By HOPE YEN,
ASSOCIATED PRESS
WASHINGTON — May 24, 2018,
12:08 AM ET
The Senate cleared the bill on a 92-5 vote Wednesday, also
averting a disastrous shutdown of its Choice private-sector program. The
program is slated to run out of money as early as next week, causing
disruptions in care.
The sweeping measure would allow veterans to see private doctors
when they do not receive the treatment they expected, with the approval of a
Department of Veterans Affairs health provider. Veterans could access private
care when they have endured lengthy wait times or VA medical centers do not
offer the services they need.
The bill's approval comes despite concerns from some Democrats
that the effort would prove costly and be used too broadly by veterans in
search of top-notch care even when the VA is able to provide treatment deemed
sufficient for their needs.
The White House said
Trump applauded passage of legislation that would transform VA "into a
high-performing and integrated health care system for the 21st century and
provide veterans with more choice in their health care options, whether from VA
doctors or from the community."
The VA secretary will have wide leeway in implementing the
legislation, which leaves it up to VA to determine what is "quality"
care. Trump said last week he will nominate acting VA secretary Robert Wilkie
to permanently lead the government's second-largest department serving 9
million veterans. Democrats say they intend to question Wilkie on whether he
plans to "privatize" or degrade the VA health system, an issue that
former VA Secretary David Shulkin says led to his firing in March.
Sen. Johnny Isakson, the Republican chairman of the Senate
Veterans Affairs Committee, lauded the bill as a big step toward providing
veterans with "more choice and fewer barriers to care."
Sen. Jon Tester, the
top Democrat on the veterans panel, said the plan will also boost VA health
care by paying off higher amounts of student loan debt for doctors who agree to
work in high-need VA positions, requiring improvement plans in communities with
few hospitals and creating a pilot program that would send medical personnel to
help fill shortages.
"The best defense against any effort to privatize the VA or
send veterans in a wholesale fashion to the private sector is to make sure the
VA is living up to its promise," he said.
Trump has made clear he will sign the bill if it reaches his
desk before Memorial Day. The House passed it on a 347-70 vote last week.
The Senate supported the bill that would create a presidentially
appointed commission to review the closure of underperforming VA facilities.
House Democrats had sought restrictions on the commission but were rebuffed by
House Republicans and the White House.
It would also expand a VA caregivers program to cover families
of veterans of all eras, not just the families of veterans who were seriously
injured in the line of duty since Sept. 11, 2001.
The $51 billion bill provides for a newly combined
"community care" program that includes Choice and other VA programs
of outside care. It could face escalating costs due to growing demand from
veterans seeking the convenience of seeing private physicians. Some House
Democrats warn the VA won't be able to handle a growing price tag, putting the
VA at risk of unexpected budget shortfalls next year.
Sen. Bernie Sanders,
I-Vt., a former chairman of the Senate Veterans Affairs Committee, criticized
the bill as moving the VA "too far in the direction of
privatization." He noted that it would not provide any money to fill more
than 30,000 positions at the VA that the Trump administration has left vacant.
"My fear is that this bill will open the door to the
draining, year after year, of much needed resources from the VA," he said.
The measure builds on legislation passed in 2014 in response to
a wait-time scandal at the Phoenix VA medical center, where some veterans died
while waiting months for appointments.
It aims to steer more patients to the private sector to relieve
pressure at VA hospitals, thus improving veterans care at VA facilities and
with private providers alike. Patients could also access private walk-in
clinics, such as MinuteClinics, to treat minor illnesses or injury if they used
VA health care in the last two years.
The legislation would loosen Choice's restrictions that limit
outside care only when a veteran must wait 30 days for an appointment or drive
more than 40 miles to a VA facility. Currently, more than 30 percent of VA
appointments are in the private sector.
A broad array of veterans' groups supported the bill. The
American Legion, the nation's largest veterans group, says the plan will
"strengthen veterans' health care for future generations while ensuring
that veterans' caregivers of all generations get the support they deserve."
The conservative Concerned Veterans for America, a long-time
advocate of expanding private care for veterans, called the measure a
"very big deal." Still, executive director Dan Caldwell stresses the
"top priority for the VA secretary is ensuring it will be implemented
properly."
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Follow Hope Yen on Twitter at https://twitter.com/hopeyen1
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