Deal struck to end VA bud­get cri­sis


WASH­ING­TON — The House over­whelm­ingly ap­proved a $3.9 bil­lion emer­gency spend­ing pack­age to ad­dress a bud­get short­fall at the De­part­ment of Vet­er­ans Af­fairs that threat­ens med­i­cal care for thou­sands of vet­er­ans.

The bill pro­vides $2.1 bil­lion to con­tinue fund­ing the Vet­er­ans Choice pro­gram, which al­lows vet­er­ans to re­ceive pri­vate med­i­cal care at govern­ment ex­pense. An­other

$1.8 bil­lion would go to core VA health pro­grams, in­clud­ing

28 leases for new VA med­i­cal fa­cil­i­ties.

The bill was ap­proved 4140 Fri­day and now goes to the Se­nate.

The Choice pro­gram was put in place af­ter a 2014 wait­time scan­dal that was dis­cov­ered at the Phoenix VA hos­pi­tal and spread through­out the coun­try. Vet­er­ans waited weeks or months for ap­point­ments amid phony records that cov­ered up the lengthy waits.

A pri­or­ity of Pres­i­dent Don­ald Trump, the pro­gram al­lows vet­er­ans to re­ceive care from out­side doc­tors if they must wait at least 30 days for an ap­point­ment or drive more than 40 miles to a VA fa­cil­ity.

VA Sec­re­tary David Shulkin has warned that with­out leg­isla­tive ac­tion, the Choice pro­gram will run out of money by mid-Au­gust, caus­ing de­lays in health care for thou­sands of vet­er­ans.

The bill would ex­tend the pro­gram for six months and de­vote $1.8 bil­lion to au­tho­rize 28 leases for new VA med­i­cal fa­cil­i­ties and es­tab­lish pro­grams to make it eas­ier to hire health spe­cial­ists. Costs would be paid for by trim­ming pen­sions for some Med­i­caid-el­i­gi­ble vet­er­ans and col­lect­ing fees for hous­ing loans.

Ma­jor vet­er­ans’ groups had op­posed an ear­lier House plan as an un­ac­cept­able step to­ward pri­va­ti­za­tion, lead­ing Democrats to block that bill on Mon­day. The ear­lier plan would have trimmed VA ben­e­fits to pay for Choice with­out ad­di­tional in­vest­ments in VA in­fra­struc­ture.

Lead­ers of the House Vet­er­ans Af­fairs Com­mit­tee said the six-month fund­ing plan was ur­gently needed and would give Congress more time to de­bate broader is­sues over the VA’s fu­ture.

“Our pri­or­ity is and has al­ways been en­sur­ing vet­er­ans have ac­cess to the very best health care avail­able, and we will con­tinue to come to­gether to de­liver the re­sults vet­er­ans de­serve,” said Reps. Phil Roe of Ten­nessee and Tim Walz of Min­nesota. Roe chairs the Vet­er­ans af­fairs panel and Walz is the top Demo­crat.

House Ma­jor­ity Leader Kevin McCarthy, R-Calif., said the Choice pro­gram has di­rectly helped vet­er­ans who would oth­er­wise face dire wait times at VA fa­cil­i­ties to re­ceive timely med­i­cal care in their own com­mu­ni­ties.

“Ul­ti­mately, it shouldn’t mat­ter where vet­er­ans get care as long as they get the care they need,” McCarthy said.

Shulkin praised the House ac­tion and urged quick ap­proval by the Se­nate. The leg­is­la­tion “will greatly ben­e­fit vet­er­ans,” he said.

While the bill may avert a shut­down to Choice, dis­putes over fund­ing may sig­nal big­ger po­lit­i­cal fights to come.

Dur­ing the 2016 cam­paign, Trump crit­i­cized the VA for long wait times and mis­man­age­ment, say­ing he would give vet­er­ans more op­tions in see­ing out­side providers. At an event Tues­day in Ohio, Trump said he would triple the num­ber of vet­er­ans “see­ing the doc­tor of their choice” as part of an up­com­ing VA over­haul.

His com­ments fol­lowed a warn­ing by the leader of the Vet­er­ans of For­eign Wars against any Trump ad­min­is­tra­tion ef­fort to “pri­va­tize” the VA. Speak­ing Mon­day at the group’s na­tional con­ven­tion in New Or­leans, out­go­ing VFW Na­tional Com­man­der Brian Duffy crit­i­cized the ini­tial House plan. The VA “is a pub­lic trust,” Duffy said.

Shulkin an­nounced the bud­get short­fall last month, cit­ing un­ex­pected de­mand from vet­er­ans for pri­vate care and poor bud­get plan­ning. To slow spend­ing, the de­part­ment last month in­structed VA med­i­cal cen­ters to limit the num­ber of vet­er­ans it sent to pri­vate doc­tors.

Cur­rently, more than 30 per­cent of VA ap­point­ments are in the pri­vate sec­tor, up from fewer than 20 per­cent in 2014. The VA has an an­nual bud­get of about $180 bil­lion.

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