A White House win for Hillary Clinton could hamper efforts to broaden veterans' access to health care in their communities, House Veterans' Affairs Committee chairman Rep. Jeff Miller, R-Fla., said Tuesday.
Miller, a top adviser on veterans issues to Republican presidential nominee Donald Trump, said the election will have "great bearing" on whether recent Veterans Affairs health reform proposals are implemented.
A 300-page report released last month by the Commission on Care recommended that VA augment its medical capabilities by creating a system of public and private health networks that would treat veterans outside VA.
Veterans would be able to choose whether they are seen at a VA facility or by a civilian provider.
Commissioners said the proposal, which also calls for retaining many existing VA facilities but closing underused ones, is needed to ensure the viability of VA medical centers and clinics while fixing the inefficient Veterans Choice program.
Some critics, including at least one commissioner, have said the proposal to expand civilian care is too costly and would pull funding from VA health facilities, eventually leading to their demise.
Others, including Clinton, have pegged the reform proposals as efforts to "privatize VA."
But Miller argues that the proposals are not privatization. Instead, the commission recommendations are an effort to ensure that veterans have access to quality health care, he said.
"We know VA is not going to be capable, with the infrastructure that exists today or what can be built over the next decade, of handling the number of veterans needing to receive health care," Miller said. "If VA wants to be providing quality care in a timely fashion to our veterans, they are going to need to look outside our current system."
Trump has said he favors a system where eligible veterans can choose where they get care, either at a VA hospital or in the private sector, paid for by VA.
In a 10-point plan released earlier this month, Trump called for expanding the Choice program to all veterans and improving accountability of VA employees, among other reforms.
Clinton has pledged to "build a 21st-century Department of Veterans Affairs to deliver world-class care."
According to Clinton's campaign materials, she would implement reforms at VA to ensure that the department delivers high-quality care in-house, but also manages community care programs to provide services to veterans in areas without VA facilities.
Miller, considered a top contender for VA secretary in a Trump administration, said he has concerns that Clinton's proposals would not reflect the bipartisan commission's recommendations.
"If Trump wins, I think you could see the Commission on Care report as a road map for VA reform. I think if Hillary Clinton is elected president, it's going to sit on the shelf and gather dust," he said.
VA is partway through a massive reform effort designed to improve programs such as claims processing, administration and health care. Changes in the Veterans Health Administration include increased hiring, expansion of services at emergency rooms and adding evening and Saturday hours to increase appointments.
VA also has asked Congress for flexibility to consolidate several community care programs, including Choice, into a revamped Choice program.
Patricia Kime covers military and veterans health care and medicine for Military Times. She can be reached at firstname.lastname@example.org.
Leo Shane III covers Congress, Veterans affairs and the White House for Military Times. He can be reached at email@example.com.