V.A. seeks to redirect billions into private care

The Department of Veterans Affairs is preparing to shift billions of dollars from government-run veterans’ hospitals to private health care providers, setting the stage for the biggest transformation of the veterans’ medical system in a generation.

What it means

Under the proposed guidelines, it would be easier for veterans to receive care in privately run hospitals and have the government pay for it. Veterans would also be allowed access to a system of proposed walk-in clinics, which would serve as a bridge between V.A. emergency rooms and private providers, and would require co-pays for treatment.

Why it matters

Veterans’ hospitals, which treat 7 million patients annually, have struggled to see patients on time in recent years, hit by a double crush of returning Iraq and Afghanistan veterans and aging Vietnam veterans. A scandal over hidden waiting lists in 2014 sent Congress searching for fixes, and in the years since, Republicans have pushed to send veterans to the private sector, while Democrats have favored increasing the number of doctors in the V.A.

What’s next

Many of the details remain unclear. Critics have warned that switching veterans to private hospitals would strain care in the private sector and that costs for taxpayers could skyrocket.

The president may reveal details of the plan in his State of the Union address this month, according to several people in the administration and others outside it who have been briefed on the plan.