the feedback of key stakeholders like the VSOs, we take their concerns seriously and we will make sure their perspectives are taken into account when we take up similar legislation soon enough,” Walz said.

Roe noted the concerns from veterans service organizations and promised to listen to their ideas. Sen. Jon Tester, D-Mont., has proposed boosting funding to both the Choice Program and the Veterans Health Administration on an emergency basis, so Congress does not have to offset the spending.

While the veterans groups argued if lawmakers funded only private sector health care without investing in VA facilities “the viability of the entire system will soon be in danger,” Shulkin has stressed the Trump administration has no interest in privatization on a grand scale.

“Some critics complain that letting veterans choose where they get certain health care services will lead to the privatization of VA,” Shulkin wrote in an USA Today op-ed this week. “Nothing could be further from the truth.” He went on to say improving internal capacity and private options “are not mutually exclusive,” and VA is “ramping up both simultaneously.”

“President Trump is dedicated to maintaining a strong VA, and we will not allow VA to be privatized on our watch,” Shulkin said. “What we do want is a VA system that is even stronger and better than it is today. To achieve that goal, VA needs a strong and robust community care program.”