​​​​​​​Congress races to fill shortfall in Veterans’ Choice program

Veterans affairs sign
Congress is scrambling to cover a budget shortfall in the Veterans' Choice program by the middle of August. (JeffOnWire CC BY 2.0)

Funds in the Veterans’ Choice program could run out by the middle of next month, and Congress is scrambling to come up with a stopgap measure to cover the shortfall.

Department of Veterans Affairs Secretary David Shulkin revealed in June that the program faces a significant budget shortfall, but with just weeks left to solve the problem House and Senate aides told the Washington Examiner that the path forward is unclear. One Senate aide said legislation is in the works, but did not specify what the plan entails.

The Choice program was created in 2014 following a nationwide scandal that revealed thousands of veterans faced long waits to receive care at VA facilities. It allowed veterans to seek care outside of the VA system if the nearest facility is too far away from where they live or they had to wait more than 30 days for an appointment in the VA network. The program was recently extended beyond its Aug. 7 end date by the Trump administration.

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Veterans groups are watching Congress closely to see how it handles the issue. Concerned Veterans for America, an advocacy group, submitted a letter (PDF) to legislators on Tuesday outlining some of the elements it believes should be included in VA healthcare reform.

“Considering that many veterans are still waiting months for critical care and have no option to receive care in the community, it is critical that Congress produces legislation that not only streamlines existing contracted care programs, but which puts the veteran at the center at the VA by empowering them with more choice,” Dan Caldwell, the group’s policy director, said in the letter.

CVA’s four suggestions include:

  1. Healthcare choices should empower veterans. Current legislative proposals are on the right track, according to Caldwell, but there’s more work that could be done to offer veterans more choice.
  2. Employ more cost controls. The VA should specifically take a look at cost controls in payment and reimbursement.
  3. Pilot innovative programs. This could assist with the demographic shift that the agency faces, Caldwell said.
  4. Increase transparency around costs and quality. Veterans and taxpayers should know where their money is going, and how well the system is caring for veterans.

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Questions about the future of the Choice program come as a Boston Globe investigation spotlighted issues at the Manchester VA Medical Center in New Hampshire. The newspaper reported unsterile conditions—for instance, one operating room at the facility was abandoned because exterminators could not contain the number of flies—and issues with appointment scheduling.

The Globe found that the hospital’s system for scheduling appointments with outside specialists had “broken down,” leaving many patients with long waits for crucial care. In one case this spring, a patient had yet to secure an appointment with an oncologist four weeks after his diagnosis of lung cancer, according to the article.

Manchester is the only VA hospital in New Hampshire, and is located about 50 miles from Boston. Despite these concerns, it’s ranked in the top third of the VA system, with a four-star rating. Since the Globe’s report, Shulkin removed two top officials at the hospital and ordered a “top-to-bottom” review, and Rep. Ann McLane Kuster, D-N.H., has requested a hearing on the issue, reports the New Hampshire Union Leader.

VA medical centers have faced intense scrutiny in the wake of the wait time scandal. Since then, hospitals from North Carolina to Houston to the District of Columbia have come under fire for practices that may have put patients at risk.