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Montana politics, elections and legislative news

Tester To Push For Extension Of Troubled Veterans Choice Health Program

Veterans Choice, file photo.
Courtesy Veterans Administration
Veterans Choice, file photo.

Senator Jon Tester says he'll push for an extension of the troubled Veterans Choice healthcare program on the Senate floor Thursday.

Tester is the ranking Democrat on the Senate Veterans Affairs committee. He co-sponsored the original, bi-partisan Veterans Choice bill in 2014. It was a $10 billion response to revelations that some veterans were being harmed by having to wait for long periods to get healthcare through the VA.

Veterans Choice was supposed to help vets who couldn't get an appointment with a VA provider within 30 days get an appointment with a non-VA doctor or clinic. Vets who live more than 40 miles from a VA health facility are also supposed to be able to use Choice.

But Choice hasn't worked well. Vets across the country have complained that it's made getting care more of a hassle, not less. And doctors and clinics say it sometimes takes months for them to get paid.

Sandra Henderson with Missoula Anesthesiology, in an exchange with VA officials at VA-sponsored event  in Missoula Tuesday said, "certainly our providers, our doctors are not going to turn down a veteran, they're not going to. They would like to get paid."

Veterans choice is set to expire in August. I asked Senator Tester about that.

Eric Whitney: If there are so many problems with the Choice program, why not let it expire in August?

Sen. Jon Tester: Because I think there's a role for community care to fill in the cracks around the VA care, and I think even if we let it expire and develop a new program, we're basically doing the same thing. There are things in Choice that were put forth with the best of intentions, like credentialing and quality care measures and things like that. We just need to make the healthcare part of it work smoother. Cut the red tape and make sure it's easy to work with for the providers. And I think we'll get more providers jumping on board, and we'll get more veterans using it if the time to set up those appointments is reduced dramatically."

Tester says there are important reforms in the Choice extension bill he and Arizona Republican Senator John McCain will be calling for a vote on in the Senate on Thursday. And he says that extending the Choice program would also buy Congress and the VA time to craft a longer term bill that would fix not just Choice, but more than half-a-dozen other, similar veterans health programs.

VA Undersecretary Dr. Baligh Yehia was visiting Ft. Harrison in Helena Monday.

"One of the things that we are working on that may folks may not know about is, actually VA has about seven-to-eight different ways of buying care. Which is, how do you partner with community providers to deliver care on behalf of veterans," he said.

"The idea of having seven-to-eight ways of doing the same thing is part of the problem, because it's confusing to veterans, it's confusing to the community providers and while Choice is the latest iteration of that, nationally it only represents about 25 percent of all the different kind of care that we buy," Yehia said. 

Yehia says that the VA has issued a request for proposals from the private sector to come up with a better way to connect veterans to health care services they either can't get from the VA, or live too far from a VA facility for it to be convenient. Senator Tester says his goal is work with the VA to see how it can partner better with private sector health care, and then write new legislation to make that happen.

"I think that people on the VA Committee understand what's happening to veterans out there and they want to find solutions," Tester said. "There are other folks that don't want the government involved in healthcare at all, and they just think it's bad business for the the government to be involved in healthcare."

"I think that in this case it's entirely appropriate," Tester said. "We have folks that have borne the wounds of battle, and I think the VA is best suited to take care of those folks. So that VA needs to be there, and then we need to have a private sector that fills in the gaps around that VA. I think it's idealism versus realism."

Senator Tester says his goal is to have legislation that overhauls how the VA works with private health care providers to help veterans voted on this fall. But first, he wants to reform and extend the Choice program until January so vets getting care outside the VA now won't see an interruption.

Eric Whitney is NPR's Mountain West/Great Plains Bureau Chief, and was the former news director for Montana Public Radio.
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