Related<\/span>\n\t\t\t\tVA programs at the center of Congress’ latest health care battle<\/h3>\n\t\t\t\t\t\t\t\t\t
A plan to change rules regarding veterans seeking community medical care at government expense could have a wide-reaching impact on the national health care debate.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/a>\n\t<\/aside>\n\t\n\n\n
The plan would intermix the medical needs of two different patient pools. The Tricare system currently serves about 9.4 million beneficiaries, including the primary health care needs for all active-duty troops and their families.<\/p>\n\n\n\n
The Department of Veterans Affairs system has roughly 9 million patients, too, but is largely focused on an older population dealing with service-connected illnesses. VA officials in recent months have talked about moving away from some primary care responsibilities in favor of increasing funds for more specialized services.<\/p>\n\n\n\n
Such moves would involve billions of dollars in upgrades and operational changes to the two massive health care systems, work that would have to be approved and funded by lawmakers.<\/p>\n\n\n\n
Shulkin said any such decisions are years away, and the internal conversations on the issue thus far have been \u201cbeyond preliminary.\u201d He said lawmakers and veterans groups have not been brought into the conversation yet because department officials are still gathering information and are not pursuing any specific recommendations.<\/p>\n\n\n\n
\u201cWe\u2019re not taking early ideas outside the walls of our organization until we have enough to know whether we really want to explore it,\u201d he said.<\/p>\n\n\n\n
Memos on the topic show several meetings among White House staffers on the issue, and plans to make the idea a major topic of the December VA\/DoD Health Executive Committee meeting.<\/p>\n\n\n\n
Republicans on Capitol Hill said they have not been part of the conversation thus far.<\/p>\n\n\n\n
\u201cThe only (health care) proposal Chairman (Phil) Roe has seen from the administration is VA\u2019s CARE proposal, which was reviewed at our legislative hearing alongside the chairman\u2019s community care proposal,\u201d said Tiffany McGuffee Haverly, a spokeswoman for the House Veterans\u2019 Affairs Committee chairman.<\/p>\n\n\n\n
\u201cAt this time the committee intends to move forward with the chairman\u2019s proposal that has the support of every member of the committee.\u201d<\/p>\n\n\n\n
Veterans groups met with White House officials on Friday and expressed frustration that they have been left in the dark on the proposal.<\/p>\n\n\n\n
\u201cWe would be willing to be open minded on the issue,\u201d said Lou Celli, director of veterans\u2019 affairs and rehabilitation for the American Legion. \u201cAnd we understand these are early discussions. But we certainly want to be brought into the conversation, or at least notified about it.\u201d<\/p>\n\n\n\n
Bob Wallace, executive director of the Veterans of Foreign Wars, said his group \u201cwould oppose any effort to erode the system specifically created to serve the health care needs of our nation\u2019s veterans by reducing VA\u2019s role to a payer of care for veterans.\u201d<\/p>\n\n\n\n
AMVETS Executive Director Joe Chenelly said he has \u201cdeep concerns\u201d over this plan and how the discussion has been handled.<\/p>\n\n\n\n
\u201cSeveral alarming ideas have become public this year before they were even mentioned to the veterans service organizations,\u201d he said. \u201cWe believe that the administration wants to do what is best for veterans, but some of these ideas negatively impacted veterans.<\/p>\n\n\n\n
\u201cSome ill-advised moves were later dropped once the administration saw the negatives, but not before eroding trust veterans have in their federal government.\u201d<\/p>\n\n\n\n
Earlier this year, White House officials were criticized for holding several meetings on veterans issues with health care executives and interested parties before meeting with veterans groups.<\/p>\n\n\n\n
The new private meetings come as VA officials are working with lawmakers on potentially sweeping changes in how the department handles veterans medical appointments both inside and outside the federal system.<\/p>\n\n\n\n
That debate, which could send billions in new spending to private-sector doctors for veterans care, has lead to accusations from critics of the administration that they\u2019re working to privatize the veterans care system instead of repairing its shortcomings.<\/p>\n\n\n\n
Roe and other House lawmakers have offered a new community care bill that would provide more options for veterans to seek private-sector care but still leave VA doctors as the primary medical manager for those patients. VA leaders, including Shulkin, have proposed going even further, allowing veterans to pursue some walk-in appointments without prior approval but still at taxpayer expense.<\/p>\n\n\n\n
Critics say the secret Tricare\/VA meetings are an indication that their concerns about the Trump administration dismantling veterans health care services are well-founded.<\/p>\n\n\n\n
\u201cThe plan to merge the VA with Tricare represents the first step on the path to total privatization of the VHA,\u201d said Suzanne Gordon, a health care advocate who has written a book on the department\u2019s medical system. \u201cIt will turn a healthcare plan that delivers integrated services to veterans into an insurance plan that pays for care that the private sector delivers.<\/p>\n\n\n\n
\u201cThat will kill the VA.\u201d<\/p>\n\n\n\t