WASHINGTON — A Colorado lawmaker on Tuesday introduced legislation to create a veterans health insurance program to allow them to skip the Department of Veterans Affairs entirely and get private-sector medical care at taxpayers’ expense.
“This bill throws out the idea of acceptable patient wait times and eliminates the requirement of the veteran to ask for VA permission to use civilian medical providers,” said Rep. Doug Lamborn, a Republican and former member of the House Veterans’ Affairs Committee.
“It gives veterans full authority to use the existing VA system or not.”
The move comes amid a fierce debate on Capitol Hill among veterans groups, conservative activists and VA officials over the future role of federal veterans’ health care and how to fulfill federal responsibilities.
Next week, lawmakers from the House veterans committee are expected to advance with bipartisan support a new proposal to overhaul the VA’s community care programs, giving more access to veterans to go outside the department for medical appointments with federal dollars.
With that plan, which has received criticism from some veterans groups for pulling away money from existing VA health services, VA doctors would still be the primary care coordinator for veteran patients.
VA Secretary David Shulkin has proposed going even further, lifting limits on walk-in services for a host of ailments in an effort to alleviate pressure on VA systems and free up private-sector access for veterans.
In an interview with the Wall Street Journal this week, Shulkin said he wants to make the VA’s hospital system compete with private-sector providers. “The direction I’m taking this is to give veterans more choice in their care and be the decision maker for their care, which I fundamentally believe is a concept that has to be implemented,” Shulkin told the newspaper.
It’s a position advanced by conservative activists in recent years but derided by Democratic lawmakers and major veterans organizations as “privatizing” the department. Shulkin has pushed back on the accusation repeatedly, saying he still envisions a critical and enduring role for VA.
Lamborn’s legislation would take a step beyond Shulkin’s proposal. The legislation creates a new health insurance system similar to to the military’s Tricare Standard program, allowing them to go to doctors outside the VA to receive a wide range of care.
“Giving them options to choose their health care plans and doctors is empowering,” Lamborn said in a statement. “This bill means veterans, especially those with extreme disabilities, can expect to have their needs taken care of quickly and efficiently. It’s good policy and makes sense.”
Whether veterans will receive faster — or better — medical appointments outside the VA system has been a key point of disagreement among veterans’ advocates.
Critics argue that private-sector physicians will not be able to easily accept tens of thousands of new veterans as patients and that many doctors unfamiliar with war wounds like traumatic brain injury and burn pit exposure are ill-equipped to offer the same full spectrum of health monitoring of trained VA staff.
A plan to change rules regarding veterans seeking community medical care at government expense could have a wide-reaching impact on the national health care debate.
And there are also concerns about the cost. Veterans groups like Veterans of Foreign Wars, Disabled American Veterans and the American Legion have testified before Congress they are concerned that shifting federal funding from internal VA programs to outside medical offices will limit resources for patients who remain in the VA system.
But a coalition of conservative groups — led by organizations with ties to the Koch brothers network of activists — has pushed for that type of complete divorce from VA as the center of veterans care efforts.
“We can’t leave the VA medical system in its current state and expect results to improve for our veterans,” said Concerned Veterans for America Executive Director Dan Caldwell, whose group has blasted the department as a failing health care system for years.
“This is a historic opportunity to finally go beyond the failed status quo at the VA and provide veterans with the best care possible. We applaud Rep. Lamborn for introducing this bill and strongly urge Congress to pass it into law.”
Lawmakers and veterans advocates are upset they have not yet been consulted on potentially sweeping health care changes for military members and veterans.
The measure faces a difficult path to become law. Democratic lawmakers in the House and Senate have strongly objected to similar proposals in the past, including an idea from House leadership last year.
Meanwhile, House Veterans’ Affairs Committee Chairman Phil Roe, R-Tenn., has said he is confident the bipartisan-backed measure on his committee’s schedule is the proper compromise to improve veterans care and VA operations. Senate lawmakers have not yet weighed in on the proposal but based on past comments are more likely to back that measure than Lamborn’s idea.
Last week, White House officials received criticism for exploring a proposal behind closed doors to link some VA services with Tricare programs in the future. Administration officials held multiple meetings and drew up preliminary implementation plans without discussing the idea with lawmakers and stakeholders, prompting concerns about transparency.