WASHINGTON -- The House voted Wednesday to give veterans more freedom to see doctors outside the Veterans Affairs health system, a shift aimed at reducing wait times and improving medical care despite the concerns of some Democrats who cast it as a risky step toward dismantling the struggling agency.
The plan seeks to fulfill President Donald Trump's promise to expand private care to veterans whenever they feel unhappy with VA health care.
The long-anticipated bill would change how veterans receive their medical treatment by allowing them to go to private physicians when they feel that government-run VA medical centers can't provide the care they needed, with the approval of a VA health provider. Veterans could access private care when they endured lengthy wait times or the treatment was not what they had expected.
The VA would decide in many cases when a veteran sees an outside doctor, based on conditions it sets that determine what is inadequate care.
The White House said in a statement that Trump applauded passage of the bill and urged the Senate to send it to his desk for his signature by Memorial Day.
"The President encourages members of the Senate to put the needs of our nation's veterans over partisan politics," it said.
Lawmakers passed the bill by a 347-70 vote, with the program to be implemented later next year as the VA works to add private doctors to its network of outside referrals.
The wide-ranging plan would avert a shutdown of the VA's troubled Choice private-sector program, which would receive $5 billion to continue operating for another year before it is made a longer-term fixture at the VA. The program will run out of money as early as May 31, which would cause disruptions in care.
The $51 billion bill has the support of nearly 40 organizations, including The American Legion and Veterans of Foreign Wars. The program could be expanded based on veterans' demands for private services and when VA care is deemed inadequate. The VA would be able to determine how quickly the program grows.
The legislation now goes to the Senate, where lawmakers are seeking a vote before their Memorial Day break. Trump has said he is ready to sign the bill.
Rep. Phil Roe, the chairman of the House Veterans Affairs Committee, praised the measure as keeping "our promise to give veterans more choice in their health care."
The program could face escalating costs because of growing demand from veterans seeking the convenience of seeing private physicians. Some House Democrats warn that the VA won't be able to handle the costs of the newly combined "community care" program that includes Choice and other VA programs of outside care, putting the VA at risk of unexpected budget shortfalls next year.
Rep. Tim Walz, the top Democrat on the Veterans Affairs Committee, cautioned that outsourcing more care to the private sector would lead to devastating cuts to VA hospitals, which many veterans see as best-suited to treat battlefield injuries, such as traumatic brain injury.
The bill 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 comes as the VA is without a permanent leader after David Shulkin was ousted as VA secretary in March.
Trump has yet to name a new secretary after his first nominee, Ronny Jackson, withdrew last month.
The legislation 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 past two years.
The bill would create a presidentially appointed commission to review the closure of underperforming VA facilities, which House Democrats opposed when the plan was drafted in March. Democrats 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.
"This is a great victory for those who want to see the VA reformed and fixed," said Dan Caldwell, executive director of the conservative Concerned Veterans for America. "This will hopefully ensure veterans aren't trapped in failing VA hospitals."
Currently, more than 30 percent of VA appointments are in the private sector.
A Section on 05/17/2018
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