More Fallout for the Department of Veterans Affairs

Dec 5, 2017

VA community care

It seems lately there is a lot of news coming from the VA. For years now, publicity and scandals have plagued the department.

Another bill recently introduced by Congressman Phil Roe (R-TN) looks at replacing the Veterans Choice Act.

The Veterans Choice Act passed in 2014 after scandals at the department regarding long wait times for veterans to receive medical treatment and falsification of records. Under that Act, veterans have more flexibility to visit private sector care facilities outside of the VA’s system of 1,233 healthcare facilities, including 168 VA medical centers.

Community Care Facility Use Increase

According to Roe, community care appointments have increased by 61% overall since FY2014. In FY2016, 30% of all VA appointments were held within the community rather than VA medical centers. He writes that the VA has collaborated with community providers to treat veterans since 1945, however, the recent increase in veteran demand for community care has brought to light serious issues within the VA’s community care system.

As an example, the VA uses 6 different methods to refer veteran patients to community providers. These 6 different methods can conflict with each other creating confusion for veterans, community providers, and VA employees.

House Committee on Veteran Affairs, led by Chairman Roe and Ranking Member Walz, worked on drafting this legislation in hopes that it will streamline the VA’s community care programs. It has 23 co-sponsors with both Democrat and Republican support.

Purpose of the Bill

The purpose of H.R. 4242 is to establish a permanent VA Care in the Community program. It would provide a greater choice of medical care to veterans under certain conditions.

The VA would set up regular networks for providing care under contract with the VA and would negotiate rates for care and services of veterans and reimburse the care facilities for their services.  The bill also provides that if the agency can’t assign an eligible veteran to a patient-aligned care team or primary care provider because they are unavailable, the veteran would be involved in selecting available primary care providers from among network providers located in the regular network where the veteran lives, or an adjacent one.  The veteran would select one of the available primary care providers to serve as his/her dedicated one.


The American Federation of Government Employees represents thousands of VA employees. AFGE has taken issue with the legislation and views it as a way to provide more medical care for veterans through the private sector, threatening the existence of their union to the agency.

“This is a deliberate strategy: Establish the basics of a privatization plan—they call it choice—and keep throwing more and more money at it and encourage veterans to use it instead of the VA. At the same time, they starve the VA of staff and other resources to make it fail. And of course, when the VA fails, the VA workers’ union disappears as well. It’s a story we know all too well. They have what they want: A broken system that has lost public support, a system with lots of valuable real estate they can sell off and a privatization infrastructure that sends all the patients whose treatment is profitable to the private sector, with a skeletal VA left to care for the sickest that the private sector doesn’t want,” AFGE National president, David Cox, said—according to an AFGE press release.

Disagreement swirls among some veteran groups about the proposed changes.

Concerned Veterans for America and several other organizations see the bill as creating the ability to use more private sector providers to provide care for veterans more efficiently.

The organizations’ executive director, Dan Caldwell, noted in a press release, “The VA Care in the Community Act contains some positive reforms but still falls short of delivering real health care choice to our veterans. Under this legislation, the VA will still retain almost complete control over when a veteran can access private health care, which could undermine the better aspects of this legislation. We believe that a few minor modifications can improve this legislation and ultimately ensure that veterans have more control over their healthcare. CVA will continue to work with members of Congress to improve this bill.”

Amvets, however, has a different perspective, according to Joe Chenelly, executive national director of Amvets. “We’re very concerned about it, we’re talking about being vastly out resourced here. They’re ignoring what all the legitimate veteran organizations know, which is ‘choice’ would be privatization.”

Congress will debate this bill, but if it does become law, the impact on veterans and VA could be substantial.

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