The Washington PostDemocracy Dies in Darkness

Far fewer veterans use choice card and private health care than expected, VA says

Only 27,000 veterans have made appointments for private medical care since the Department of Veteran’s Affairs Choice Card program rolled out at the start of November, Secretary Robert “Bob” McDonald said this week.

It’s such a tiny number compared with the 9 million people who use VA health care that McDonald has asked for “flexibility” to reallocate billions of dollars for other pressing matters, from hiring more claims officers to help wade through a vast veterans’ benefits backlog to managing other patient medical needs.

The VA’s release of the choice chard numbers is at the heart of a controversy over President Obama’s 2016 budget, which asks for authority to reallocate funds from the temporary $10 billion program that Congress established last year to help former troops struggling to obtain care at vastly overstrapped VA clinics.

House Veterans Affairs Committee Chairman Rep. Jeff Miller (R-Fla.) has roundly rejected the plan, calling it a “complete non-starter, which I will not support.”

He is instead pushing to expand the program to give veterans more care in private clinics. “If there’s going to be any reallocation, it’s going to be to further improve and strengthen the program itself and not address other unspecified needs,” Miller told McDonald.

The  program, was created after the VA’s patient wait list scandal, which kept veterans on lists for months as they waited for care for everything from suicide prevention to cancer-related surgeries. A series of government reports earlier this year documented a widespread coverup of the issue through falsification of appointment data and extensive treatment delays.

The card gives veterans who have been waiting more than 30 days for appointments or who live more than 40 miles from a VA facility the chance to see a private doctor.

The VA has been hiring tens of thousands of doctors and nurses to curb to fill shortages that they said contributed to the delays. They now say wait times are down. Nationally, VA  completed more than 37 million appointments between May 1, 2014 and December 31, 2014. That’s an increase of 1.8 million more appointments than were completed during the same time period in 2013, a fact sheet by the agency said.

Before the choice card, veterans could receive outside care for emergencies — wherever the closest hospital is, for instance — or for procedures the VA didn’t offer. And separate from the choice card, the VA made over 2 million authorizations for Veterans to receive care in the private sector from May 1, 2014, through January 31, 2015 — a 45 percent  increase in authorizations when compared to the same period in the previous years, according to data from the department.

But many veterans report that they often have to wait months and even years to be reimbursed for this care, and some say this issue could be one reason why veterans haven’t used their care cards.

Frederick H. Nordhorn, a commissioner of the Prince George’s County Commission For Veterans and a former Army sergeant who served from 1973 to 1979 in Germany, said he has over 10 dings on his credit reports because of private medical bills the VA hasn’t paid.

He spoke to McDonald directly about it, reaching him on his cell phone, which the secretary gave out to The Washington Post and on live television when he first took office with an agenda of reform. McDonald promised to help. And several members of his staff called Nordhorn after he spoke to the secretary. But the issue has yet to be resolved.

“They put Robert McDonald in a swamp, and he’s up to his neck in alligators and snakes. And for extra fun they hung a few hornets nests,” Nordhorn said. “These are deep problem of dysfunction that need fixing that have been going on for decades. No wonder veterans aren’t sure if they should use or trust the choice card. They feel discouraged at every turn.”