As the Department of Veterans Affairs works toward expanding its use of private-sector doctors, three veterans groups proposed this week that the White House and Congress approve a budget for private care in 2020 that’s nearly double what was appropriated for 2019.
The Veterans of Foreign Wars, Disabled American Veterans and Paralyzed Veterans of America suggested a community care budget of more than $18 billion – up from the $9.4 billion appropriated for fiscal year 2019, which ends Sept. 30. Without an increase in funding, the groups are concerned money for private care could be stripped from the VA health care system.
The VA Mission Act, a law that expands veterans’ access to private doctors, is set to go into effect in June. The veterans groups warned Thursday that the Mission Act “has created a financial obligation that, absent sufficient resources to fully and faithfully enact this legislation, could erode efforts to reform and modernize the VA health care system.”
The groups based their proposal on limited information available about the VA’s proposed rules for its new community care program. VA Secretary Robert Wilkie unveiled Jan. 30 his proposed rules that stipulate when veterans would be allowed to receive private-sector medical treatment – changes that he said would revolutionize the VA health care system.
Under the VA’s proposed rules, veterans who must drive more than 30 minutes to reach their VA mental health or primary care providers – or wait longer than 20 days for an appointment – would be allowed to use a private doctor.
The VA plans to post the proposed rules to the Federal Register, where members of the public will be allowed to provide input. The rules were not posted as of Friday.
Some lawmakers on both sides of the aisle have urged Wilkie for more transparency and collaboration about the access standards.
Adrian Atizado, deputy legislative director for Disabled American Veterans, said the groups would update their budget proposal if they received more information from the agency, such as concrete cost estimates.
“Part of the concern is there’s not going to be enough information,” Atizado said. “They may have some information, but very little budget justification… It’s like a fortress over there.”
For more than 30 years, the VFW, DAV and PVA have compiled and sent an annual report of VA budget and policy recommendations, known as the Independent Budget, to lawmakers and the presidential administration.
In a break from their normal practice, the groups listed only one “critical” issue this year: ensuring the VA “fully and faithfully” implements the VA Mission Act.
“[We] recognize that Congress and the administration continue to face immense pressure to reduce federal spending,” the groups wrote. “However, we believe that the ever-growing demand for health care and benefits, particularly with more health care being provided in the community purchased by VA, certainly validates the continued need for sufficient funding.”
The VA budget more than doubled in the past decade from $90 billion in 2009 to surpassing $200 billion for the first time in fiscal year 2019.
The $200 billion includes $88 billion in discretionary spending. The VFW, DAV and PVA proposed a $15 billion increase of discretionary spending for fiscal year 2020, to $103 billion.
President Donald Trump is expected to release his budget request for fiscal year 2020 sometime in March.
One group that has gained more influence under Trump’s administration is lobbying for cuts to the VA budget. Concerned Veterans for America, a conservative group backed by billionaires Charles and David Koch, listed “cost controls for the VA budget” as one of its priorities this year.
“It doesn’t make sense for the VA to continue to have these large budget increases,” said Dan Caldwell, executive director of CVA. “It’s going to be tougher with the new Congress. We don’t think at this time there’s an appetite for some of these reforms, if we’re being honest, but we still need to have that discussion.”
The group is proposing the VA eliminate unused infrastructure, and it questions whether the agency needs to fill all of the tens of thousands of staff vacancies nationwide. CVA also wants the VA and Congress to consider introducing copays when veterans use private-sector care.
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