Rep. Mark Takano, D-Calif., warned a major legislative package for improving access to community-based medical services for veterans would drain health care dollars from hospitals and clinics run by the Department of Veterans Affairs. Takano is shown speaking at a VA health care event in this 2017 photo. (Joe Gromelski/Special to Stars and Stripes)
WASHINGTON — An omnibus bill to increase community services for disabled and aging veterans and their caretakers was attacked by the top Democrat on the House Veterans’ Affairs Committee as a thinly veiled attempt to privatize health services and drain dollars from the Department of Veterans Affairs.
“House Republicans have hijacked a historically bipartisan, bicameral process for veterans’ packages, to push their main priority of privatizing VA health care,” Rep. Mark Takano, D-Calif., said about the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act.
Sponsored by Rep. Juan Ciscomani, R-Ariz., a member of the House Veterans’ Affairs Committee, the bill has 21 Republican co-sponsors. No Democrats have signed onto the bill.
But Takano said the scope of the new legislation needs to be scaled back or it will lead to further erosion of support for traditional VA programs.
The bill, which was introduced May 14 in the House, is sweeping legislation that contains provisions from 22 bills that support veterans’ health benefits and services in community settings and at home.
Takano described the bill as a “harmful privatization package” that is expensive and not fiscally responsible. The Congressional Budget Office estimates the cost of the bill will be $942 million through fiscal 2026.
But Meredith Beck, national policy director at the Elizabeth Dole Foundation, said the bill is a priority of her organization that has fallen victim to politics and is “plagued by mischaracterization of its provisions.”
Meredith Beck, national policy director of the Elizabeth Dole Foundation, listens June 5, 2024, during a joint hearing on Capitol Hill of the Senate Aging and Veterans’ Affairs committees. The hearing discussed improving services for veterans and their caregivers. (Joe Gromelski/Special to Stars and Stripes)
The bill has received support from veterans organizations, including the Disabled American Veterans and Veterans of Foreign Wars.
The bill contains language from the Elizabeth Dole Home Care Act, introduced in 2023, that would increase coverage to 100% from 65% for in-home and end-of-life care for veterans who otherwise would be sent to nursing homes. The legislation also would cover home health aides and increase support for family caregivers of disabled veterans living at home.
The bill has measures from the CARE Act, which provides training and certifies navigators to help veterans and their families access community services, and the COPE Act, which supports mental health counseling for caregivers.
The bill also stops the Veterans Health Administration from overriding a physician’s recommendation for non-VA care when it is in the best medical interest of the veteran.
Not all Democrats align with Takano in opposing the bill.
Sen. Jon Tester, D-Mont., chairman of the Senate Veterans’ Affairs Committee, indicated his support for the legislation at a joint hearing Wednesday of the Senate Aging Committee and Senate Veterans’ Affairs Committee.
Sen. Jon Tester, D-Mont., speaks June 5, 2024, during a joint hearing on Capitol Hill of the Senate Aging and Veterans’ Affairs committees on improving services for veterans and their caregivers. (Joe Gromelski/Special to Stars and Stripes)
“I want to note that the House is currently deliberating the path forward on a package of bills negotiated by the Senate and House Veterans’ Affairs committees named the Elizabeth Dole 21st Century Veterans Health Care and Benefits Improvement Act. This is comprehensive legislation that would expand access to home and community-based care programs for our veterans and bolster home health care staffing attempts to strengthen the VA caregiver and long-term care programs,” Tester said. “I look forward to working with the veterans service organizations to finally get this over the finish line on behalf of our nation’s caregivers.”
Tester in 2018 was one of three Democrats who co-sponsored the Mission Act — a Republican-led initiative that enabled veterans to seek private medical care when a particular service or treatment was not readily available at a VA hospital or clinic. Sens. Richard Blumenthal of Connecticut and Doug Jones of Alabama were the other Democrats.
Demand for community care has been rising 15% yearly since passage of the Mission Act, the VA said.
The Veterans Healthcare Policy Institute, a nonprofit research organization, said the omnibus bill contains “Trojan horses” that shift dollars from the VA health system to private health care.
The institute said greater emphasis on non-VA community care will lead to delays for modernizing VA hospitals, clinics and other facilities.
Upgrading VA medical buildings with repairs and equipment was projected to cost $76 billion, according to a March 2023 report by the Government Accountability Office, a federal watchdog organization.
“The relentless outsourcing of care from the Veterans Health Administration to private sector providers — and the resulting drain on the VHA budget — has reached a tipping point, one that threatens the future of the nation’s largest and only veteran-centric health care system,” according to the institute.
VA Secretary Denis McDonough in April touched on the fiscal challenge of supporting VA health as the demand for private care accelerates.
“Either [the VA] purchases the care for the veteran in the community, or we ensure that the VA has all the capacity in-house to provide that care. That gets more difficult as more veterans are referred” to private doctors for their care, he said.
Takano said private care has less oversight than VA care and lacks the quality-of-care standard that veterans receive inside VA.
“This moves us farther from our goal of bringing more veterans back into VA care,” he said.
Takano said he has urged Rep. Mike Bost, R-Ill., who is chairman of the House Veterans’ Affairs Committee, to bring to the House floor a bill “that will not undercut VA’s mission.”
“Congress must craft veterans’ legislation with an honest accounting of the cost in a way that doesn’t sacrifice current health care and benefits,” he said.
