Paycheck Chronicles

VA Says CHOICE Program Will Be Broke In Three Weeks

Active VA Secretary Robert Wilkie says the VA Choice Program could run out of money by month's end.

In his third warning letter to Congress, Wilkie said that the program could run out of money as soon as May 31, and once that happens VA "will be unable to create new referrals or authorizations under [the] program".

That means that the program for all purposes would be finished.

VA Choice Program Had Problems From Start

The VA Choice Program was designed to allow certain veterans to get health care from civilian doctors if they lived more than 40 miles from a VA facility or were unable to get an appointment at the VA within 30 days.

However, shortly after the program began VA changed the definition of "40 miles" to "40 miles by most common traveled route". For example, someone living on a peninsula could be 10 miles as the crow flies from a VA clinic, but 80 miles from the clinic if they drove.

Also the definition of waiting time was refined to take into account medical necessity and convenience.

Strangely, the VA just released the results of a RAND Corporation study that determined VA health care was rated the same or better than in private hospitals, and veterans could get care faster through the VA than the general public could using private healthcare. 

Also, last fall an Inspector General audit found that VA had made more than $90 million in improper payments under the program in just two years.

Fear Of Privatization

Many veterans, and veterans groups fear the VA Choice act is the first step towards privatization of VA heath care.

The previous VA Secretary said publicly that he was fired because "The advocates within the [Trump] administration for privatizing VA health services ... saw me as an obstacle to privatization who had to be removed."

For its part, the VA said "There is no effort underway to privatize VA, and to suggest otherwise is completely false and a red herring designed to distract and avoid honest debate about the real issues surrounding veterans' health care."

Whatever the truth is, the fact remains that nearly two million veterans have used the VA Choice Program since it began, and if the money runs out, those who still use it would find themselves suddenly without a physician, or having to choose between paying for care themselves, or going back the the VA for care.

Legislation Introduced To Continue Program

On May 3, Representative David P. Roe (R-TN) introduced HR5674, the "VA Maintaining Internal Systems and Strengthening integrated Outside Networks Act of 2018" or "VA MISSION Act of 2018".

Roe is the Chairman of the House Committee on Veterans' Affairs. 

In the short term, the VA MISSION act seeks $5.2 billion in funds to address the VA Choice program’s funding shortfall and will fund it through the next year.

In the long term, the legislation seeks a compromise to replace the existing VA Choice program with a new consolidated community care program and develop an integrated network of VA and community providers to supplement, not replace VA health care. 

The language in the bill is fairly vague. It replaces the 40 mile rule in the current program with language that just says "an excessive driving distance, geographical challenge, or environmental factor that impedes the access to VA care".

The new program would allow the VA and the veteran to decide if private care is better for the individual. It also allows a veteran to seek private care if the nearest VA facility doesn't meet timeliness or quality standards.

The bill also includes safeguards to prevent VA from making overpayments to civilian doctors and eases the sharing of health information for veterans receiving care in the private sector. 

Veterans Groups Support Legislation

While most veterans' groups oppose VA privatization, 38 of them sent a letter to Congress today, supporting this compromise bill and urging for its swift passage.

The bill is set for a hearing in the House Committee on Veterans' Affairs on Tuesday May 8.  

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