Reform bill would enable vets to get treatment outside the VA

Greg Nash

Senate Republicans on Tuesday said they would offer legislation to allow veterans to go to any hospital within 40 miles of their home to get healthcare.

The bill, backed by Sen. John McCain (R-Ariz.), would also mimic legislation passed by the House in giving the secretary of the troubled Veterans Affairs Department the power to remove any top executive based on job performance.

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But its signature offering is a “choice card” that would let a veteran go outside the VA to seek medical help, so long as the private provider accepts Medicare or the military’s TRICARE health plan and is within 40 miles.

The bill requires the VA secretary to publish wait-time goals for the scheduling of an appointment. If those goals are not met, veterans would be able to seek private care within the given radius.

McCain argued the card would ensure that veterans receive care in a “timely fashion” after reports that some waited months for care at VA facilities, and that VA officials sought to cover up those waiting times.

“The American people are deeply angered and are demanding that we make changes to fix this problem,” McCain, a Vietnam War veteran, said during a Capitol Hill press conference.

Republicans on Tuesday began to rally around McCain’s bill, but it faces an uncertain future in the Senate, where Democrats are expected to back legislation to be introduced Thursday by Sen. Bernie Sanders (I-Vt.), the chairman of the Senate Veterans’ Affairs Committee.

Senate Majority Leader Harry Reid (D-Nev.) and the White House are working with Sanders on his bill, increasing his leverage.

Sanders opposes the bill approved by the House that McCain included in his legislation. Sen. Marco Rubio (R-Fla.) has offered that legislation in the Senate, where it has been backed by 10 Democrats, many of whom are considered vulnerable in this fall’s elections.

Sanders said that his bill, like the GOP measure, would give the VA chief the power to promptly fire incompetent personnel, but that the Republican effort would go too far and could open up the agency to lawsuits from employees arguing they were fired for political reasons.

“When you’re running a healthcare system with 300,000 employees, and with six and a half million people utilizing the system, you cannot politicize the system to that degree,” he told The Hill on Tuesday.

McCain, however, argued that his proposal would get to the root of the VA’s problems by eliminating incentives that led bureaucrats at the agency to allegedly create fake waiting lists that hid how long it took some veterans to get treatment.

McCain’s proposal would remove scheduling and wait time goals as factors for determining employee awards or bonuses. It also would require that wait times at VA medical centers be published online to improve transparency.

“Unlike the Sanders bill, this bill addresses the root causes of the current VA scandal and empowers veterans with greater flexibility to get the quality medical care that he or she deserves.”

Similarities between the two approaches suggest a compromise remains possible.

For example, while McCain’s bill appears to go farther in giving veterans the option of seeking private care, Sanders would allow vets to seek private care if they can’t get into a VA in a timely fashion.

But there are also significant differences between the two approaches.

For example, the Sanders bill would authorize the VA to lease 27 new facilities in order to provide more care, expand dental care for veterans and provide help to veterans who are sexually assaulted or raped while serving in the military.

There is tremendous public pressure for Congress to overhaul the VA’s medical practices following VA Secretary Eric Shinseki’s forced resignation on Friday. He stepped down in the wake of two reports that uncovered widespread fraud at VA clinics around the country.

Sen. Jeanne Shaheen (D-N.H.), who is up for reelection later this year, on Tuesday offered a bill to withhold bonuses for senior VA executives. Her bill would also require the Government Accountability Office to audit random VA medical facilities to determine if veterans have been delayed access to care.

McCain’s bill is backed by Republican Sens. Jeff Flake (Ariz.), Tom Coburn (Okla.) and Richard Burr (S.C.), the ranking member on the Senate Veterans’ Affairs Committee.

Burr admitted the bill does not encompass “everything that Congress would like to pass as it relates to VA legislation, but it addresses the urgent things needed right now.”

McCain said he had spoken to a “number” of Democrats about the scaled-down legislation and that the bill could be beefed up during the amendment and debate process.

He predicted that measure, called the Veterans Choice Act, would get through Congress “in a week.”

McCain said that despite the woes that have beset the VA, the agency should not be scrapped. He noted there are several areas of medicine “which only the VA has the talent and the expertise” to address, such as traumatic brain injuries, post-traumatic stress disorder and prosthetics.

“I’m afraid that if you did away with a lot of that, then obviously we would lose that ability,” he told reporters.