Few vets use care 'choice,' VA says

Secretary looks to shift project funding, but lawmakers resist

In this photo taken Oct. 1, 2014, Veterans Affairs Secretary Robert A. McDonald, right, accompanied House Veterans Affairs Committee Chairman Rep. Jeff Miller, R-Fla., speaks in Tampa, Fla. Fewer veterans are taking advantage of a new law aimed at making it easier for them to get private health care and avoid the long waits that plagued  VA facilities nationwide. In fact, so few veterans are signing up for the much-ballyhooed Choice cards that allow access to private health care that the Veterans Affairs Department says it wants to redirect some of the $10 billion Congress allocated for the program. Republicans say the VA should do a better job selling the choice program. Lawmakers also want to address a quirk in the law that makes it harder for veterans in rural areas to prove they live at least 40 miles from a VA clinic. The government measure the distance as the crow flies, rather than driving miles, leaving thousands of veterans out of the choice program.
In this photo taken Oct. 1, 2014, Veterans Affairs Secretary Robert A. McDonald, right, accompanied House Veterans Affairs Committee Chairman Rep. Jeff Miller, R-Fla., speaks in Tampa, Fla. Fewer veterans are taking advantage of a new law aimed at making it easier for them to get private health care and avoid the long waits that plagued VA facilities nationwide. In fact, so few veterans are signing up for the much-ballyhooed Choice cards that allow access to private health care that the Veterans Affairs Department says it wants to redirect some of the $10 billion Congress allocated for the program. Republicans say the VA should do a better job selling the choice program. Lawmakers also want to address a quirk in the law that makes it harder for veterans in rural areas to prove they live at least 40 miles from a VA clinic. The government measure the distance as the crow flies, rather than driving miles, leaving thousands of veterans out of the choice program.

WASHINGTON -- Far fewer veterans than expected are taking advantage of a new law aimed at making it easier for them to get private health care and avoid the long waits that have plagued Department of Veterans Affairs facilities nationwide.

Only 27,000 veterans have made appointments for private medical care since the VA started mailing out "Choice Cards" in November, the VA said in a report to Congress this month. The number is so small compared with the 8.6 million cards that have been mailed out that VA Secretary Robert 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 insist the problem is the department and that it needs to do a better job promoting the choice program. They also want to change 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.

"Veterans put their lives on the line to defend this country. The very least we can do is ensure they don't have to jump through hoops to receive the care they need and have earned," said Sen. Jon Tester, D-Mont., whose state has just one VA hospital.

The choice program was a key component of last year's sweeping law approved in response to reports that dozens of veterans died while waiting for appointments at a VA hospital in Phoenix, and that appointment records were manipulated to hide the delays. A series of government reports said workers throughout the country falsified wait lists while supervisors looked the other way, resulting in chronic delays for veterans seeking care and bonuses for managers who falsely appeared to meet on-time goals.

The law, signed by President Barack Obama in August, allows veterans who have waited more than 30 days for an appointment to get VA-paid care from a local doctor. It also allows veterans who live at least 40 miles from a VA hospital or clinic to get private care and makes it easier to fire VA employees accused of wrongdoing.

The choice program expands an existing program that allows veterans to get outside care for emergencies or procedures not available at the VA. Veterans have long complained about waiting months or even years to be reimbursed for private care, and many are skeptical that the choice card will alleviate those problems.

"I don't believe any of us thought that there would be a wholesale rush to leave the VA system at all, but we are still early in the program," Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, told reporters during a recent tour of the VA.

McDonald's bid to shift the money has met a bipartisan wall of opposition in Congress, where leaders said the landmark law they adopted last summer to overhaul the VA has not been fully implemented. Taking money away from the choice program just three months after it started is premature, lawmakers and veterans advocates said.

Miller called the plan a complete nonstarter. And Sen. John McCain, R-Ariz., one of the law's authors, said Congress not only would reject the idea "but refuse to even consider" it.

Connecticut Sen. Richard Blumenthal, the senior Democrat on the Senate veterans panel, said he would oppose any reallocation of funds "so long as there are delays and issues with quality of care" at VA.

McDonald counters that the proposal, which has not been formally submitted, would help ensure that "every veteran receives the care they have earned and deserve regardless of where they choose to get it from."

McDonald, who took over as VA secretary in July, said he never intended to "gut the choice program or somehow eliminate" it. Instead, he said, he simply seeks the kind of budget flexibility he enjoyed as Procter & Gamble chief executive officer.

"Imagine your household. You are hungry, but you can't move the money from the gasoline account to the food account. Well, that is the situation I face," he said at a Feb. 11 budget hearing before the House Veterans Affairs Committee.

The Senate Veterans Affairs Committee considers the VA's budget on Thursday.

Louis Celli, director of veterans affairs and rehabilitation at the American Legion, called McDonald's explanation disingenuous.

"Draining funds from the bill short-circuits the program and ultimately hurts vets," Celli said, noting that VA officials had pushed for the program as a short-term way to expand patient access to care.

Rep. Tim Huelskamp, R-Kan., said a veteran in his rural district drives 340 miles each way for cardiology treatment at a VA hospital in Kansas City.

"If the VA choice program can't provide something closer for him, then we need to relook at how we are implementing that," Huelskamp told McDonald at the hearing.

A Section on 02/22/2015

Upcoming Events