WASHINGTON — Veterans Affairs Secretary Robert McDonald said Thursday he remains committed to a law making it easier for veterans to get private health care, but he offered few answers for lawmakers irritated at the slow effort to put the law in place.
“I’m as frustrated as you all are,” McDonald told the Senate Veterans Affairs Committee, as he explained low enrollment numbers for the VA’s new “choice” program.
Far fewer veterans than expected are taking advantage of the program, which is intended help veterans avoid long waits that have plagued VA facilities nationwide.
Only 27,000 veterans have made appointments for private medical care since the VA started mailing out “Choice Cards” in November, the VA says. The number is so small, compared to the 8.6 million cards that have been mailed out, that McDonald wants authority to redirect some of the $10 billion Congress allocated for the program to boost care for veterans at the VA’s 970 hospitals and clinics.
Republicans and Democrats alike told McDonald that was a non-starter. Several senators questioned VA’s commitment to the choice program, the centerpiece of an agency overhaul by approved by Congress last year in response to a scandal over long wait times for veterans seeking health care and falsified records covering up the delays.
The law allows veterans who have waited more than 30 days for an appointment to get VA-paid care from a local doctor. It also allows veterans who live at least 40 miles from a VA hospital or clinic to get private care and makes it easier to fire VA employees accused of wrongdoing.
“The concern I have is that the VA has a mentality against outside care,” Sen. Jerry Moran, R-Kan., told McDonald.
The VA’s request to redirect money from the choice program to traditional VA care “demonstrates a lack of interest in this program.” Moran said.
McDonald insisted that was not true.
“We are for the choice program. We are for outside care,” he said.
The budget request, which has not formally been submitted, is merely intended to ensure “flexibility” if current spending patterns hold true, McDonald said. He compared his request to an individual who wants to buy food from funds initially set aside for other expenses, like gasoline.
Senators also pressed McDonald about a quirk in the new law that makes it hard for some veterans in rural areas to prove they live at least 40 miles from a VA health site. The government measures the distance as the crow flies, rather than by driving miles, leaving thousands of veterans ineligible.
“Given the clear intent of Congress to reduce barriers to care, it is perplexing that the VA is not using its authority to allow non-VA care for those who face a geographic challenge in accessing care, including long drive times or health conditions that make travel difficult,” 42 senators from both parties said in a letter to McDonald Wednesday.
The letter was led by Sen. John McCain, R-Ariz., one of the chief authors of the VA law and a longtime proponent of improving veterans’ access to outside care.
The VA has authority to broaden its interpretation of the 40-mile rule, the letter said, “and we urge you to rectify the overly narrow definition without delay.”
McDonald told senators Thursday that he is open to changes in the way the 40-mile is interpreted, but he and other VA officials stressed that relaxing the rule’s requirements was likely to result in higher costs for the program.
In a related development, McDonald said he opposed a plan offered by a veterans’ advocacy group to turn the Veterans Health Administration, the VA’s health-care arm, into a nonprofit corporation.
Concerned Veterans for America said its plan would improve the quality and timeliness of health care for veterans.
McDonald said the proposal amounted to “contracting out a sacred mission to care for those who have borne the battle,” a reference to the VA’s mission statement.
“Reforming VA health care cannot be achieved by dismantling it and preventing veterans from receiving the specialized care and services that can only be provided by VA,” McDonald said.
