VA Chief Backs Outside Care as Choice Program Falters
WASHINGTON Veterans Affairs Secretary Robert McDonald said Thursday he was committed to a law making it easier for veterans to get private health care, but he offered few answers for lawmakers irritated at the slow effort to put it in place.
"I'm as frustrated as you all are," McDonald told the Senate Veterans' Affairs Committee as he explained low enrollment numbers for a program intended help veterans avoid long waits that have plagued VA facilities.
Only 27,000 veterans have made appointments for private medical care since the agency started mailing out "Choice Cards" in November, the VA says. The number is so small, compared with the 8.6 million cards mailed, that McDonald wants authority to redirect some of the $10 billion Congress allocated for the program to boost care for veterans at the VA's 970 hospitals and clinics.
Republicans and Democrats told McDonald that was a nonstarter. Several senators questioned the VA's commitment to the program, the centerpiece of an agency overhaul in response to a scandal over long wait times for veterans seeking health care and falsified records covering up the delays.
The law allows veterans who have waited more than 30 days for an appointment to get VA-paid care from a local doctor. Veterans who live at least 40 miles from a VA hospital or clinic can get private care, and it is now easier to fire VA employees accused of wrongdoing.
"The concern I have is that the VA has a mentality against outside care," Sen. Jerry Moran, R-Kan., told McDonald.
The VA's request to redirect money from the choice program to traditional VA care "demonstrates a lack of interest in this program," Moran said.
McDonald insisted that was not true.
"We are for the choice program. We are for outside care," he said. McDonald promised to improve marketing efforts and he asked for patience.
"It's early days," he said, noting that the final batch of choice cards was only mailed in January.
The budget request, yet to be submitted formally, is intended to ensure "flexibility" if spending patterns hold true, McDonald said.
Senators also pressed McDonald about a quirk in the law that makes it hard for some veterans in rural areas to prove they live at least 40 miles from a VA health site. The government measures the distance as the crow flies, rather than by driving miles, leaving thousands of veterans ineligible.
"Given the clear intent of Congress to reduce barriers to care, it is perplexing that the VA is not using its authority to allow non-VA care for those who face a geographic challenge in accessing care, including long drive times or health conditions that make travel difficult," 42 senators from both parties said Wednesday in a letter to McDonald.
The VA has authority to broaden its interpretation of the 40-mile rule, the letter said, "and we urge you to rectify the overly narrow definition without delay."
McDonald told senators that he is open to changes in the way the 40-mile is interpreted, but he and other VA officials stressed that relaxing the rule's requirements was likely to result in higher costs for the program.
In a related development, McDonald said he opposed a plan offered by a veterans' advocacy group to turn the Veterans Health Administration, the VA's health care arm, into a nonprofit corporation.
Concerned Veterans for America said its plan would improve the quality and timeliness of health care for veterans.
The proposal amounted to "contracting out a sacred mission to care for those who have borne the battle," McDonald said. "Reforming VA health care cannot be achieved by dismantling it."
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