Chairman Roe on the Future of VA Community Care

Chairman Roe on the Future of VA Community Care
Today, the House Committee on Veterans’ Affairs, chaired by Rep. Phil Roe, M.D., held a hearing to examine the Department of Veterans Affairs Choice Program and the future of VA community care programs, authorities and budget impact. 

You can view Chairman Roe’s opening remarks from today’s hearing here: 

Opening Remarks As Prepared for Delivery:

Though it is somewhat unusual for the Committee to meet in the evening hours, today’s topic is one well worth staying up late for a couple extra hours.

I want to keep our work this evening laser focused on the future – on how we can all work together to create a better, brighter, healthier one for our veterans and for the healthcare system that was built to serve them – rather than on rehashing mistakes that were made long ago. Yet, as we begin to move forward this evening, we must not lose sight of where we started.

Three years ago next month – in this very room – the Committee heard testimony from a veteran named Barry Coates who spoke about waiting almost a year for care from a Department of Veterans Affairs (VA) medical facility in South Carolina.

When Barry was finally seen – long after he should have been – he was diagnosed with stage four colon cancer that had spread to his liver and to his lungs. He passed away in January of last year.

It was Barry’s story – and accompanying allegations that forty veteran patients had died while waiting to receive care from the VA medical center in Phoenix, Arizona – that kicked off a nationwide access and accountability scandal the likes of which VA had never seen. It also led directly the creation of the Choice program and to the allocation of billions of more taxpayer dollars to increase access to care for veteran patients.

In the three years since then, more than two million authorizations for care have been approved and over one million veterans have been able to get care that otherwise might not have been readily available.

However, all of us around this dais continue to hear from veterans day-after-day experiencing lengthy and frustrating delays when attempting to schedule appointments through VA using Choice.

In fact, just a couple of weeks ago, I was contacted by a veteran with a story much like Barry’s. This veteran was diagnosed with cancer last fall and referred to Choice for treatment.

While I am relieved to say that he is now receiving the care that he needs from the provider of his choice he suffered through weeks of doubt due to a series of mishaps and miscommunication between VA, the Third Party Administrator managing Choice in this particular region, and the community provider who had agreed to treat him.

It appears that – three years after Barry’s testimony – a lot has changed but too much has stayed the same.

What’s more, recent work performed by the VA Inspector General (IG) and the Government Accountability Office (GAO) illustrate very clearly that Choice is not set up to succeed at its primary mission – providing timely care to veteran patients who cannot access that care within VA because it’s not offered, not available within a reasonable amount of time, or would entail the veteran traveling a great distance. 

For example, GAO is going to testify this evening that veterans could potentially wait up to eighty-one calendar days before receiving care due to the burdensome bureaucratic process that VA imposed on Choice. That is unacceptable to me and, I’m sure, everyone in this room.

I ran a practice in East Tennessee for 35 years; I assure you, it does not have to be this complicated and it should most certainly not take this long. Luckily, Choice is not the same program today as it was when it was reviewed by GAO and the IG last year and it is certainly not the program that it was when it was first created.

Through a series of four legislative changes and seventy contract modifications and counting, Choice has been continually improved upon and made stronger. But, it remains far from perfect and, in far too many cases, it fails the very veterans it was created to serve.

I am working diligently with Ranking Member Walz, with the Secretary and his senior leaders, with our Senate colleagues, and with our veteran service organization partners to chart a path forward for Choice and for all of VA’s care in the community programs in short order. I hope to have draft language to share in the coming weeks and to have a VA healthcare reform bill on the President’s desk this year.

However, the first step to reforming Choice is making sure that there is smooth transition to the way ahead. This is why it is critical that this Committee act tomorrow to markup H.R. 369, a bill I introduced earlier this year to remove the current three-year sunset date for the Choice program. 

Absent legislation, Choice will begin shutting down in just a matter of weeks and will end completely five short months from today – cutting off a key access avenue at a time when veterans are seeking care in the community more than ever before and, critically, at a time when VA’s non-Choice community care account is unable to absorb additional demand for care.

VA is already facing a $3.4 billion deficit in the community care account next fiscal year that VA leaders have told Committee staff will require additional appropriations to address.

By removing the sunset date to the Choice program, we are not endorsing the program in its current state but we are ensuring that emergency funds that Congress made available for critical veteran care are used for that purpose until they are expended.

Community care appointments have increased by 61% overall since Choice was created and, last year, 30% of all VA appointments were held in the community rather than in VA medical facilities.

The future of VA relies on not only a strong VA healthcare system but on a VA healthcare system that is inextricably linked with community resources to fill the gaps and meet the needs of our veterans when and where they are. 

We must get this right and learn from the mistakes, miscommunication, and undue bureaucratic processes that have plagued Choice since its inception not only for the veterans who depend on this system today but also for generations of American heroes to come.

That is what I am committing to once again this evening. 
https://veterans.house.gov/news/press-releases/chairman-roe-future-va-community-care


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