Vets Health Care Reform Expected to Be Last Act of Congress on the VA This Year

Vietnam War veteran Bernie Klemanek of Louisa County, Virginia salutes with fellow veterans during a Veterans Day event at the Vietnam Veterans Memorial on the National Mall November 11, 2013 in Washington, DC.
National Journal
Stacy Kaper
June 12, 2014, 1:15 a.m.

The Sen­ate’s pas­sage Wed­nes­day of le­gis­la­tion in­ten­ded to stop vet­er­ans from dy­ing wait­ing for health care is likely to be Con­gress’s last ma­jor re­form bill for the year to ad­dress fail­ings in vet­er­ans’ ser­vices or clean up the em­battled Vet­er­ans Af­fairs De­part­ment.

The bill, which makes it easi­er to fire in­com­pet­ent VA of­fi­cials and ex­pands vet­er­ans’ ac­cess to health care, passed the Sen­ate 93-3. The le­gis­la­tion still needs to be re­con­ciled with sim­il­ar le­gis­la­tion passed by the House be­fore it can be sent to Pres­id­ent Obama and im­ple­men­ted in­to law.

The re­forms are be­ing her­al­ded on Cap­it­ol Hill as a sig­ni­fic­ant step to­ward try­ing to cut down the long wait times for health care that have left vet­er­ans lan­guish­ing in need of med­ic­al ser­vice for months on end — or un­able to even get onto wait lists at all. But it doesn’t come close to solv­ing all of the prob­lems fa­cing vet­er­ans or the VA, such as the dis­ab­il­ity-claims back­log which has roughly 300,000 claims pending for 125 days or more and the total in­vent­ory of claims hov­er­ing just un­der 1.3 mil­lion. It also fails to ad­dress sev­er­al short­com­ings in be­ne­fits, plan­ning for fu­ture vet­er­an needs, and vul­ner­ab­il­it­ies in its fund­ing struc­ture.

“It’s a huge con­cern,” said Robert Norton, a deputy dir­ect­or of the Mil­it­ary Of­ficers As­so­ci­ation of Amer­ica. “I would say we are wor­ried that, as­sum­ing they pass the VA health care ac­cess and ac­count­ab­il­ity, they prob­ably will say, ‘We are done for the sum­mer.’ They may come back and look at something in the fall, but more the like­li­hood is we may get kicked to the curb un­til after the elec­tions and then we are in­to the lame duck.”

Law­makers them­selves were mixed Wed­nes­day on wheth­er Con­gress would have the polit­ic­al will to come back to ad­dress any ad­di­tion­al VA is­sues this year — or, frankly, wheth­er ad­di­tion­al vet­er­ans’ le­gis­la­tion was ne­ces­sary.

“I don’t know what more le­gis­lat­ively [we need],” said Sen. John Mc­Cain, the Ari­zona Re­pub­lic­an, who co­sponsored the VA health care le­gis­la­tion. “But there are sys­tem­ic prob­lems, and this is a huge step in the right dir­ec­tion.”

The House has passed a smor­gas­bord of bills to ad­dress a vari­ety of VA is­sues, but the Sen­ate was un­able to pass an om­ni­bus vet­er­ans’ bill earli­er this year from Sen­ate Vet­er­ans Af­fairs Com­mit­tee Chair­man Bernie Sanders, largely be­cause of Re­pub­lic­ans’ ob­jec­tions to its cost and off­set.

With so much dif­fi­culty in get­ting bills through the Sen­ate, once the cham­ber has tackled an is­sue, the sen­ti­ment is usu­ally that the box has been checked. This is par­tic­u­larly true in an elec­tion year, where the win­dow for le­gis­lat­ing is con­densed and the end of the year is typ­ic­ally left to play catch-up on ex­pir­ing pro­vi­sions and oth­er must-pass meas­ures that law­makers were un­able to fin­ish — or un­will­ing to touch be­fore Novem­ber.

“I can guar­an­tee there will be more is­sues,” said Sen. Mike Jo­hanns, a Neb­raska Re­pub­lic­an. “I think in terms of a ma­jor piece of le­gis­la­tion the an­swer is yes, this will prob­ably be the last big re­form bill on the VA this year, just simply be­cause once le­gis­la­tion is passed, it does take some time for im­ple­ment­a­tion just to see how it’s work­ing.”

Both the House and Sen­ate have primar­ily sought to use the power of the bully pul­pit to put pres­sure on the VA to im­prove its back­log of dis­ab­il­ity claims. And there are a num­ber of oth­er vet­er­ans’ be­ne­fits and ad­vanced ap­pro­pri­ation is­sues that vet­er­ans’ groups want to see ad­dressed, but they say they are wor­ried they may have lost a golden op­por­tun­ity for ac­tion.

“I’m hop­ing that the House and Sen­ate and the ad­min­is­tra­tion do not ig­nore this is­sue,” said Ron­ald Ab­rams, ex­ec­ut­ive dir­ect­or with the Na­tion­al Vet­er­ans Leg­al Ser­vices Pro­gram, who works on vet­er­ans’ claims is­sues. “Right now it burns brightly…. Once the out­rage passes, stuff hap­pens, and it goes to the back burn­er.”

Joe Moore, an at­tor­ney and part­ner at Bergmann & Moore, a Beth­esda-based law firm that handles Vet­er­ans’ dis­ab­il­ity-claim ap­peals against VA, said Con­gress should do more to hold the VA’s feet to the fire on pro­cessing dis­ab­il­ity claims and ap­peals.

“VA’s in­ab­il­ity to pro­cess dis­ab­il­ity claims in an ac­cur­ate and timely man­ner would be im­proved sig­ni­fic­antly if VA shared ac­cur­ate facts with Con­gress,” he said.

“Con­gress should man­date that VA provide Con­gress fre­quent and trans­par­ent budget­ing, staff­ing, train­ing, ac­cur­acy, timeli­ness, and oth­er per­tin­ent facts, so VA can is­sue com­plete, ac­cur­ate, and prompt dis­ab­il­ity-claim de­cisions for our vet­er­ans.”

Louis Celli, le­gis­lat­ive dir­ect­or at the Amer­ic­an Le­gion, said the group would like to see the claims back­log is­sues ad­dressed, an ad­di­tion­al VA ac­count­ab­il­ity meas­ure from Maine Demo­crat Mike Michaud that would make the VA sub­mit a 5-year plan, and ur­gent con­gres­sion­al pres­sure brought to bear on the VA’s and De­fense De­part­ment’s plans to share health data.

“VA and DOD are bor­der­ing on con­tempt of Con­gress by not provid­ing a com­pre­hens­ive plan to fix the in­teg­rated health care re­cords pro­ject, and the claims back­log,” he said. “Every ini­tial claim that is stalled rep­res­ents a vet­er­an who can­not ac­cess VA health care un­til they get their dis­ab­il­ity rat­ing. Wait­ing for com­pens­a­tion aside, they need ac­cess to the VA.”

The Mil­it­ary Of­ficers As­so­ci­ation of Amer­ic­an and the Dis­abled Amer­ic­an Vet­er­ans want to en­sure that train­ing avail­able for home care­givers of dis­abled vet­er­ans is ex­pan­ded bey­ond just Ir­aq and Afgh­anistan vet­er­ans to vet­er­ans of all con­flicts.

These vet­er­an’ groups are also seek­ing to ex­pand the VA ac­counts fun­ded in ad­vance, known as “ad­vanced ap­pro­pri­ations,” to en­sure that VA ser­vices are not vul­ner­able to gaps in cov­er­age if there is an­oth­er gov­ern­ment shut­down.

Also on MOAA’s wish list are pro­vi­sions to ex­pand sur­viv­or be­ne­fits to those who re­marry as early as age 55 so that they are com­men­sur­ate with oth­er fed­er­al sur­viv­or be­ne­fits, and to al­low ca­reer re­serv­ists eli­gible for pen­sions to be honored as vet­er­ans even if they nev­er served on act­ive duty.

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