On June 6, 2018, the President signed the VA Mission Act, a $52 billion bill that overhauls veterans access to private healthcare and caregiver benefits nationwide. On Wednesday, May 23, 2018, the bill passed the United States Senate in a 92-5 vote, just before the VA Choice Program was set to run out of funding in June.
At this time, Congress is still considering measures to fund the bill.
What Is In the VA Mission Act?
The VA Mission Act is aimed at expanding private healthcare access for veterans who experience long wait times at their VA provider or are too far away from their VA healthcare provider to conveniently receive care at those facilities. The bill also seeks to expand the VA caregiver program to pre-9/11 veterans and provide oversight for underperforming VA facilities.
Community Care Providers and Choice Program
Congress enacted the Veterans Access, Choice and Accountability Act in 2014 following the wait-time scandal at the Phoenix VA Medical Center. The Choice program within the bill intended to give eligible veterans access to private healthcare in place of VA care when the wait time for an appointment at a VA facility was longer than 30 days, or the veteran lived more than 40 miles driving distance from the VA. The VA Mission Act expands access to private care in coordination with a veteran’s VA provider, and seeks to remedy some of the more high-profile shortcomings of the program, such as VA’s slow pace of paying the private providers for veterans’ care and limited access to care.
Specifically, the VA Mission Act puts in place new rules that allow a veteran to seek private care if they and their VA doctor agree that it is in the veteran’s best interest. The bill also allows veterans to seek private care if their closest VA facility is considered to be “deficient” compared to other nearby healthcare facilities. Additionally, the bill gives veterans the ability to use walk-in visits at private clinics if they have used VA healthcare within two years.
Since enacted in 2014, the Choice Program has experienced multiple funding crises and was expected to run out of funding again on May 31, 2018.
The new private healthcare program in the VA Mission Act is not expected to go into effect until one year after the bill is signed. VA will continue to use the current Choice Program until that time.
Expansion of Caregiver Program
VA’s Program of Comprehensive Assistance for Family Caregivers was implemented in 2011 to provide benefits to caregivers of post-9/11 disabled veterans. Caregivers are often spouses or family members who end up leaving their jobs to care for a veteran full-time due to the extent or nature of that veteran’s disability. Common disabilities that can require full-time care are traumatic brain injuries (TBI), post-traumatic stress disorder (PTSD), and other disabilities such as loss of limbs. The Caregiver Program provided the caregivers of post-9/11 veterans with monthly compensation, medical training and healthcare, in addition to the acknowledgement of their vital role in their veteran’s healthcare.
The Caregiver Program has seen its fair share of controversy since its implementation in 2011. In 2017, NPR reported that VA medical centers nationwide were dropping caregivers from the program for seemingly no reason. A May 2018 NPR report reveals that VA is still shedding caregivers from the program, with some VAs cutting benefits at higher rates than others. According to the report, the Charleston, South Carolina VA “dropped 94 percent of its caregivers in three years.”
Despite the controversy, the VA Mission Act expands the VA caregiver benefits to caregivers of pre-9/11 veterans in addition to post-9/11. The expansion allows severely disabled pre-9/11 veterans to receive the same caregiver benefits as post-9/11.
The caregiver expansion would be implemented over the course of several years and would first become available to veterans injured before May 7, 1975, and then two years after the bill is enacted, the program would expand to veterans injured between 1975 and 2001.
Determinations of eligibility and compensation amount are made by the Veterans Health Administration (VHA), and caregivers can appeal adverse decisions through the agency.
Other Provisions in the VA Mission Act
The bill creates an asset-review commission that will review VA infrastructure and make recommendations on where VA should invest, and where they should cut back funding. Additionally, the bill includes provisions that offer incentives to fill vacancies in the department. The bill would also require VA to post job vacancies in the agency and annually report bonuses given out to executives. There are currently over 30,000 job vacancies in the agency’s work force.