WASHINGTON — Veterans Affairs Secretary David Shulkin said his department's controversial Choice Card program needs to be reauthorized to ensure better medical care access for all veterans, but he also promised major changes are coming soon.
“We’ve learned a great deal in the last few years,” said Shulkin in his first appearance as a Cabinet secretary before the House Veterans’ Affairs Committee. “I have worked in the private sector, and we would not have designed a system quite as complex as this.
“”But I think [it] has helped a lot of veterans. … It was a national emergency when it was started [in 2014], and it was the right thing to do.”
The Choice Card program — one of multiple offerings by the department for veterans to seek medical care outside the VA system — is set to expire this summer, even though money for the program may still be available.
Lawmakers and VA officials are working to figure out how to continue the program while also reforming its numerous flaws. Shulkin has promised that specific plans for a “Choice 2.0” will be outlined in months to come, but for now is urging lawmakers not to delay an extension.
“If we don’t do this extension, this is going to be a disaster for veterans,” he said. “We’re going to see the same problems as 2014.”
The Choice program was created by Congress in the wake of the 2014 VA wait times scandal. Veterans who face lengthy waits for VA medical appointments or who live 40 miles from the nearest VA facilities have the option to seek care with private physicians, with the department picking up the costs.
But veterans advocates have complained the two-year-old program has been plagued by numerous problems, including difficult eligibility rules and delays in reimbursements. Lawmakers set aside $10 billion for the program in 2014, making reauthorization a costly expense for an annual VA budget that already approaches $180 billion.
Still, Shulkin said, the path ahead is in fixing the program, not abandoning it. Without an extension of the program soon, officials will start denying any new enrollments for care that could extend beyond the August expiration.
Sen. John McCain, R-Ariz., has co-sponsored legislation that would remove the end date for the program, allowing it to continue to spend the estimated $1 billion that will be left in Choice funds at the start of August. He has also been an advocate for renewing the program after that.
“I am concerned that veterans nationwide may encounter significant lapses in care if we do not act quickly,” he told committee members. “This outcome is not only avoidable, it is unacceptable, and we in Congress must act.”
Most members of the House Veterans’ Affairs Committee voiced support for the move.
Chairman Phil Roe, R-Tenn., said he would push for an extension, but added that “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.”
Shulkin has said he wants to consolidate a host of outside care programs into a simplified system for veterans, and also get rid of the distance and wait time rules to make access to care easier for veterans.
He has also advocated for a network of partner systems to work closely with VA, allowing more options for veterans, but also more education of non-military doctors in conditions such as post-traumatic stress disorder and battlefield amputations. He estimated about 13 percent of private sector physicians can adequately treat military mental health issues.
Shulkin also promised major changes in VA automated systems, including an online scheduling system to cut down on staffing costs and give veterans more control over when they schedule doctor visits.
“We do need to put the control of health care back in the hands of veterans,” he told lawmakers. “They’re the ones who can best schedule appointments. They’re the ones who say whether we’re doing a good job or not.”
But making those changes will take time, he warned.
In the meantime, lawmakers are expected to act on the choice extension in coming weeks.
Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at firstname.lastname@example.org.