VA fund­ing short­fall ob­structs Choice

Med­i­cal op­tions start to be cut

The Washington Times Weekly - - National - BY DAVE BOYER

Marine Corps veteran Nancy Brown qual­i­fies for a pro­gram that al­lows her to see a pri­vate doc­tor be­cause she lives about 60 miles from the near­est VA hos­pi­tal in Rich­mond, Vir­ginia, but she was turned down re­cently when she sought an ap­point­ment to treat her ail­ing knee.

“There are no more re­fer­rals,” said Ms. Brown, 57, of Fred­er­icks­burg, Vir­ginia. “They’re deny­ing it now, telling peo­ple they can’t see you. What are veter­ans to do?”

The pop­u­lar Veter­ans Choice Pro­gram, cre­ated af­ter the 2014 health care scan­dal in the Depart­ment of Veter­ans Af­fairs, is de­signed to give veter­ans more treat­ment op­tions if they can’t get an ap­point­ment at a VA fa­cil­ity within 30 days or they live more than 40 miles from the near­est VA hos­pi­tal. But the pro­gram is run­ning out of money.

The VA ini­tially pro­jected that Veter­ans Choice would be run­ning a sur­plus of $1.1 bil­lion by Aug. 7. But VA Sec­re­tary David J. Shulkin sur­prised law­mak­ers last month when he re­vealed that the money is ex­pected to run dry by mid-Au­gust be­cause of un­ex­pect­edly high de­mand.

“On fi­nan­cial pro­jec­tions, we have to do bet­ter,” he said. “We do not want to see veter­ans im­pacted at all by our in­abil­ity to man­age bud­gets.”

Mr. Shulkin has ditched a pro­posal to shift money from an ac­count fund­ing dis­abil­ity ben­e­fits for about 225,000 el­derly and dis­abled veter­ans af­ter an out­cry from veter­ans groups, and Congress is pre­par­ing an emer­gency spend­ing mea­sure to make up the bud­get short­fall in the Choice pro­gram.

House Veter­ans’ Af­fairs Com­mit­tee Chair­man Phil Roe, Ten­nessee Repub­li­can, plans to in­tro­duce leg­is­la­tion next week that would ex­tend fund­ing for six months, with off­sets else­where in the VA bud­get.

The com­mit­tee held pro­duc­tive dis­cus­sions last Tues­day night on the is­sue, Mr. Roe said.

“We would like to pro­ceed with a fully paid-for six-month [ex­ten­sion],” he said, adding that it would buy time for the com­mit­tee to ad­dress other is­sues re­lated to veter­ans’ care. “I think we will come out hope­fully with a bet­ter prod­uct and more time for un­der­stand­ing and more in­put from other sources.”

Fac­ing the short­fall, the VA has been in­struct­ing its med­i­cal cen­ters to limit the num­ber of veter­ans sent to pri­vate doc­tors. Some veter­ans have been sent to VA fa­cil­i­ties at greater dis­tances from their homes or to De­fense Depart­ment hos­pi­tals. The agency also was de­lay­ing spend­ing by its re­gional of­fices on some med­i­cal equip­ment.

For veter­ans like Ms. Brown, the de­lay has been frus­trat­ing, es­pe­cially since Pres­i­dent Trump signed leg­is­la­tion in April ex­tend­ing the Choice pro­gram in­stead of al­low­ing it to ex­pire next month.

“I shouldn’t have to worry about this be­cause Trump signed the ap­proval,” she said. “I do need this Choice re­fer­ral.”

A veter­ans group that ad­vo­cates for more pri­vate health care op­tions said Congress should use this op­por­tu­nity to em­power veter­ans with more choices for treat­ment in their com­mu­ni­ties.

“While Congress must quickly move for­ward on a tem­po­rary fix for the VCP bud­get short­fall, the Choice pro­gram must ul­ti­mately be over­hauled, ex­panded and per­ma­nently re­formed,” said Dan Cald­well, pol­icy di­rec­tor at Con­cerned Veter­ans for Amer­ica.

Mr. Shulkin is promis­ing to ex­pand the pro­gram un­der the VA’s bud­get for fis­cal 2018, which be­gins Oct. 1. Mr. Trump has pro­posed $2.9 bil­lion in ad­di­tional fund­ing for Choice next year and an­other $3.5 bil­lion in fis­cal 2019. The VA is one of the few fed­eral agen­cies to be tar­geted for in­creases in spend­ing.

The re­vised Choice pro­gram would elim­i­nate the 30-day and 40-mile re­quire­ments and al­low VA per­son­nel to per­form a “health risk assess­ment” to de­ter­mine whether the VA or a pri­vate doc­tor is the bet­ter op­tion for a pa­tient.

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