WASHINGTON — President Donald Trump has been promising expanded health care choices for veterans dating back to his election campaign in 2015.

But 2019 could be the year his administration actually makes that happen.

Veterans Affairs has been working on expanded community care rules for veterans' medical appointments since last summer, when Congress approved the VA Mission Act. Details of that work are expected to be released in early 2019, and a full set of new regulations is scheduled to be released in early spring.

Among other priorities, the legislation mandated a retooling of the department’s policies for veterans seeking private-sector care, a massive undertaking that supporters have hailed as giving more flexibility and freedom to veterans who face long lines at VA hospitals and clinics.

VA Secretary Robert Wilkie in December hailed the work as part of “a real transformational period at the department.”

But critics have attacked the work as the first step toward privatizing key parts of the VA mission.

Democrats, including House members who will be taking control of the chamber this year, have promised intense oversight into the new outside care rules, to ensure they aren’t written to siphon off needed federal resources to private businesses.

As written, the legislation requires VA to remain a core coordinator of veterans health care plans but also to ensure “the scheduling of medical appointments in a timely manner,” “continuity of care and services,” and “no lapse in health care services.”

That leaves a significant amount of work to be settled in the details of VA’s implementation plan.

Currently, the VA’s Choice program — the best known and most used of the community care programs — is restricted to veterans who live more than 40 miles from a VA facility or face a wait of more than 30 days for VA services.

The new programs will likely jettison those rules in favor of a looser set of guidelines, including language for veterans who face “an unusual or excessive burden” getting their care at VA facilities.

Veterans groups have advocated for more flexibility for care options but also warned against abandoning the current Veterans Health Administration, a key safety net for millions of veterans across the country.

A congressional hearing previewing the Mission Act implementation work was scheduled for early December but was postponed due to the death of former President George H.W. Bush. That has only added more mystery and urgency to the drafts under consideration by top VA officials.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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