The Department of Veterans Affairs is looking at the possibility of merging its health system with the Pentagon’s as part of its effort to expand private health care.
Curt Cashour, a VA spokesman, said the plan is a potential “game changer” that would “provide better care for veterans at a lower cost to taxpayers”.
A spokesman for the Democrats on the House Veterans Affairs Committee. Griffin Anderson said the proposal was developed without input from Congress and it would amount to a merger of the VA’s Choice and military’s TRICARE private health care programs.
However, some veterans are opposed. Veteran’s groups say this cost-saving measure could threaten the viability of VA hospitals and clinics. News of these ideas has stirred alarm from veterans groups, who said they hadn’t been consulted. Sharp criticism came from Congressional Democrats who said they would oppose any VA privatization effort that forces veterans “to pay out of pocket for the benefits they have earned with their heroism”.
“Today, we see evidence that the Trump administration is quietly planning to dismantle veterans health care,” said House Minority Leader Nancy Pelosi. “House Democrats will fight tooth and nail against any efforts to diminish or destroy VA’s irreplaceable role as the chief coordinator, advocate, and manager of care for our veterans.”
Some healthcare experts expressed surprise that the VA would consider a TRICARE merger. The 2 programs usually serve very different patient groups—older, sicker veterans treated by VA, and healthier service members, retirees, and their families covered by TRICARE.
TRICARE is insurance paid by the government but uses private doctors and hospitals. VA provides its care through medical centers and clinics owned and run by the federal government; however, veterans can see private doctors through VA’s Choice program with referrals by VA if appointments aren’t readily available.
Carrie Farmer, a Sr. policy researcher on military care at Rand Corp. (who has conducted wide-ranging research for VA) said, “My overarching concern is these are dramatic changes in the way healthcare is delivered to veterans. They haven’t seen studies on what the consequences are in terms of both costs and quality of care.”
Cashour confirmed that VA Secretary David Shulkin was working with the White House and the Pentagon to explore “the general concept” of integrating VA and Pentagon health care, building upon an already planned merger of electronic healthcare records between VA and the Pentagon. “This is part of the president’s efforts to transform how government works and is precisely the type of business like commonsense approach that rarely exists in Washington,” Cashour said.
So far, 4 of the nation’s largest veteran organizations—American Legion, Veterans of Foreign Wars, AMVETS, and Disabled American Veterans—called this merger a “non-starter” if it sought to transform VA care into an insurance plan.
“VA is a health provider and the VFW would oppose any effort to erode the system specifically created to serve the healthcare needs of our nations’ veterans by reducing VA’s role to a payer of care for veterans,” said Bob Wallace, executive director of VFW’s Washington office.
Louis Celli, director of veterans affairs and rehabilitation for the American Legion noted that something similar occurred with TRICARE. Military retirees were promised free care from military base hospitals, but then TRICARE began offering insurance to use private sector care, and TRICARE beneficiary co-pays are now rising. The precedent the TRICARE model sets is not something we would accept on the VA side,” he said.
A spokeswoman for Rep. Phil Roe of Tennessee, Republican Chairman of the House Committee, said he planned to proceed with his bipartisan legislative plan to fix Choice without integrating TRICARE.
