House to act on VA accountability; Dems wary on private care

The House will vote next week on Senate-passed legislation to make firing employees easier for the troubled Department of Veterans Affairs, as the department sought to push forward on initiatives urged by President Donald Trump aimed at improving care and boosting accountability.

Testifying before a Senate panel, VA Secretary David Shulkin urged Congress to act by this fall on additional legislation to give veterans broader access to private doctors. The plan to eliminate administrative restrictions and give the program more money immediately prompted Senate Democrats to criticize aspects of the plan as unacceptable “privatization” at the expense of core VA services.

“I will not be the guy to allow the administration to chip away at VA health care,” said Sen. Jon Tester of Montana, the top Democrat on the Senate Veterans’ Affairs Committee, pointing to a proposed VA budget that would give double-digit increases to outside care while funding for VA programs remains mostly flat. Sen. Patty Murray, D-Wash., referring to proposed pilot programs that could lead to the closing of VA facilities, pledged to “fight them with everything I have.”

It was an early sign of the likely political disputes ahead over the future direction of the VA, coming after a 2014 scandal at the Phoenix VA medical center. Some veterans died while waiting months for appointments at the center.

Shulkin described the broad outlines of the plan to the Senate committee, a copy of which was obtained by The Associated Press. Dubbed the Veterans CARE program, it would replace Choice and its current restrictions that veterans can go outside the VA network only in cases where they had to wait more than 30 days for an appointment or drive more than 40 miles to a facility. Veterans CARE stands for “Coordinated Access Rewarding Experiences” program.

Under the plan, veterans would consult their VA health providers about their medical problem, and the two parties would jointly decide whether it was best to receive care within the VA or with a private doctor. A veteran could take into account the length of time waiting for a VA appointment, poor performance at the local VA hospital based on ratings on the department’s website, or if the VA is otherwise unable to provide the service.

Veterans also would be able to access walk-in clinics, such as CVS MinuteClinics, to treat minor illnesses or injury.

Shulkin said the VA was seeking a “spirit of innovation” with its expansion of private treatment, part of an effort to improve overall care for veterans. But he allowed that the VA would be open to modifications in discussion with Congress. “I am not in support of a program that leads to privatizing or leading to the shutting down of programs,” he insisted.

On the accountability bill, House Majority Leader Kevin McCarthy told a small group of reporters Wednesday that fixing the VA is a “big focus of ours,” requiring swift action. The House will vote on the bill next Tuesday.

“It’s coming back over to us so we’re going to pass that, go right to the president, get a signature,” McCarthy, R-Calif., said. He tweeted later: “Our vets deserve the best.”

The Senate passed the bipartisan bill by voice vote Tuesday. The bill would lower the burden of proof needed to fire VA employees – from a “preponderance” to “substantial evidence,” allowing a dismissal even if most evidence is in a worker’s favor. Still, it was seen more in balance with workers’ rights than a version passed by the House in March.

The Senate bill would turn a campaign promise of Trump’s into law. It would create a permanent VA accountability office, which was established in April by executive order. In a tweet Tuesday night, Trump praised the Senate measure and urged the House to “get this bill to my desk ASAP! We can’t tolerate substandard care for our vets.”

The VA has been plagued by years of problems, including the 2014 scandal in which VA employees created secret waiting lists to cover up delays in care. During the presidential campaign, Trump pledged to bring greater accountability to the VA. Describing the VA at the time as “the most corrupt,” he promised to give veterans more choice in seeking care from outside providers.

___

AP Congressional Correspondent Erica Werner contributed to this report.