The Veterans Affairs Department opposes efforts to expand the Veterans Choice program and instead wants permission from Congress to roll several private care programs into the Choice benefit, VA Deputy Secretary Sloan Gibson said Tuesday.

Addressing members of the Senate Veterans Affairs Committee in a legislative markup, Gibson said a bill sponsored by Sen. John McCain, R-Ariz., to let any enrolled veteran use the Choice program would "erode the VA's ability to address the special needs of veterans."

"If veterans who currently do not use the VA health care system begin to seek community care through the Choice program, VA will have to divert resources from … internal VA care, dramatically undercutting our ability to provide care tailored to the unique needs of veterans," Gibson said.

McCain's proposed bill would make permanent the Choice program, which is set to expire next year. It would allow any veteran who uses VA health services to use the program, which currently lets veterans get care at a private health facility if they live more than 40 miles from a VA facility or have to wait more than a month for an appointment.

The proposed legislation also would require VA to expand pharmacy hours and let veterans be seen at commercial walk-in clinics without preauthorization or a co-payment.

McCain said the legislation is needed because some doctors are refusing to see veterans under the Choice program, knowing it has an expiration date.

"I've heard testimony from a number of veterans who have sat in the ER for 14 hours without being seen. Veterans would just like to see a provider on the same day. This legislation would do that," McCain said.

A VA medical facility in California on Tuesday began letting enrolled veterans get health services care at walk-in clinics with a referral. Gibson said implementation of a similar program nationwide would be cost-prohibitive with the current VA budget.

"This provision is too broad and does not include any feature such as the inclusion of copayments that would ensure it is used in a measured way that would not overrun the funds appropriated by Congress," Gibson said.

Veterans groups that testified, including the Veterans of Foreign Wars, Paralyzed Veterans of America, Disabled American Veterans and American Legion, also said they oppose McCain's bill, adding they believe issues must be fixed with the current program before it is expanded.

"The Choice Program ... has yet to achieve what Congress envisioned when it passed the Veterans Access, Choice and Accountability Act," said Carlos Fuentes, senior legislative associate with the VFW.

McCain urged the Senate Veterans Affairs Committee to consider the bill, which he said will improve the original legislation co-written in 2014 by McCain and then-Senate Veterans Affairs Chairman Sen. Bernie Sanders, I-Vt.

Patricia Kime covers military and veterans health care and medicine for Military Times. She can be reached at pkime@militarytimes.com.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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