WASHINGTON — The U.S. Senate overwhelmingly passed a VA Health bill on Wednesday that would expand the private health care options for veterans, extending and streamlining the current VA Choice program and providing it with $5.2 billion.
Both Ohio Sens. Sherrod Brown and Rob Portman voted for the bill, which embraces increased flexibility, allowing veterans to seek private provider options if VA centers within 40 miles cannot meet the necessary care requirements The current VA bill — which increased flexibility in part as a reaction to reports of long waiting lists for services at VA health centers — expires May 31. The bill, which passed the Senate 92-5, now goes to President Donald Trump, who is expected to sign it.
Critics of the bill — including a group of 17 labor organizations, some representing federal workers — argued it would "outsource primary care to the private sector." But Brown, a member of the Senate Veterans Affairs Committee, said the bill was "a good bill for veterans." House Minority Leader Nancy Pelosi voted against a House version of the bill, saying it "opened the door to privatization."
But Brown, a Democrat, appeared to dispute that notion, saying during a press call Wednesday that he would oppose any effort to privatize the VA.
"I think we need to be very cautious because there's a lot of pressure from a lot of interests, especially the Koch brothers, who just love privatization," Brown said. "I wouldn't have written the bill exactly this way, but Republicans are in the majority."
Portman, a Republican, said the bill helps open up more options for veterans seeking care. He said he's talked to veterans who are barred from seeing certain specialists because they live within 40 miles of a VA facility. "This removes that sort of arbitrary distance and helps them be able to get the care they need," he said.
Portman said he was also satisfied with how the bill addresses opioids, ensuring that the VA does not give veterans more than they need, thus discouraging addiction.
David Blom, president and chief executive of OhioHealth, was on the Congressional Commission on Care that, in 2016, issued a report on veterans' health care with 18 recommendations, some of which are contained in the bill. He said the proposal helps smooth friction points between the VA and the health-care system at large that will lead to expanded options for veterans.
"The barrier used to be so high ... that patients suffered, the veteran suffered," he said. "And the bill that is before us makes it easier for the veteran to access community health care."
Also of significance is that the bill allows access to community doctors for veterans who live in areas where VA centers perform poorly, said Lt. Gen. Martin Steele, who served on the commission with Blom and spoke to veterans at an OhioHealth event last year. A report published in the April Journal of General Internal Medicine showed that, while the VA performed on average the same as or significantly better than non-VA hospitals in most areas, there was a great deal of performance variation across VA facilities.
"We owe it to this cohort of people who selflessly served this country," said Steele, who retired from the U.S. Marine Corps after more than 34 years of service and lives in Florida. "We’re trying to do something to ensure they’re receiving proper medical care, as they well deserve, for the rest of their lives."
According to the U.S. Census, some 21 million Americans are veterans. Nearly 865,000 live in Ohio. Steele said about 6 million veterans regularly use VA health services.
Blom said he's also optimistic about ongoing changes that will make the VA's electronic medical record system compatible with those used by most hospitals. He'd next like to see leaders address issues around the supply chain, racial disparities, eligibility rules and workforce promotions and discipline.
Also needed, Steele said, are mandatory workforce development rules that would ensure adequate leadership succession and more consistent performance across the system.
Still, both men are pleased to see action on the bill.
"It is positive progress in fixing a system that is in dire need of fixing," Blom said. "It won't all be fixed through this bill, but it's a good first step."
The bill passed the House last week 347-70, with all Ohio members supporting it.
Jessica Wehrman and JoAnne Viviano are reporters with The Columbus Dispatch.